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

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.