Managing Emotional Intensity Difficulties in Older Adults With Personality Disorders: A Proof-of-Concept Study

Problematic emotion management is a core symptom of personality disorders and does not tend to improve spontaneously with age. Systems Training for Emotional Predictability and Problem Solving (STEPPS), a treatment program targeting emotional intensity difficulties, has been found to be effective for younger adults with borderline personality disorder. After a pilot study and a Delphi study, STEPPS was adjusted for older adults to better suit this population. The aim of present study was to evaluate first outcomes (e.g., level of improvement) of the adjusted STEPPS Older Adults (STEPPS-OA). A total of 52 patients, with a mean age of 67 years (range: 60-80), participated in this proof-of-concept study with pre-, mid-, and post-treatment measurement points. A total number of 38 patients completed the treatment; 14 patients (27%) dropped out. A majority of the patients (58%) had borderline personality disorder. After treatment, patients reported significantly decreased borderline personality disorder severity and symptomatic distress. Furthermore, there was a significant improvement of adaptive emotion regulation strategies and all personality functioning factors. Finally, some maladaptive personality traits (i.e., Disinhibition and Negative Affectivity) decreased significantly. Results of this proof-of-concept study indicate STEPPS-OA is a promising treatment option for managing emotional intensity difficulties for older adults with personality disorders.