Borderline Personality Disorder and Emotion Dysregulation最新文献

Background: Adaptive strategies of emotion regulation are important for adolescents, as maladaptive strategies of such can manifest as psychopathology that is sometimes severe. Individual biological characteristics and influences from peers have been shown to have an effect on the development of emotion regulation strategies in adolescents. Maternal factors, however, have received less attention in this age group regarding how they might predict emotion regulation in adolescents. Given that prior work has demonstrated that certain maternal factors, like emotion regulation and personality, play a crucial role in the development of emotion regulation strategies in early childhood, we sought to examine these associations in adolescents in our current study.

Methods: Adolescents and their mothers (n = 123) both self-reported data on their own emotion regulation, and mothers also self-reported data on their own personality dysfunction. We operationalized maternal and adolescent emotion regulation as emotion suppression, a maladaptive emotion regulation strategy that is commonly used by adolescents.

Results: Our data demonstrated that both maternal emotion suppression and interpersonal personality dysfunction were positively associated with adolescent emotion suppression. No associations among maternal intrapersonal personality functioning and adolescent emotion suppression were detected.

Conclusions: Maternal personality dysfunction and emotion suppression both independently predicted adolescent emotion suppression use. These results support the idea that maternal characteristics play a role in shaping emotion regulation in adolescence.

Background: Interpersonal impairments in patients diagnosed with borderline personality disorder (BPD) are characterized by the fear of being rejected and high levels of loneliness. Potential underlying factors are alterations in the processing of social interactions and the associated perceptions of social partners. In this regard, BPD patients tend to attribute the cause of negative rather than positive events to their own person and to perceive others as less trustworthy than healthy controls (HCs). To date, no study has investigated whether the effect of experimentally influenced causal attributions of social interactions on the perception of a social partner differs between BPD patients and HCs.

Methods: A new virtual reality paradigm was developed to investigate the perception of benevolence following the induction of social rejection and acceptance, while experimentally manipulating whether an external cause for this behavior was provided. The data of 62 participants (32 HCs, 30 BPD patients) were analyzed using linear mixed-effects models. Associations of benevolence ratings with attributional style, rejection sensitivity, self-esteem, childhood trauma, and loneliness were investigated via correlational and multiple linear regression analyses.

Results: Across both groups, a social partner was rated as less benevolent following rejection than following acceptance. An external explanation mitigated this negative effect of rejection. Overall, benevolence ratings were lower in BPD patients than in HCs. This group difference was stronger following acceptance than following rejection. Independent of acceptance and rejection, an external explanation was associated with a higher level of benevolence only in the HC group. No associations of the effects of the experimental conditions with attributional style, childhood trauma, rejection sensitivity, self-esteem, or loneliness were found.

Conclusion: Our findings indicate that acceptance and provided external explanations for rejection have a less positive impact on the perception of a social partner's attitude toward oneself in BPD patients than in HCs. More research is needed to identify predictors of benevolence perception and which steps of social information processing are altered. The therapeutic implications include the importance of strengthening the perception and enjoyment of being accepted as well as improving the mentalizing ability of BPD patients.

Background: Engagement in Non-Suicidal Self-Injury (NSSI) is high among adolescents with borderline personality disorder (BPD), but the trajectory of NSSI in the transition period from adolescence to adulthood is unclear, and studies that look at predictors of persistence are highly needed.

Methods: This study followed 111 adolescents aged 14-17 with BPD over a five-year period to observe the prevalence and predictors of NSSI. Information on NSSI was based on both self-report and clinician-administered interviews.

Results: At the outset, 92.8% reported a history of NSSI, with an average of nearly five different types of NSSI. Despite this high initial prevalence, the rates of NSSI within the past two weeks decreased over time from 48% at baseline to 26% after one year, and further to 10% after two years. After five years, 37% reported engaging in NSSI within the past six months. Notably, all but one participant who reported NSSI after five years had engaged in NSSI already at baseline. The study identified that higher adolescent-rated but lower parent-rated BPD severity was associated with engagement in NSSI at baseline. Furthermore, ongoing NSSI after five years was predicted by lower parent-rated BPD severity and externalizing behaviors.

Conclusions: NSSI is frequent in the early course of BPD, and persists in more than one-third after five years. Our findings highlight that baseline engagement in NSSI is a risk factor for persistence of NSSI in the transition period into early adulthood. Furthermore, the findings underscore the significance of integrating both adolescent and parent perspectives on BPD pathology in the assessment and management of NSSI.

Background: Insecure adult attachment has been associated with psychiatric disorders characterized by emotional dysregulation, such as borderline personality disorder (BPD), bipolar disorder (BD) and attention deficit/hyperactivity disorder (ADHD). However, little is known about the differences in attachment patterns between these diagnostic groups. The aim of this study was to identify clusters of adult attachment style in a cross-diagnostic group of patients with BDP and/or BD and/or ADHD and explore the characteristics of these clusters based on temperament profile, childhood trauma and psychiatric diagnoses.

Methods: K-means cluster analysis was used to identify subgroups, based on the Attachment Style Questionnaire Short Form dimensions, in a clinical cohort of 150 young adults (113 women and 37 men, mean age ± SD = 23.3 ± 2.1) diagnosed with BPD, and/or BD, and/or ADHD.

Results: Three distinct clusters were identified: a secure, an insecure/avoidant-anxious and an insecure/avoidant cluster. These three clusters differed in temperament profile and related psychiatric diagnoses.

Conclusions: The three clusters of attachment in individuals with BPD, BD and/or ADHD could support differentiation between the disorders as well provide information usable for planning of treatment.

Background: Perinatal borderline personality disorder (BPD) is a common condition in perinatal mental health settings with few specialised treatment options, and little is known about the enduring effects of available treatment programs. This study explored the follow-up experiences of women with BPD after completing Mother-Infant Dialectical Behaviour Therapy (MI-DBT).

Methods: Semi-structured interviews were conducted with eight women who had completed MI-DBT 3 years prior. Reflexive Thematic Analysis was used to analyse the interviews to gain a richer understanding of these mothers' lived experience.

Results: A thematic analysis generated four main themes which indicated that participants found that MI-DBT improved their ability to hold their child in mind, be aware of their own internal state and behaviours, manage their own emotional reactions and stay calm, and manage interpersonal interactions within adult relationships. Mothers with perinatal borderline personality disorder also highlighted the need for ongoing support in the context of parenting.

Conclusions: This study is the first of its kind to explore the longer-term experiences of mothers following such an intervention, giving voice to this vulnerable group of women. The findings of this study provide a greater understanding of the complex challenges experienced as part of parenting for mothers with borderline personality disorder, and provides both insight into mothers' experiences of life after MI-DBT and the impact of the program on their lives. The clinical and research implications of the study's findings are discussed.

Trial registration: This research was retrospectively registered on 07/03/2024, ACTRN12624000225516.

Background: Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood.

Methods: A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis.

Results: Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week.

Conclusions: Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

Background: Traumatic childhood experiences are a major risk factor for developing mental disorders later in life. Over the past decade, researchers have begun to investigate the role of early trauma in impairments in personality functioning following the introduction of the Alternative Model of Personality Disorders in Section III of the Diagnostic and Statistical Manual for Mental Disorders 5. Although first studies were able to empirically demonstrate a significant link between early trauma and impairments in personality functioning, only little is known about the underlying mechanisms. One possible mechanism is body connection due to its involvement in self-regulatory processes and its link to both early trauma and personality (dys)functioning.

Objective: In the current study, we investigated whether body connection, which encompasses the awareness, integration, and utilization of one's own bodily signals, mediates the relationship between childhood trauma and personality functioning.

Participants and setting: A total of 1,313 adult participants recruited in Germany and Chile anonymously provided self-report data in an online survey.

Methods: Self-report data included the short form of the Childhood Trauma Questionnaire (CTQ-SF), the Scale of Body Connection (SBC), and the brief form of the Levels of Personality Functioning Scale (LPFS-BF 2.0) as well as demographic data (age, sex, education, clinical diagnoses).

Results: Traumatic childhood experiences explained 27.2% of the variance in impairments in personality functioning. Interestingly, 60.5% of this effect was explained by body connection, particularly body dissociation. Additional exploratory analyses revealed that body dissociation and, to a much lesser extent, body awareness, accounted for 64.41% of the variance in self functioning and 55.75% of the variance in interpersonal functioning explained by childhood trauma.

Conclusion: Body connection appears to be an important mediator in the association between early trauma and impaired personality functioning, underscoring the need for interventions specifically targeting the avoidance and ignorance of signals from one's own body in individuals with traumatic childhood trauma.