Changes in self-destructiveness of borderline patients in psychotherapy: A prospective follow-up

Alex N. Sabo*, John G. Gunderson, Lisa M. Najavits, Deborah Chauncey, Cassandra Kisiel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Scopus citations


Thirty-seven female inpatients with borderline personality disorder were followed prospectively for up to 5 years to assess changes in two forms of self-destructiveness: Suicidal behavior/ideation, and self-harm behavior/ideation. It was found that suicidal behavior declined significantly at 1-, 2-, 3-, 4-, and 5-year follow-up; self-harm behavior showed trends but no significant decline over 5 years. Ideation (both suicidal ideation and self-harm) did not decline notably. Three alternate courses of self-harm behavior are identified: "fluctuating," "consistently low," and "steadily declining." The majority of patients fell in the fluctuating category. The fluctuating group showed higher baseline dysphoria than did the consistently low group, while the latter reported higher baseline drug use. Inter correlations showed that self-harm behavior and suicidal behavior were not associated, nor were suicidal behavior and suicidal ideation. Clinical and research implications are discussed.

Original languageEnglish (US)
Pages (from-to)370-376
Number of pages7
JournalJournal of Nervous and Mental Disease
Issue number6
StatePublished - Jan 1 1995

ASJC Scopus subject areas

  • Psychiatry and Mental health


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