Interpersonal and Emotional Problem Solving Skills and Parasuicide among Women with Borderline Personality Disorder

Abstract

This study examined the predictive relationship between interpersonal and emotional problem solving skills and parasuicide in a sample of 33 chronically parasuicidal outpatient women meeting criteria for borderline personality disorder. Subjects were assessed initially and at 4-month intervals for 1 year using a revised version of the Means-End Problem Solving Procedure (MEPS) and the Parasuicide History Interview. Inappropriate problem solving measured at the 4- and 8-month assessment points was a significant predictor of subsequent parasuicide. Both suicidal and nonsuicidal inappropriate responses predicted parasuicidal behavior. Active, passive, and self-soothing problem-solving strategies failed to predict. Results suggest the usefulness of differentiating interpersonal from emotional problem-solving and provide predictive validity for the modified MEPS Procedure. It appears that patient progress may be monitored by tracking MEPS problem-solving scores, and that treatment may benefit from directly targeting the reduction of maladaptive response patterns.