Borderline Personality Disorder and Emotion Dysregulation最新文献

{"title":"Help-seeking patterns for non-suicidal self-injury across borderline symptom profiles in a large sample of university students.","authors":"Rosie James, Rebecca Overgaard, Sofie Westling, Magnus Nilsson","doi":"10.1186/s40479-026-00375-x","DOIUrl":"10.1186/s40479-026-00375-x","url":null,"abstract":"<p><strong>Background: </strong>Non-suicidal self-injury (NSSI) is common in young adults and may represent a marker of current or emerging borderline pathology. However, rates of help-seeking for NSSI are low, potentially delaying recognition of clinically relevant borderline symptoms. To our knowledge, research on NSSI help-seeking has not examined whether help-seeking differs according to underlying borderline symptom profiles. This study therefore examined whether patterns of NSSI help-seeking differ across borderline symptom profiles in a community sample of university students.</p><p><strong>Methods: </strong>In this cross-sectional study, latent class analysis was used to identify borderline symptom profiles in a community sample of 1,476 (68.5% female) Swedish university students based on the McLean Screening Instrument for BPD. Differences in help-seeking behavior, encouragement to seek help, help sources, and help-seeking attitudes were examined using three-step auxiliary analyses. Mixture logistic regression models assessed within-profile predictors.</p><p><strong>Results: </strong>Four borderline symptom profiles were identified in the full sample: Full Spectrum, Internalizing, Externalizing, and Asymptomatic. Among participants with lifetime NSSI (n = 581), help-seeking did not differ significantly across profiles, whereas encouragement to seek help and help-seeking attitudes did. Encouragement was the most consistent correlate of help-seeking across profiles, while attitudes were not reliably associated with help-seeking behavior. Among participants who had sought help and provided help-source data (n = 297), sources of help did not differ across profiles. There was no evidence that predictors of help-seeking differed across profiles.</p><p><strong>Conclusions: </strong>NSSI help-seeking did not differ significantly across borderline symptom profiles. Instead, encouragement from others to seek help was more consistently associated with help-seeking across profiles. This may be particularly important for individuals with more internalizing presentations, whose distress may be less visible and therefore less likely to elicit encouragement to seek support.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149065236","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}

{"title":"Elevated Negative Affectivity and Psychoticism in individuals with active Nonsuicidal Self-Injury (NSSI) compared with individuals with previous or no NSSI.","authors":"Christina Thylander, Magnus Nilsson, Danielle van Westen, Johannes Björkstrand, Sofie Westling","doi":"10.1186/s40479-026-00373-z","DOIUrl":"10.1186/s40479-026-00373-z","url":null,"abstract":"<p><strong>Background: </strong>Non-suicidal self-injury (NSSI) is a transdiagnostic symptom associated with substantial clinical burden and increased risk of suicidal behavior. Although NSSI occurs across a wide range of psychiatric disorders, research has consistently linked it to maladaptive personality traits. However, most studies have compared individuals with NSSI to healthy controls, limiting our understanding of which personality traits are specifically associated with NSSI. The inclusion of clinical control groups may therefore help clarify which personality traits are associated with NSSI rather than with psychopathology more broadly. This study aimed to investigate whether individuals with psychiatric disorders and active NSSI differ in personality traits, as assessed with the Personality Inventory for DSM-5 (PID-5), compared to those with prior but no active NSSI and those without a history of NSSI.</p><p><strong>Methods: </strong>231 individuals at a psychiatric outpatient unit completed the PID-5 and the Inventory of Statements About Self-injury and were assessed with regards to demographic information, psychiatric illness and previous suicide attempts. Symptom levels of depression and anxiety were measured. Participants were divided into groups of active NSSI (≥ 5 episodes in the past 12 months; n = 123), previous NSSI (≥ 5 episodes, but none in the past 12 months; n = 68) and no previous history of NSSI (n = 40).</p><p><strong>Results: </strong>Participants with active NSSI scored significantly higher in negative affectivity (F(2, 224) = 10.33, p < .001, η_p² = 0.08) and psychoticism (F(2, 224) = 8.91, p < .001, ηp² = 0.07), compared to those with a previous history of NSSI and those with no previous history of NSSI. The analyses were adjusted for age, sex assigned at birth and symptoms of depression and anxiety.</p><p><strong>Conclusions: </strong>Active NSSI seems to be associated with increased traits of negative affectivity and psychoticism. This study contributes with new knowledge regarding NSSI and personality traits, which may guide future research on mechanisms, etiology, and treatment approaches.</p><p><strong>Trial registration: </strong>The study was registered on Clinical Trials: NCT04905797, registration date April 29, 2021.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026402","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}

{"title":"Recovery from borderline personality disorder in relation to the concept of \"a life worth living\": a therapist perspective.","authors":"Josephine Ljungberg","doi":"10.1186/s40479-026-00352-4","DOIUrl":"10.1186/s40479-026-00352-4","url":null,"abstract":"<p><strong>Background: </strong>Despite increased interest in clients' subjective experiences of recovery from borderline personality disorder (BPD), qualitative research exploring how Dialectical Behavior Therapy (DBT) therapists conceptualize recovery and its relationship to DBT's overarching treatment goal, \"a life worth living,\" remains scarce. The aim of the present study was to explore DBT therapists' descriptions of recovery sufficient for treatment termination in clients with BPD, as well as to examine its relation to the concept of a life worth living.</p><p><strong>Methods: </strong>Eight semi-structured interviews with DBT therapists were conducted and analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Therapists described recovery as a transition from suffering to a life of normal freedom, viewed as an individual process in which clients at treatment termination had ceased self-destructive behaviors and acquired skills, leading to changes in self-image and self-acceptance and enabling the creation of a stable and viable way of life. Therapists perceived recovery and a life worth living as mutually reinforcing processes.</p><p><strong>Conclusions: </strong>The results emphasize early integration of clients' goals and values in DBT and clarify recovery at treatment termination as a clinically sufficient foundation for a life worth living, contributing to a practice-informed operationalization of recovery within DBT.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957073","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}

{"title":"Does changing clinicians' attitudes toward self-harm reduce coercive interventions in mental health inpatient settings? A quasi-experimental study of staff training.","authors":"Kristine Høst Poulsen, Carsten Hjorthøj, Bo Bach, Erik Simonsen, Mickey T Kongerslev","doi":"10.1186/s40479-026-00346-2","DOIUrl":"10.1186/s40479-026-00346-2","url":null,"abstract":"<p><strong>Background: </strong>Staff education may improve clinicians' attitudes toward self-harm, but whether this translates into reduced coercion is unclear. We evaluated a regional strategy to improve care for self-harming patients and its impact on staff attitudes and coercive interventions across services.</p><p><strong>Methods: </strong>Quasi-experimental dual design: (a) interrupted time-series of registry data on coercive interventions (Jan 2021-Dec 2024) and (b) three-wave pre-post surveys using the revised 17-item Self-Harm Antipathy Scale (SHAS-DR) at baseline, 2 months, and 8 months post-training. Change points: June 2022 (strategy announcement) and June 2023 (training implementation).</p><p><strong>Results: </strong>In registry data, coercive interventions declined after the strategy announcement (level IRR 0.39, 95% CI 0.21-0.73) with no subsequent trend change. A temporary increase occurred at the training point (level IRR 2.58, 95% CI 1.57-4.25), consistent with implementation disruption. Reductions were largest for mechanical restraints, particularly among self-harming patients, while rapid tranquillization remained most frequent. Annual coercive episodes fell from 1,280 (2021) to 409 (2024). Staff attitudes improved and were sustained. Mean SHAS-DR decreased from 40.0 (SD 10.8) at baseline to 34.8 (SD 7.4) at 2 months and 35.4 (SD 8.2) at 8 months; baseline-to-follow-up changes were significant (p ≤ 0.001).</p><p><strong>Conclusions: </strong>The strategy coincided with an immediate reduction in coercion and a transient rise during training, while staff attitudes reflected reduced antipathy toward people who self-harm. Sensitivity analyses suggested changes were not driven by high-frequency patients. Sustained reductions likely require continued organizational and relational supports.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708152","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}

{"title":"Transcutaneous auricular vagus nerve stimulation and emotional responding in borderline personality disorder: a randomized single-blind, sham-controlled study.","authors":"Giuseppe Guerriero, Anthony C Ruocco, Hanne K Carlsen, Alexander R Daros, Duaa Kosara, Steinn Steingrimsson","doi":"10.1186/s40479-026-00367-x","DOIUrl":"10.1186/s40479-026-00367-x","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) is characterized by severe emotional vulnerability, including heightened sensitivity, exaggerated reactivity, and delayed recovery from emotional arousal. Altered interoceptive-affective processing may contribute to these features. Transcutaneous auricular vagus nerve stimulation (taVNS) provides a non-invasive method for modulating vagal-afferent pathways involved in interoception and emotion regulation. This study examined whether active taVNS, relative to sham stimulation, was associated with lower self-reported negative affect during a video-based mood-induction paradigm in women with BPD.</p><p><strong>Methods: </strong>Thirty-four female psychiatric outpatients with DSM-5 BPD were randomized to receive active taVNS or sham stimulation during a single-session experimental paradigm. Self-reported negative affect was assessed repeatedly using the Positive and Negative Affect Schedule (PANAS) Negative Affect scale. The primary analysis modeled PANAS Negative Affect across four collapsed task phases: Pre-Induction, Post-Neutral, Post-Negative, and Recovery-Negative, adjusting for baseline negative affect and stimulation intensity. Exploratory physiological analyses examined heart rate, lnRMSSD, phasic electrodermal activity (EDA) response frequency, and tonic skin conductance level.</p><p><strong>Results: </strong>Active taVNS was associated with lower PANAS Negative Affect across the mood-induction paradigm compared with sham stimulation, Treatment Group: F(1, 36.44) = 5.74, p = 0.022. Negative affect varied significantly across task phases, F(3, 94.12) = 22.60, p < 0.001, confirming successful mood induction. The Treatment Group × Phase interaction was not significant, F(3, 94.12) = 0.75, p = 0.525. Exploratory physiological analyses showed no treatment-related effects on heart rate, lnRMSSD, or phasic EDA response frequency. Tonic skin conductance level showed no main effect of Treatment Group, but an exploratory Treatment Group × Epoch interaction.</p><p><strong>Conclusions: </strong>In this preliminary single-session randomized sham-controlled study, active taVNS was associated with lower self-reported negative affect during a mood-induction paradigm in women with BPD. This subjective effect was not accompanied by treatment-related effects on heart rate, lnRMSSD, or phasic EDA response frequency, while the tonic skin conductance interaction should be interpreted cautiously as exploratory. These findings support further investigation of taVNS as a mechanistic probe of acute affective responding in BPD.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05892900. Retrospectively registered 7 June 2023.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670942","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}

{"title":"Dissociative symptoms during the SARS-CoV-2 pandemic situation in mental health patients.","authors":"Max C Pensel, Johanna M H L Siems, Alexander Blazejak, Charlotte Steinau, Jana Fink, Marie-Therese Schmitz, Alexandra Philipsen, Henrik Rohner","doi":"10.1186/s40479-026-00363-1","DOIUrl":"10.1186/s40479-026-00363-1","url":null,"abstract":"<p><strong>Background: </strong>Dissociative symptoms arise in reaction to significant stress and are common in post-traumatic stress disorder (PTSD).</p><p><strong>Methods: </strong>We longitudinally investigated the course of dissociative symptoms in psychiatric patients over the first year of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic situation (04/2020-05/2021). The group was separated into patients with relevant symptoms of PTSD at study start (Group 1: PTSDG) and those without (Group 2: noPTSDG), and we also employed a control group (Group 3: CG). Dissociative symptoms were tracked using the \"Fragebogen zu Dissoziativen Symptomen\" (FDS), an adapted and extended German version of the \"Dissociative Experience Scale\" (DES). Datasets of 93 participants were analyzed over up to three time periods. In addition, the regional incidence of positive SARS-CoV-2 tests (7di) and the intensity of non-pharmacological interventions (NPI) were included in multilevel linear models.</p><p><strong>Results: </strong>Patients reported stronger dissociative symptoms in the PTSDG than in the noPTSDG, while the CG showed the lowest symptom intensity. Importantly, regarding the course of symptoms over time, while public counts of positive SARS-CoV-2 tests had no influence, dissociative symptom severity was significantly impacted by the intensity of non-pharmacological interventions, particularly in the PTSDG and regarding depersonalization and derealization.</p><p><strong>Conclusion: </strong>Patients with relevant symptoms of PTSD at study start suffered from intense dissociative symptoms over the first year of the SARS-CoV-2 pandemic situation, driven by non-pharmacological interventions. In a milder way, other psychiatric patients were also affected. The results underline the responsivity of these patient groups regarding social and political stress.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608852","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}

{"title":"Follow-up effects of a brief Good Psychiatric Management treatment for borderline personality disorder.","authors":"José Blanco Machinea, Loris Grandjean, Hélène Beuchat, Stéphane Kolly, Philippe Conus, Yves de Roten, Jérémie André, Hervé Tissot, Ueli Kramer","doi":"10.1186/s40479-026-00357-z","DOIUrl":"10.1186/s40479-026-00357-z","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) is among the most frequent, debilitating, and lethal mental conditions. Treatment for patients with BPD involves structured psychotherapy, but such treatment is often not readily available due to imbalances in supply and demand for care. Brief treatments that are available as first-line interventions may address this delay in care. No controlled study has assessed the effectiveness of brief psychiatric interventions, such as 10 sessions of Good Psychiatric Management (GPM) over 12 months follow-up, in comparison with treatment as usual. Whereas most psychotherapy studies in patients with BPD focus on symptom reduction at the end of treatment, more research is needed on the patients' symptom levels after one year.</p><p><strong>Methods: </strong>The present study compares brief psychiatric treatment (4 months of GPM) with treatment as usual (4 months of TAU). Participants (N = 76 patients with BPD) undergo assessments at intake, after two months, at discharge (4 months) and 1 year follow-up (16 months after intake). At these four time-points, each patient was assessed using the clinician rated Zanarini BPD (ZAN-BPD) scale.</p><p><strong>Results: </strong>The study found brief GPM to show significantly greater symptom reduction in ZAN-BPD scores between intake of 4-month treatment and 12-month follow-up (16 months later), compared to treatment as usual.</p><p><strong>Conclusion: </strong>This study shows that after one year, the effects of a brief psychiatric treatment are strengthened in both groups. Additionally, brief GPM presents an advantage in helping BPD patients make further progress after the intervention has ended, which potentially helps diminish the societal burden of disease related to BPD symptomatology.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457398","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}

{"title":"The role of different forms of adverse childhood experiences in borderline personality disorder: results from a network analysis including clinical and non-clinical populations.","authors":"Ruben Vonderlin, Büsra Senyüz, Carola Claus, Saskia Mahalingam, Anna Schulze, Stefan Koch, Ulrich Voderholzer, Christian Schmahl, Jürgen Margraf, Tobias Teismann, Nikolaus Kleindienst, Tali Boritz, Shelley McMain, Martin Bohus, Stefanie Lis","doi":"10.1186/s40479-026-00356-0","DOIUrl":"10.1186/s40479-026-00356-0","url":null,"abstract":"<p><strong>Background: </strong>Borderline Personality Disorder (BPD) has been associated with a range of adverse experiences, including emotional, physical, and sexual abuse, neglect, invalidation, bullying, and unpredictable environments during childhood and adolescence (ACE). While these different forms of ACE often co-occur, most research has examined them in isolation, leaving unclear their interrelations and specific significance for BPD psychopathology.</p><p><strong>Objective: </strong>This study investigates the level of different forms of ACE exposure in BPD and clinical controls, whether they are differentially related to the severity of BPD symptoms and how they are inter-related with each other.</p><p><strong>Methods: </strong>Cross-sectional data were collected from individuals diagnosed with BPD (n = 171), clinical controls (CC; n = 93), and non-clinical controls (NC; n = 73). BPD symptoms were measured using the BSL-23, while different types of ACE were assessed using the CTQ (abuse/neglect), ICES (invalidation), QUIC (unpredictability), and BSA (bullying). Graph-theoretical network analyses were conducted across groups to investigate associations between BPD symptom severity and ACE types, as well as interrelationships among ACEs. Data-driven community detection was applied to identify clusters of closely connected ACE types.</p><p><strong>Results: </strong>The BPD group showed higher ACE severity across all forms of ACE compared to CC and NC groups. Network analysis revealed unique associations between BPD symptom severity and emotional abuse, peer bullying, parental unpredictability, and lack of safety and security. Examination of interrelationships among ACE types resulted in a five-cluster solution demonstrating a complex pattern of unique associations.</p><p><strong>Conclusions: </strong>This study advances our understanding of how different forms of ACE relate to BPD psychopathology and how they are interrelated with each other. The findings suggest that the impact of ACE extends beyond physical and sexual abuse to include relational and environmental adversities with relevance for BPD symptom severity in adulthood.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"13 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449781","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}

{"title":"Case study: The DBT implementation journey of dialectical behaviour therapy in five European countries.","authors":"Amy Gaglia Essletzbichler, Miriam Bierman, Magdalena Skuza, Natálie Češková, Anita Johanna Tørmoen","doi":"10.1186/s40479-026-00359-x","DOIUrl":"10.1186/s40479-026-00359-x","url":null,"abstract":"<p><strong>Background: </strong>This paper is a narrative review of the implementation trajectories Dialectical Behaviour Therapy in five countries, the UK, Germany Norway, Poland, and the Czech Republic in Europe over the past 30 years. The aim of this comparison is to identify common and divergent systems levels facilitators and hindrances of DBT implementation.</p><p><strong>Methods: </strong>DBT experts in each respective country were asked to provide a narrative account of their country's implementation journey. Histories were then considered in accordance with existing DBT implementation frameworks.</p><p><strong>Results: </strong>Common themes emerged such as the importance national guidelines on evidence-based treatment shape implementation, university affiliations promote dissemination, implementation and research activities, national societies help to create standards.</p><p><strong>Conclusion: </strong>There are common DBT implementation trajectories that exist across geography and nationally specific mental health care systems. The discussion of the refining of national DBT practices based on emerging literature and the importance of outcomes of implementation such as therapists' behaviour or client related outcome data adds to existing information.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450085","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}

{"title":"Borderline personality symptom severity predicts reduced mentalization and affective empathy and altered responses to fairness in the Ultimatum Game.","authors":"Pascal Louis, Simon Rigoulot, Dominick Gamache, Audrey Bernier, Justine Le Blanc-Brillon, Claudia Savard, Sébastien Hétu","doi":"10.1186/s40479-026-00358-y","DOIUrl":"10.1186/s40479-026-00358-y","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality (BP) symptoms are characterized by emotional instability, impulsivity, and interpersonal difficulties. Deficits in mentalization (ability to attribute mental states to self and others) and affective empathy (congruent and incongruent emotional reactions), may contribute to these social impairments. This study investigated whether, in a community sample, mentalization and affective empathy mediate the relationship between BP symptom severity and altered social decision-making in the Ultimatum Game (UG), where participants were asked to accept/reject fair and unfair monetary offers from Proposers displaying various emotional facial expressions (happy, angry, neutral).</p><p><strong>Methods: </strong>A community sample of 111 participants completed a measure of BP symptom severity, a dispositional mentalization/affective empathy questionnaire, an emotion recognition task to assess behavioral mentalization, and played the role of Responders in the UG. Relations between BP symptom severity and mentalization and affective empathy measures were tested using hierarchical regressions. Social decision-making was analyzed using multilevel logistic regression models examining the effects of fairness, emotion, and BP symptom severity on acceptance decisions. The potential mediating role of mentalization and affective empathy was evaluated using multilevel mediation analyses.</p><p><strong>Results: </strong>Higher BP symptom severity was significantly associated with poorer dispositional affective empathy (on both resonance and dissonance scores). Higher BP symptom severity was also associated with lower dispositional mentalization and impaired behavioral mentalization, especially for the recognition of happiness and anger. In the UG, BP symptom severity interacted with fairness of the offer: individuals with higher BP symptom severity were less likely to accept fair offers, whereas acceptance of unfair offers did not differ as a function of symptom severity. BP symptom severity was not associated with differential sensitivity to Proposers' emotional expressions. Preliminary analyses indicated that mentalization and affective empathy were not associated with behavioral responses in the UG; therefore, mediation analyses were not conducted.</p><p><strong>Conclusions: </strong>Findings highlight mentalization and affective empathy impairments as important elements of BP symptomatology. However, altered social decision-making associated with BP symptoms appears to be specific to responses to fairness rather than to emotional expressions per se. Further research in clinical populations is needed to clarify the mechanisms underlying these interpersonal decision-making patterns.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413371","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}