Borderline Personality Disorder and Emotion Dysregulation最新文献

Background: Borderline personality symptoms are often associated with social-cognitive impairments, but the impact of childhood trauma on emotional processing remains poorly understood. This study explored the moderating role of childhood abuse and neglect in the relationship between borderline traits and emotion recognition.

Methods: A total of 216 non-clinical adults first completed self-report measures, including the Borderline Personality Disorder subscale of the Coolidge Axis-II Inventory and the Childhood Trauma Questionnaire. They then performed a facial emotion recognition task involving five expressions-neutral, anger, happiness, sadness, and fear-with all but neutral shown at low and moderate intensity levels. Emotion recognition was evaluated in terms of accuracy, response latency, and misattribution patterns.

Results: While no direct associations emerged between borderline traits and recognition accuracy for specific emotional expressions, higher trait levels were linked to increased misidentification of neutral faces and greater misattribution of anger. Additionally, childhood neglect and abuse moderated the effects of borderline traits on emotion recognition, with neglect altering responses to neutral and low-intensity happy cues, and abuse to subtle anger. A general pattern of emotional hypersensitivity was observed among participants who reported low levels of trauma, reflected in greater misinterpretation of neutral expressions and improved recognition of subtle emotional cues; as self-reported trauma levels increased, this pattern tended to diminish or even reverse. Considered alongside response time and misattribution patterns, the findings suggest avoidance and disengagement tendencies in emotional processing under severe trauma.

Conclusions: In conclusion, when childhood abuse and neglect accompany BPD symptoms, emotion processing may demand nuanced clinical attention tailored to trauma-related dynamics.

Background: There is a need for a parenting intervention that specifically addresses the concerns for parents with borderline personality disorder (BPD) due to the challenges that these parents experience and the stigma that surrounds parenting with BPD. Such interventions may also prevent intergenerational transmission of psychopathology and support clinicians to provide care within a personality disorder framework. This study aims to evaluate the effectiveness of a brief parenting group intervention for parents with BPD.

Trial design: The design was a parallel randomized controlled trial (RCT) with two arms: the brief parenting intervention group and a treatment as usual (TAU) group.

Methods: Participants were parents with a diagnosis of BPD who were parenting at least one child between birth and 5 years old. Participants were randomised to either the brief parenting group intervention (Coming up for AIR (CUFA)) through a public mental health service or to TAU. Participants, clinicians, and researchers were not blind to the allocation. It was hypothesised that the CUFA parenting intervention would reduce self-reported parenting stress (primary outcome) and improve parental mental health (secondary outcome) compared to TAU.

Results: Participants (N = 93) were randomly allocated to the parenting intervention (n = 45) and TAU (n = 48). For the analyses of the per protocol sample 25 participants in the CUFA parenting intervention and 21 participants in the TAU condition were included. Multi-level analysis on the intention to treat sample indicated that the CUFA parenting intervention (d_pre-post = 1.29) significantly reduced parenting stress compared to TAU (d_pre-post = 0.01). This finding was replicated in the per protocol sample.

Conclusion: A brief parenting intervention can have a positive effect on reducing parenting stress and improving parental mental health. Offering a parenting intervention needs a supportive and integrated approach to lower barriers for service attendance. Future research may investigate the effect on child wellbeing. It is important and in line with treatment guidelines to offer a parenting intervention to people with BPD.

Trial registration: Trial registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12620001257954.

Background: Emotion dysregulation is a central feature in trauma-associated disorders such as posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD). However, it remains unclear whether emotion dysregulation is a transdiagnostic phenomenon closely linked to childhood trauma, or if disorder-specific alterations in emotion processing exist. Following a multimethodological approach, we aimed to assess and compare the reactivity to and regulation of emotions between patients with BPD and PTSD, as well as healthy controls, and identify associations with childhood trauma.

Methods: A total of 135 women, 43 healthy controls, 43 with BPD and 49 with PTSD, took part in a multimethodological assessment of emotional reactivity and regulation. Self-report measures were used to assess childhood trauma and emotion dysregulation. Additionally, participants performed a classic emotion regulation (ER) paradigm. Subjective emotional valence ratings and neurophysiological responses (P3 and late positive potential, LPP) were measured in response to negative, positive, and neutral pictures (emotional reactivity) and during active regulation vs. passive viewing of negative pictures (ER).

Results: Regarding emotional reactivity, during the experimental paradigm both patient groups reported lower emotional valence after viewing positive or neutral pictures compared to healthy controls. Furthermore, P3 amplitudes in response to neutral pictures were reduced in both patient groups and in response to negative pictures, specifically in patients with PTSD. Regarding ER, while both patient groups self-reported significant disturbances in ER, neither valence ratings nor neurophysiological responses assessed during the ER task (P3, LPP) differed from healthy controls. Across groups, childhood trauma was related to decreased emotional valence ratings on neutral and positive pictures and higher self-reported emotion dysregulation.

Conclusions: Patients with BPD and PTSD exhibited a reduced emotional reactivity in response to positive and neutral information. Specifically, patients with PTSD demonstrated hypo-reactivity to neutral and trauma-unrelated negative stimuli, which might be due to altered attentional resource allocation following trauma. Although patients reported using adaptive ER strategies less frequently in daily life, they effectively implemented them when instructed to, highlighting important clinical and theoretical implications.

Background: The tendency to forgive is associated with traits such as agreeableness and neuroticism, mental well-being, and interpersonal functioning. Given documented associations with interpersonal conflict and aggression in borderline personality disorder (BPD), forgiveness (or, lack thereof) may be particularly relevant for BPD symptomatology but remains understudied. This study examines forgiveness in BPD compared to a heterogeneous clinical control group without personality disorder (CC), exploring its associations with aggression and interpersonal dysfunction using both direct (self-reported) and indirect (implicit) measures.

Methods: Fifty-one female BPD patients and fifty-one CC participants completed self-report measures of forgiveness (Transgression-Related Interpersonal Motivations Inventory, Tendency to Forgive Scale) and a Forgiveness Implicit Association Test (F-IAT), alongside assessments of borderline symptoms, aggression, and interpersonal problems. Independent-samples t-tests compared the two samples, while Pearson correlations explored associations between clinical characteristics within the BPD sample.

Results: Both groups revealed largely comparable scores in both explicit and implicit forgiveness, with no significant differences across measures. Within the BPD group, higher TRIM-Revenge scores were associated with greater aggression, particularly anger, while TTF scores showed negative associations with overall aggression, physical aggression, and hostility. Circumplex analysis indicated that the F-IAT aligned with nonassertive, TRIM-Revenge with cold and competitive, and TTF with warm and non-dominant interpersonal styles, whereas TRIM-Avoidance and TRIM-Benevolence exhibited limited interpersonal relevance.

Conclusions: Despite limited prior research suggesting reduced forgiveness in BPD, the present findings indicate that women with BPD exhibit forgiveness tendencies comparable to those of the CC. Notably, explicit forgiveness was systematically associated with aggression and interpersonal difficulties, whereas implicit and explicit measures showed limited convergence. These findings underscore the utility of a multidimensional approach to assessing forgiveness in BPD, revealing distinct clinical and interpersonal correlates across forgiveness dimensions.

Background: Borderline personality disorder (BPD) is often underdiagnosed in Malaysia due to limited specialized training and validated screening tools. Although the McLean Screening Instrument for BPD (MSI-BPD) is a well-established measure, it lacks validation in Southeast Asia. This study evaluated the MSI-BPD's psychometric properties in a Malaysian context.

Methods: Two samples, including a clinical sample of psychiatric outpatients (N = 101; mean age = 28.02 years; 74.3% female) and a healthy control group (N = 314; mean age = 29.75 years; 74.8% female), were recruited from a public hospital in Kuala Lumpur, Malaysia and a private university in Malaysia, respectively. Participants in the clinical sample completed the MSI-BPD along with other self-report psychological symptom measures, and BPD diagnoses were confirmed through a semi-structured clinical interview. Psychometric analyses were conducted on the clinical sample to assess the scale's internal consistency, convergent and discriminant validity, factor structure, and predictive validity concerning BPD diagnosis. Both the clinical and healthy control samples were included in a known-groups validity analysis to further evaluate the scale.

Results: The MSI-BPD exhibited good internal consistency (Cronbach's α = 0.82) and convergent validity, as evidenced by significant correlations with related psychological symptoms. The scale also demonstrated good discriminant validity and predictive accuracy (area under the curve = 0.91), with an optimal cut-off score of 8. Confirmatory factor analyses supported a four-factor model (with factors identified being affective disturbances, impulsivity, unstable relationships, and disturbed cognition) as the best fit among the five evaluated models. The study also established the known-groups validity of the MSI-BPD, demonstrating its ability to distinguish clinical samples from healthy controls, with clinical participants scoring significantly higher than controls.

Conclusions: The MSI-BPD is a valid and reliable tool for screening BPD in Malaysia. The findings enhance our understanding of BPD's construct validity and factor structure in Southeast Asia, which leads to a more universal and cross-cultural understanding of BPD. Validating the screening instrument is crucial for improving mental health assessments and interventions, as well as strategies to better identify individuals at-risk for BPD for early intervention optimizing outcomes in a low-resource Southeast Asian context.

Background: Borderline Personality Disorder (BPD) is a complex mental health condition characterized by pervasive instability in mood, interpersonal relationships, self-concepts, and behavior. A reliable assessment of BPD symptom severity is essential for effective treatment planning and evaluation. This study introduces and evaluates the Borderline Symptom List Interview (BSL-I), a semi-structured interview designed to assess the severity of BPD symptoms comprehensively.

Method: The BSL-I is a freely accessible 31-item interview designed to assess BPD symptom severity. It evaluates (a) the frequency and subjective distress associated with BPD-specific and typical psychopathological symptoms, (b) the behavioral consequences of these symptoms, (c) functional impairment, and (d) facets of positive mental health. The items were developed through an iterative process, incorporating feedback from international experts and individuals with lived experience of BPD. Psychometric properties of the BSL-I were examined cross-sectionally in different samples of clients meeting DSM-5 criteria for BPD (n = 171), clinical controls (n = 89), and healthy controls (n = 43).

Results: The BSL-I demonstrates good internal consistency within the BPD sample (Cronbach's α = 0.82) and good interrater reliability (ICC = 0.768). It significantly discriminates between BPD clients and clinical controls (Cohen's d = 2.02) and healthy controls (Cohen's d = 3.88). High correlations were observed with other established BPD symptom measures, including the number of IPDE criteria (r = 0.70, p < 0.001) and the BSL-23 (r = 0.83, p < 0.001).

Discussion: Our findings indicate that the BSL-I is a reliable and valid multidimensional instrument for assessing the severity of BPD. Both clinical experts and clients found the application of the BSL-I acceptable and feasible. Future research might explore its sensitivity to change resulting from psychosocial treatments and assess its utility for treatment planning and outcome measurement.

Conclusion: The BSL-I is a practical and psychometrically sound instrument for assessing the severity of BPD symptoms in clinical and research contexts.

Background: Borderline personality disorder (BPD) is characterized by instability in interpersonal relationships and fear of abandonment, which intensify during stress. Social stressors seem to activate the hypothalamic-pituitary-gonadal (HPG) axis in healthy controls (HC), but this has not been investigated in patients with BPD. This study aimed to investigate the effects of social stress, i.e., social exclusion on changes of progesterone and estradiol levels in women with BPD compared to HC.

Methods: 82 women with BPD and 82 HC were randomly assigned to either an exclusion or overinclusion condition of the Cyberball paradigm. Saliva samples were collected at baseline (T1), immediately after Cyberball (T2) and 15 min post-Cyberball (T3). Two 3 × 2 × 2 repeated-measures ANOVAs were conducted with time (T1, T2, T3) as the within-subject factor, and group (BPD vs. HC) and condition (exclusion vs. overinclusion) as between-subject factors.

Results: On progesterone change, the analysis revealed no significant main effects of group or condition, but a significant group × condition interaction. Post-hoc tests showed that within the BPD group, change of progesterone levels at T3 i.e., after Cyberball, were higher after exclusion than overinclusion. For changes of estradiol levels, no significant main effects for group, condition, or their interaction were found.

Discussion: This study provides initial evidence that women with BPD exhibit distinct hormonal dynamics in progesterone after social exclusion versus overinclusion. Further research is needed to better understand this hormonal pattern and its implications for social functioning in BPD.

Background: In this study, network analysis technique is applied to dissect the links between personality organization, reflective functioning, attachment security, primary affective traits, childhood trauma and psychopathological symptoms.

Methods: A total sample of 498 (77% female) participants from the general population was investigated. A cross-sectional network between personality organization [IPO-16], hypomentalizing [RFQ-6], attachment [ECR-RD8]), primary affective traits [BANPS-GL], depression, anxiety and somatization symptoms [BSI-18], addiction [WHO-ASSIST] and childhood trauma [CTQ] was estimated via the EBICglasso and relimp algorithm. Regularized partial correlation edge weights, node centrality, predictability, bridge centrality, relative importance and stability coefficients were analyzed.

Results: We observed personality organization, SADNESS and hypomentalizing as the most influential personality constructs within the investigated network. Personality organization and hypomentalizing were also observed as nodes with the highest bridge centrality, signifying their potential relevance as mediator between trauma, affect and psychiatric symptom severity.

Conclusions: The results enable a data-driven, in-depth examination of the complex and often reciprocal relations among psychopathological symptoms, childhood adversity and psychodynamic personality constructs. Our observations highlight critical interconnections among childhood trauma, primary affects, personality functioning and psychopathology and pinpoint personality organization, hypomentalizing and SADNESS as central psychodynamic personality constructs.