Borderline Personality Disorder and Emotion Dysregulation最新文献

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"If I could read your mind…": parental mentalizing in mothers with borderline personality disorder. “如果我能读懂你的心……”:边缘型人格障碍母亲的父母心理化。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-16 DOI: 10.1186/s40479-025-00290-7
Jana Zitzmann, Anna Georg, Charlotte Rosenbach, Babette Renneberg
{"title":"\"If I could read your mind…\": parental mentalizing in mothers with borderline personality disorder.","authors":"Jana Zitzmann, Anna Georg, Charlotte Rosenbach, Babette Renneberg","doi":"10.1186/s40479-025-00290-7","DOIUrl":"10.1186/s40479-025-00290-7","url":null,"abstract":"<p><strong>Background: </strong>Individuals with a borderline personality disorder (BPD) show impairments in their ability to mentalize. Particularly in the parent-child relationship, mentalizing is an important foundation for sensitive parenting and the quality of interactive behavior. Previous studies of parental mentalizing in mothers with BPD are scarce and have focused primarily on one aspect of the multidimensional construct. In addition, there is currently no research comparing different mental disorders on different aspects of parental mentalizing, leaving disorder-specific differences unclear. Aim of this study is to examine disorder-specific differences in reflective functioning and mind-mindedness, two facets of parental mentalizing.</p><p><strong>Methods: </strong>We compared mothers with BPD (n = 156) with a clinical control group of mothers with depressive or anxiety disorders (n = 65) and with healthy mothers (n = 91) using non-parametric inference for multivariate data. Mothers completed the Parental Reflective Functioning Questionnaire (PRFQ) and participated in a five-minute speech sample (FMSS) in which they reflected on their child and their relationship with their child. Verbal transcripts of the FMSS were rated using an adapted manual for coding mind-mindedness with the FMSS that incorporates the assessment of additional characteristics of mind-related speech.</p><p><strong>Results: </strong>Mothers with BPD showed the highest impairments in parental mentalizing compared to both other groups, as evident in both operationalizations: They made more maladaptive attributions (PRFQ pre-mentalizing) than the other two groups and reported lower interest and curiosity and certainty in mental states than healthy mothers. In addition, mothers with BPD used more mental attributes with negative valence when asked to describe their child and the relationship compared to both other groups and more self-related mental attributes compared to healthy mothers. Additionally, Pearson correlational analyses revealed that only the use of mental attributes with negative valence was associated with all three subscales of the PRFQ in the anticipated directions. This supports the idea that the two operationalizations target different facets of parental mentalization.</p><p><strong>Conclusions: </strong>Our findings revealed impaired parental mentalization in several domains for mothers with BPD. Disorder-specific differences were observed in the amount of maladaptive attributions and in the negativity of mental state references. These aspects should be considered in diagnostic and therapeutic processes when working with mothers with BPD. As a limitation, it should be noted that the group comparisons did not control for sociodemographic variables, which may have contributed to some of the observed group differences.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"20"},"PeriodicalIF":4.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between emotional impulsivity (Urgency), aggression, and symptom dimensions in patients with borderline personality disorder. 边缘型人格障碍患者情绪冲动(急迫性)、攻击性与症状维度的关系
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-15 DOI: 10.1186/s40479-025-00292-5
Sylvia Martin, Jonathan Del Monte, Richard Howard
{"title":"The relationship between emotional impulsivity (Urgency), aggression, and symptom dimensions in patients with borderline personality disorder.","authors":"Sylvia Martin, Jonathan Del Monte, Richard Howard","doi":"10.1186/s40479-025-00292-5","DOIUrl":"10.1186/s40479-025-00292-5","url":null,"abstract":"<p><strong>Background: </strong>A hallmark of borderline personality disorder (BPD) is a disposition to anger, irritability and aggression. High impulsivity, particularly high emotional impulsivity (urgency), has been associated with aggression in BPD patients.</p><p><strong>Aims: </strong>This study aimed to explore, in a sample of patients with BPD, the subtleties of the relationship between borderline symptomatology, different facets of impulsivity, and an aggressive disposition.</p><p><strong>Methods: </strong>Two hundred and twenty patients with a DSM-5 (Sect. 2) diagnosis of BPD were assessed on measures of impulsivity (UPPS model), aggression (Brief Aggression Questionnaire, BAQ-12) and borderline symptoms (Borderline Personality Questionnaire, BPQ).</p><p><strong>Results: </strong>Results showed: (i) there was a close relationship between BPD symptomatology and an aggressive predisposition measured by BAQ-12; (ii) emptiness and intense anger were the BPD symptom dimensions most significantly associated with aggression (iii) both negative and positive urgency, and to a lesser extent lack of premeditation and sensation seeking, mediated the relationship between borderline symptom dimensions and aggression.</p><p><strong>Discussion & conclusion: </strong>Results suggest a close relationship between almost all dimensions of BPD, but especially anger, and impulsive aggression. They further suggest that urgency, particularly negative urgency, mediates this relationship. Future studies will need to parse aggression into motivationally distinct types.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"19"},"PeriodicalIF":4.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What strategies do people with borderline personality disorder use to maintain their well-being and performance at work? 边缘型人格障碍患者使用什么策略来维持他们的健康和工作表现?
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-14 DOI: 10.1186/s40479-025-00293-4
Nadine Larivière, Marc Corbière, Eve-Lyne Robitaille-Beaumier, Pierre David, Lionel Cailhol
{"title":"What strategies do people with borderline personality disorder use to maintain their well-being and performance at work?","authors":"Nadine Larivière, Marc Corbière, Eve-Lyne Robitaille-Beaumier, Pierre David, Lionel Cailhol","doi":"10.1186/s40479-025-00293-4","DOIUrl":"https://doi.org/10.1186/s40479-025-00293-4","url":null,"abstract":"<p><strong>Background: </strong>People with borderline personality disorder (BPD) often experience instability in their career paths. Previous studies have mainly focused on their challenges in work participation. There has been limited attention on their job tenure strategies. This qualitative study aimed to identify job tenure strategies of people with BPD who are currently employed.</p><p><strong>Methods: </strong>Between November 2021 and March 2024, participants completed an online survey combining questionnaires and qualitative open-ended questions covering eleven themes, such as task management, adherence to workplace rules and self-perception of competence. The sample comprised 103 women, 22 men, and five non-binary persons, with an average age of 35. In addition to BPD, about half of the participants reported co-occurring diagnoses, such as anxiety disorders. For 54% of participants, their current primary job was aligned with their formal training. For 65%, it corresponded to their personal interests, and for 83%, with their competencies.</p><p><strong>Results: </strong>To maintain well-being and performance at work, participants reported using strategies that involved balancing work and daily life through stable routines and health-supporting lifestyle habits. Key strategies enabling work functioning focused on self-regulation, cultivating positive workplace relationships, as well as task and time management. Organizing a calm work environment that facilitates concentration, using stress reduction and emotional regulation techniques, and seeking support from colleagues and managers were frequent examples.</p><p><strong>Conclusions: </strong>The findings highlight a variety of self-directed, interpersonal and task-related actions that people with BPD use to maintain job tenure when employed. These personalized strategies can enrich the development of sustainable work reintegration interventions. Future research should examine the empirical effectiveness of these strategies and explore additional job tenure factors, such as work accommodations tailored to the needs of people with BPD.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"18"},"PeriodicalIF":4.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Measurement invariance on two self-report instruments for men and women with borderline personality disorder. 边缘型人格障碍男性和女性两种自我报告工具的测量不变性。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-12 DOI: 10.1186/s40479-025-00296-1
Leonie Strunk, Kathrin Dreyße, Christoph Kröger
{"title":"Measurement invariance on two self-report instruments for men and women with borderline personality disorder.","authors":"Leonie Strunk, Kathrin Dreyße, Christoph Kröger","doi":"10.1186/s40479-025-00296-1","DOIUrl":"https://doi.org/10.1186/s40479-025-00296-1","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice and research, self-report instruments are frequently used for assessing the severity of borderline personality disorder (BPD) symptomatology experienced by men and women. Men with BPD are often underrepresented in samples used to evaluate self-report questionnaires. Measurement invariance (MI) is used to examine whether self-report questionnaires determine the same latent construct across groups or varying conditions (e.g., measurement occasions).</p><p><strong>Methods: </strong>The present study investigated measurement invariance for two self-report measures of BPD features: the Borderline Symptom List (BSL-23) and the Impulsivity and Emotion Dysregulation Scale (IES-27). An inpatient sample of N = 3507 individuals (n = 560 males) was used to test for measurement variance between males and females, and over time from pre- to post-treatment.</p><p><strong>Results: </strong>Confirmatory factor analysis results supported a unidimensional structure for the BSL-23 and a three-factor model for the IES-27. Both instruments were found to be measurement invariant with regard to sex and time.</p><p><strong>Conclusions: </strong>The results suggest that the BSL-23 and IES-27 can be used to assess BPD symptoms in men and women, as well as to assess treatment effects at admission and at the end of treatment.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"17"},"PeriodicalIF":4.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Validating the Italian version of the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF 2.0): internal structure, temporal stability and construct validity. 验证意大利版人格功能水平量表-简要表2.0 (LPFS-BF 2.0):内部结构、时间稳定性和构念效度。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-12 DOI: 10.1186/s40479-025-00286-3
Emanuela S Gritti, De Carli Pietro, Joost Hutsebaut, Alessandra Simonelli, Johannes Zimmermann
{"title":"Validating the Italian version of the Level of Personality Functioning Scale - Brief Form 2.0 (LPFS-BF 2.0): internal structure, temporal stability and construct validity.","authors":"Emanuela S Gritti, De Carli Pietro, Joost Hutsebaut, Alessandra Simonelli, Johannes Zimmermann","doi":"10.1186/s40479-025-00286-3","DOIUrl":"https://doi.org/10.1186/s40479-025-00286-3","url":null,"abstract":"<p><strong>Background: </strong>Contemporary models of personality assessment emphasize a dimensional rather than a categorical framework for measuring an individual's level of personality functioning. This viewpoint has also been incorporated into official diagnostic manuals, such as the Alternative DSM-5 Model for Personality Disorders (AMPD). Assessment instruments for personality functioning according to the AMPD are increasingly being developed and used, but controversies remain regarding the two-factor (vs. one-factor) structure and psychometric properties of such instruments in different countries.</p><p><strong>Methods: </strong>To help fill these gaps in the literature, in this study we tested the internal structure, temporal stability, and construct validity of the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF 2.0), a convenient self-report screening questionnaire of the AMPD level of personality functioning, on a final sample of 482 non-clinical adults (369 females, 112 males, one non-binary; age range = 18-83, M = 34.6, SD = 16.4). Internal structure of the Italian LPFS-BF 2.0 was tested by Confirmatory Factor Analysis. Temporal stability and construct validity of the total score and of the Self and Interpersonal functioning subscale scores were tested using Pearson's correlations and Steiger's Test.</p><p><strong>Results: </strong>A two-factor structure for the LPFS-BF 2.0 was supported, and correlation analyses provided convergent and discriminant validity evidence for the total and the two Self and Interpersonal subscale scores against external self-report measures of problematic self and interpersonal functioning, overall personality dysfunction, general psychological symptoms and lower quality of life. As such, the total score and the two Self and Interpersonal subscales yielded correlations with external criteria of medium to large effect sizes (i.e., Pearson's r), all significant at the p < .001 level. Finally, the present study provides the first empirical assessment of the LPFS-BF 2.0 temporal stability over an interval of 11.5 weeks, demonstrating a high temporal stability for both the total scale and the two subscales (rs above .70 for all three, ps < .001).</p><p><strong>Conclusions: </strong>The Italian version of the LPFS-BF 2.0 yielded similar psychometric properties to the original scale and other international adaptations, suggesting its utility for personality assessment research and practice.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"16"},"PeriodicalIF":4.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma-focused dialectical behavior therapy: study protocol for a randomized controlled multi-center trial in online and face-to-face formats. 以创伤为中心的辩证行为治疗:在线和面对面形式的随机对照多中心试验的研究方案。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-05-09 DOI: 10.1186/s40479-025-00294-3
Ruben Vonderlin, Tali Boritz, Carola Claus, Büsra Senyüz, Saskia Mahalingam, Julia Schmelz, Silja Knolle-Ventjeer, Philip S Santangelo, Ulrich W Ebner-Priemer, Christian Schmahl, Jürgen Margraf, Tobias Teismann, Stefanie Lis, Nikolaus Kleindienst, Shelley McMain, Martin Bohus
{"title":"Trauma-focused dialectical behavior therapy: study protocol for a randomized controlled multi-center trial in online and face-to-face formats.","authors":"Ruben Vonderlin, Tali Boritz, Carola Claus, Büsra Senyüz, Saskia Mahalingam, Julia Schmelz, Silja Knolle-Ventjeer, Philip S Santangelo, Ulrich W Ebner-Priemer, Christian Schmahl, Jürgen Margraf, Tobias Teismann, Stefanie Lis, Nikolaus Kleindienst, Shelley McMain, Martin Bohus","doi":"10.1186/s40479-025-00294-3","DOIUrl":"https://doi.org/10.1186/s40479-025-00294-3","url":null,"abstract":"<p><strong>Background: </strong>Borderline Personality Disorder (BPD) is a severe mental health condition that requires intensive psychotherapeutic treatment. Dialectical Behavior Therapy (DBT) is a specialized treatment approach for BPD with broad empirical evidence. However, as with other disorder-specific treatments, the effect sizes of the standard DBT approach are only modest and access to treatment is limited. To enhance the efficacy of DBT, we developed an adaptation called Trauma-Focused DBT (TF-DBT), which is based on the principles, treatment modes, and functions of DBT. The goal was to (i) condense and accelerate the core therapeutic processes of DBT and (ii) expand therapeutic strategies for addressing BPD symptoms beyond Stage I of DBT (i.e., focusing on behavioral dyscontrol). TF-DBT adopts an accelerated experiential approach that is phase-based in its delivery. It emphasizes the processing of maladaptive emotions related to a wide range of developmental relational trauma (i.e., experiences of traumatic invalidation, emotional abuse, bullying, sexual abuse, or neglect in childhood or adolescence).</p><p><strong>Aim: </strong>The primary aim of this study is to investigate the efficacy of this novel DBT adaptation (TF-DBT) compared to standard DBT (S-DBT) as developed by M. Linehan. We hypothesize that TF-DBT is superior to S-DBT on all BPD symptom measures. A second aim of the study is to investigate the efficacy of the delivery format of both treatments (i.e., online vs. face-to-face), with the hypothesis that online therapy is non-inferior to face-to-face treatment.</p><p><strong>Methods: </strong>This study will enroll N = 260 individuals diagnosed with BPD according to DSM-5. Participants will be randomly assigned to 12 months of outpatient TF-DBT or S-DBT in an online or face-to-face format.</p><p><strong>Discussion: </strong>The expected results might help to improve psychotherapy efficacy for BPD. Additionally, they will improve our understanding of the efficacy of online-delivered DBT treatments which might contribute to facilitating access to treatment.</p><p><strong>Trial registration: </strong>German Clinical Trials Register: registration number DRKS00031808, date of registration 04 July 2023. WHO Universal Trial Number: U1111-1273-3381.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"15"},"PeriodicalIF":4.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dialectical behavior therapy in autistic adults: effects on ecological subjective and physiological measures of emotion dysregulation. 自闭症成人的辩证行为治疗:对情绪失调生态、主观和生理测量的影响。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-04-23 DOI: 10.1186/s40479-025-00288-1
Mădălina Elena Costache, Federica Gioia, Nicola Vanello, Alberto Greco, Antonio Capobianco, Sébastien Weibel, Luisa Weiner
{"title":"Dialectical behavior therapy in autistic adults: effects on ecological subjective and physiological measures of emotion dysregulation.","authors":"Mădălina Elena Costache, Federica Gioia, Nicola Vanello, Alberto Greco, Antonio Capobianco, Sébastien Weibel, Luisa Weiner","doi":"10.1186/s40479-025-00288-1","DOIUrl":"https://doi.org/10.1186/s40479-025-00288-1","url":null,"abstract":"<p><strong>Background: </strong>Although Ecological Momentary Assessment (EMA) and physiological measurements provide a valuable opportunity to evaluate therapeutic interventions in real time, no study has used this approach to assess Dialectical Behavior Therapy (DBT) in autistic adults with high levels of emotion dysregulation (ED).</p><p><strong>Methods: </strong>In this study, 26 autistic adults were evaluated before and after participating in a standard 5-month DBT program, using Ecological Momentary Assessment (EMA). The EMA included: (1) twelve evaluations per day over a 7-day period, measuring alexithymia, emotional states, subjective arousal and emotion control; (2) continuous physiological monitoring with a wristband to record heart-rate (HR), heart-rate variability (HRV) and skin conductance levels (SCL).</p><p><strong>Results: </strong>Following DBT, no significant differences were found with respect to negative emotions and higher conflicting emotions, but increased rates of identified emotions, positive emotions and emotion control were found. Baseline autonomic responses remained unchanged, whereas subjective arousal was found to correlate positively with HRV. Overall, these results suggest that participants showed enhanced emotion awareness and emotion regulation capabilities following DBT.</p><p><strong>Conclusion: </strong>Our study adds to previous research showing that DBT is efficient in treating ED in autistic adults, using real-time measurements of subjective and physiological markers collected through EMA. Specifically, alexithymia measures decreased post-DBT while positive emotions and emotion control increased. Randomized controlled trials should consider using these methods to improve the assessment of the impact of DBT in the daily life of autistic individuals with ED and/or suicidal behavior.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"14"},"PeriodicalIF":4.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical practice guidelines for the treatment of borderline personality disorder: a systematic review of best practice in anticipation of MAiD MD-SUMC. 边缘型人格障碍治疗的临床实践指南:对MAiD MD-SUMC预期最佳实践的系统回顾。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-04-10 DOI: 10.1186/s40479-025-00284-5
Hira M Aslam, Jonah Brodeur, Paul S Links
{"title":"Clinical practice guidelines for the treatment of borderline personality disorder: a systematic review of best practice in anticipation of MAiD MD-SUMC.","authors":"Hira M Aslam, Jonah Brodeur, Paul S Links","doi":"10.1186/s40479-025-00284-5","DOIUrl":"https://doi.org/10.1186/s40479-025-00284-5","url":null,"abstract":"<p><strong>Background: </strong>Countries permitting assisted dying for mental disorder as the sole underlying condition (MD-SUMC) find that individuals with Borderline Personality Disorder (BPD) constitute a significant proportion of people requesting MAiD. In anticipation of forthcoming changes to Canadian MAiD legislation, clinical practise guidelines will be important in the decision-making process for eligibility to ensure that evidence-based treatments have been exhausted in making determinations of irremediability.</p><p><strong>Aims: </strong>This is a systematic review of international, English-language treatment guidelines for BPD with two primary objectives: First, to identify areas of consensus and disagreement in best practise for the treatment of this disorder and second, to assess whether the guidelines offered insight into defining irremediable BPD and/or its management.</p><p><strong>Methods: </strong>In accordance with PRISMA guidelines, we performed a systematic review of five databases and identified five clinical practise guidelines in the English language. Two authors independently performed data extraction on the core components of these treatment guidelines, which was synthesized into a narrative review.</p><p><strong>Findings: </strong>Several conclusions may be drawn about the state of the evidence on BPD treatment. First, psychological therapies are broadly considered the preferred treatment modality for BPD but there is no consensus regarding whether any one intervention is preferable. Second, all guidelines suggest pharmacotherapy may have a role in the management of BPD, but the nature and extent of this is disputed. Third, there is no guidance alluding to, defining, or commenting on the management of irremediable BPD. Finally, there are no Canadian treatment guidelines for BPD. The implications of these findings for MAiD MD-SUMC are discussed.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"13"},"PeriodicalIF":4.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Individual patterns and synchrony of heart rate variability in adolescent patients with borderline personality psychopathology and their mothers: a case-control study. 青少年边缘型人格精神病理学患者及其母亲心率变异性的个体模式和同步性:一项病例对照研究。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-04-09 DOI: 10.1186/s40479-025-00289-0
Katharina Williams, Anna Fuchs, Jana Kuehn, Leonie Fleck, Stefan Lerch, Marialuisa Cavelti, Julian Koenig, Michael Kaess
{"title":"Individual patterns and synchrony of heart rate variability in adolescent patients with borderline personality psychopathology and their mothers: a case-control study.","authors":"Katharina Williams, Anna Fuchs, Jana Kuehn, Leonie Fleck, Stefan Lerch, Marialuisa Cavelti, Julian Koenig, Michael Kaess","doi":"10.1186/s40479-025-00289-0","DOIUrl":"10.1186/s40479-025-00289-0","url":null,"abstract":"<p><strong>Background: </strong>In adolescent Borderline Personality Disorder (BPD), interactions with caregivers often provoke dysregulation. Vagally-mediated heart rate variability (HRV), a physiological marker of regulatory capacities, shows alterations in BPD. Studies on individual and dyadic HRV in adolescents with BPD (BPD-A) and their mothers (BPD-M) are lacking. We examined 1) individual resting state -, reactivity- and recovery- HRV, 2) intrapersonal concordance of interactional quality with HRV, 3) mother-adolescent interpersonal HRV-synchrony and 4) the association of interpersonal HRV-synchrony with behavioral synchrony in a case-control design.</p><p><strong>Methods: </strong>Thirty-eight (sub)syndromal BPD-A and BPD-M were compared to 35 healthy control adolescents and their mothers (HC-A/-M). HRV was assessed during a positive interaction, a stress task and resting before and after interactions (recovery). Behavior during interactions was observed and coded using the \"Coding Interactive Behavior\"- Manual. Data were analyzed using multilevel modeling.</p><p><strong>Results: </strong>BPD-A showed a lower resting HRV than HC-A, while no group differences were found for mothers. From resting to positive interaction, BPD-A/BPD-M/HC-M showed a significant increase in HRV; this increase was not significant for HC-A. HRV-reactivity to stress was not significant in either group but influenced by general emotional and behavioral problems within both adolescent samples. Significant intrapersonal concordance of HRV and behavior could only be found for HC-M during the positive interaction (positive association). For BPD-M, a complete disconnect between behavior and HRV was observed. BPD-dyads and dyads lower in behavioral synchrony displayed HRV-synchrony during stress, in HC-dyads and dyads higher in behavioral synchrony during rest after dyadic interactions.</p><p><strong>Conclusions: </strong>Our study is the first investigating altered HRV-reactivity, behavior-HRV-concordance and HRV-synchrony in adolescents with BPD traits and their mothers, adding new insight to physiological regulation and co-regulation in adolescent BPD pathology. Limitations and implications of these results are discussed.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"12"},"PeriodicalIF":4.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical predictors of insomnia in borderline personality disorder: a polysomnographic and subjective examination. 边缘型人格障碍患者失眠的临床预测因素:多导睡眠图和主观检查。
IF 4 2区 医学
Borderline Personality Disorder and Emotion Dysregulation Pub Date : 2025-04-03 DOI: 10.1186/s40479-024-00277-w
Mariana Mendoza Alvarez, Johan Verbraecken, Laurence Claes, Marie Vandekerckhove, Livia De Picker
{"title":"Clinical predictors of insomnia in borderline personality disorder: a polysomnographic and subjective examination.","authors":"Mariana Mendoza Alvarez, Johan Verbraecken, Laurence Claes, Marie Vandekerckhove, Livia De Picker","doi":"10.1186/s40479-024-00277-w","DOIUrl":"10.1186/s40479-024-00277-w","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are common in patients with borderline personality disorder (BPD) and are associated with a poor prognosis and symptom severity. Research findings on sleep abnormalities in individuals with BPD have been inconsistent, with limited evidence linking subjective and objective measures.</p><p><strong>Methods: </strong>We compared 44 women with BPD with 41 healthy controls. We examined differences (using ANCOVAs and ordinal logistic regression) and associations (using correlations) between objective sleep assessment (polysomnography) and subjective measures (Consensus Sleep Diary, Insomnia Severity Index, Pittsburgh Sleep Quality Index). We explored predictors of insomnia in BPD patients, including BPD severity, symptomatology, comorbid conditions, and medication use, via standard least squares regressions and ANOVAs.</p><p><strong>Results: </strong>A total of 22% of patients with BPD had clinically significant insomnia (cut-off ≥ 15), 85% reported mild (subthreshold) insomnia (cut-off > 10) (Insomnia Severity Index; ISI), and 94% reported sleep quality disturbances (PSQI > 5). Compared with those in HC, PSG results in individuals with BPD revealed a longer duration in bed, longer sleep period, REM latency, wake after sleep onset latency, Stage N1 sleep duration, shorter N2 sleep duration, and, with age, more arousals and awakenings. The correlations between objective and subjective sleep measures were weak in both groups. In patients with BPD, a greater degree of insomnia predicted a reduction in total sleep time and increased awakenings and arousals on PSG. Clinical BPD severity, emotional reactivity and dysregulation, depression symptoms, posttraumatic stress symptoms, alexithymia, and presleep arousal were associated with greater insomnia in BPD patients.</p><p><strong>Conclusions: </strong>Our study confirmed high rates of insomnia and sleep disturbances in individuals with BPD, which contrasted with relatively minor PSG alterations. Clinical BPD severity and symptomatology are associated with sleep abnormalities in individuals with BPD. Insomnia is a neglected yet important characteristic of the BPD phenotype, warranting more attention in future research and clinical guidelines.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"12 1","pages":"11"},"PeriodicalIF":4.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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