Borderline Personality Disorder and Emotion Dysregulation最新文献

{"title":"Advancing the treatment of long-lasting borderline personality disorder: a feasibility and acceptability study of an expanded DBT-based skills intervention.","authors":"Joaquim Soler, Elisabet Casellas-Pujol, Juan Carlos Pascual, Carlos Schmidt, Elisabet Domínguez-Clavé, Ausias Cebolla, David Alvear, Anna Muro, Matilde Elices","doi":"10.1186/s40479-022-00204-x","DOIUrl":"10.1186/s40479-022-00204-x","url":null,"abstract":"<p><strong>Background: </strong>Long-term follow-up studies in patients with borderline personality disorder (BPD) consistently show persistent impairment in psychosocial adjustment, although symptoms tend to decrease over time. Consequently, it might be better to deemphasize symptom-oriented interventions and instead promote interventions that incorporate patient perspectives on recovery. In this study we aimed to examine the feasibility and acceptability of a novel intervention (dialectical behavioral therapy combined with positive psychology and contextual-based skills) in the clinical treatment of long-lasting BPD difficulties.</p><p><strong>Methods: </strong>This was a qualitative study. We developed an initial 8-week group intervention for long-lasting BPD. Upon completion of the 8-week program, the participants were asked to participate in a group discussion to provide feedback. Based on that feedback, the intervention protocol was modified and then offered to a second group of patients, who also provided feedback. The protocol was revised again and administered to a third group. A total of 32 patients participated in the group interventions; of these, 20 provided feedback in the qualitative study. The main outcome measure was acceptability.</p><p><strong>Results: </strong>The following overarching themes emerged from the group interviews: helpful, unhelpful and neutral practices; internal/external barriers; facilitators; and effects. Participants reported difficulties in imagining an optimal future and self-compassion. By contrast, positive skills were associated with an increase in positive emotions. The main internal barrier was facing difficult emotions. The main external barriers were language-related issues. The group format was perceived as a facilitator to success. Dropout rates, which were assessed as an additional measure of acceptability, decreased substantially in each successive group, from 60 to 40% and finally 20%.</p><p><strong>Conclusions: </strong>The intervention was feasible to implement in the clinical setting and participants rated the final set of skills highly. Most of the skills were considered useful. Participant feedback was invaluable to improve the intervention, as evidenced by the large increase in the retention rate from 40 to 80%. Randomized clinical trials are needed to test the efficacy of this intervention in promoting well-being in participants with long-lasting BPD.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"9 1","pages":"34"},"PeriodicalIF":4.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9743724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338704","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 impact of outcome expectancy on therapy outcome in adolescents with borderline personality disorder.","authors":"Anna-Valeska Bäumer,&nbsp;Lukas Fürer,&nbsp;Carolin Birkenberger,&nbsp;Andrea Wyssen,&nbsp;Martin Steppan,&nbsp;Ronan Zimmermann,&nbsp;Jens Gaab,&nbsp;Michael Kaess,&nbsp;Klaus Schmeck","doi":"10.1186/s40479-022-00200-1","DOIUrl":"https://doi.org/10.1186/s40479-022-00200-1","url":null,"abstract":"<p><strong>Background: </strong>Outcome expectancy has been found to be a significant predictor of psychotherapy outcome. However, given that severity, chronicity and comorbidity are moderators of outcome expectancy, it is important to provide evidence of whether the same holds true in clinical conditions marked by these attributes, such as in borderline personality disorder (BPD). The aim of the present study was to investigate the role of patients' outcome expectancy in adolescents undergoing early intervention for BPD using pre-post difference of psychosocial functioning as outcome.</p><p><strong>Methods: </strong>Forty-four adolescent BPD patients were treated with Dialectical Behavior Therapy for Adolescents (DBT-A) or Adolescent Identity Treatment (AIT). We investigated the effect of outcome expectancy on outcome with type of treatment as moderator. Based on the relevant literature, we assess the correlation between outcome expectancy and pretreatment symptomatology, namely BPD severity, personality functioning, childhood trauma and depression.</p><p><strong>Results: </strong>The results showed a significant effect of expectancy on outcome (stand. β = 0.30, p = 0.020) above autoregression. ANOVA analysis revealed no difference between the two treatments. Further, results indicate that pretreatment symptomatology, i.e., depression, childhood trauma and personality functioning dimensions self-direction and intimacy, are associated with early treatment expectancy.</p><p><strong>Conclusion: </strong>Outcome expectancy as a common factor plays a key role in successful psychotherapy with adolescent BPD patients. Elevated pretreatment depression, childhood trauma and impairment in personality functioning dimensions self-direction and intimacy are risk factors associated with lower expectancy. Low outcome expectancy should be addressed in early psychotherapy to improve the therapeutical process.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"30"},"PeriodicalIF":4.1,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9721041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40464358","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":"Evaluation of a skills-based peer-led art therapy online-group for people with emotion dysregulation.","authors":"Mahlie Jewell,&nbsp;Rachel C Bailey,&nbsp;Renae L Curran,&nbsp;Brin F S Grenyer","doi":"10.1186/s40479-022-00203-y","DOIUrl":"https://doi.org/10.1186/s40479-022-00203-y","url":null,"abstract":"<p><strong>Objective: </strong>We developed and piloted a novel art-based online skills program led by a peer mental health professional with lived experience of complex mental health, including Borderline Personality Disorder (BPD). Key challenges of living with BPD and emotion dysregulation were addressed through artmaking informed by a dialectical framework and skills, to evaluate acceptability and efficacy.</p><p><strong>Method: </strong>A structured, manualised 2-hour weekly arts-based skills program was piloted for people with BPD over 18 weeks. Evaluation included both quantitative and qualitative measures at commencement and completion.</p><p><strong>Results: </strong>Thirty-eight participants enrolled in the program (89.5% identified she/her pronouns, average age 33.6 years), and 31 completed (82% retention). Multilevel modelling analysis of the primary outcome variable Difficulties in Emotion Regulation Scale (DERS) demonstrated a large improvement over time (effect size Cohen's d = 1.77). Qualitative thematic analysis found participants had improved capacity to regulate emotions and tolerate distress, improved connection with others, enhanced understanding of the self, and higher hope for living well. We found that artmaking facilitated processes and helped the expression of difficult emotions, symbolise challenging relationships, and facilitate greater self-understanding. Participants reported high levels of satisfaction, and 77.4% reported that the program had increased wellbeing.</p><p><strong>Conclusion: </strong>This novel artmaking program for emotion dysregulation and BPD was acceptable and potentially effective. Peer facilitation using arts-based skills is a modality of therapy for further investigation.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":"9 1","pages":"33"},"PeriodicalIF":4.1,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10320752","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":"Maladaptive personality traits as predictors of prosocial and trusting behavior in two economic games.","authors":"Johanna Hepp,&nbsp;Melissa R M Mohr,&nbsp;Inga Niedtfeld","doi":"10.1186/s40479-022-00201-0","DOIUrl":"https://doi.org/10.1186/s40479-022-00201-0","url":null,"abstract":"<p><strong>Background: </strong>Dimensional models of personality disorders postulate interpersonal dysfunction as the core feature of personality pathology, and describe maladaptive personality traits that characterize the specific pattern of dysfunction that is experienced. Herein, we examined whether maladaptive traits predict prosocial and trusting behavior, both of which are highly relevant behaviors for interpersonal functioning. Specifically, we examined antagonism as a predictor of prosocial behavior in a dictator game, and suspiciousness as a predictor of trust in the faith game.</p><p><strong>Materials and methods: </strong>The study was preregistered and conducted online. The preregistration protocol is available at https://osf.io/er43j . Data and code are available at https://osf.io/2rvbg/ . Participants (N = 445) completed the German version of the Personality Inventory for DSM-5 to measure antagonism and suspiciousness. Additionally, they played the dictator game (more money taken away from another person indicates less prosocial behavior) and the faith game (choosing the sure choice instead of the faith choice indicates less trust). We conducted a linear regression model to test whether antagonism is associated with prosocial behavior in the dictator game and a logistic regression model to test whether suspiciousness predicts selection of the sure choice in the faith game.</p><p><strong>Results: </strong>As hypothesized, higher levels of antagonism were associated with less prosocial behavior in the dictator game. The remaining hypotheses were not supported, as suspiciousness was not significantly associated with the likelihood of choosing the sure choice in the faith game. Exploratory analyses on participants' estimates of the sure choice amount suggest successful experimental manipulation in the faith game.</p><p><strong>Conclusions: </strong>The results on antagonism and prosocial behavior are consistent with those of previous studies that used categorial classification systems of personality disorders or examined non-pathological personality traits. Potential explanations for the non-significant effects of suspiciousness are discussed, including the small size and range of the sure choice payoff and that the anonymity of the game may have precluded suspicious traits from expressing. Future research with higher stakes and known interaction partners is needed to further probe the effects of suspiciousness.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"32"},"PeriodicalIF":4.1,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40462972","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":"Trustworthiness judgments and Borderline Personality Disorder: an experimental study on the interplay of happiness and trustworthiness appraisals and the effects of wearing face masks during the Covid-19 pandemic in Germany.","authors":"Miriam Biermann,&nbsp;Anna Schulze,&nbsp;Franziska Unterseher,&nbsp;Marie Hamm,&nbsp;Konstantina Atanasova,&nbsp;Dagmar Stahlberg,&nbsp;Stefanie Lis","doi":"10.1186/s40479-022-00193-x","DOIUrl":"https://doi.org/10.1186/s40479-022-00193-x","url":null,"abstract":"<p><strong>Background: </strong>Judging positive emotional states or the trustworthiness of others is important for forming and maintaining social affiliations. Past studies have described alterations in these appraisal processes in Borderline Personality Disorder (BPD), which might have been exacerbated during the Covid-19 pandemic by the requirement to wear face masks. In the present study, we investigated in an online-survey a) whether social judgments are particularly strongly affected in individuals with BPD when they have to judge happiness and trustworthiness in facial stimuli covered by a mask, b) whether appraising a positive emotional state affects trustworthiness appraisals differentially in BPD and healthy individuals and c) whether social judgments are related to how individuals with BPD experience wearing masks during the pandemic.</p><p><strong>Methods: </strong>Participants (67 HC, 75 BPD) judged happiness and trustworthiness of faces with calm expression with and without masks. Additionally, data on participants' confidence in their judgments, the experience of the burden induced by wearing masks, the protective benefits of masks, and compliance to wearing masks were collected.</p><p><strong>Results: </strong>Happiness and trustworthiness were evaluated less confidently and less intense in the BPD group compared to HC. Masks reduced happiness and trustworthiness ratings in both groups. Lower happiness appraisals contributed to lower trustworthiness appraisals except for those with BPD and low levels of symptom severity. Lower trustworthiness ratings were associated with a higher burden, attributing a lower benefit to masks and lower compliance with wearing masks in BPD.</p><p><strong>Conclusions: </strong>Masks do not exacerbate deficits in social judgments. However, lower trustworthiness appraisals in general were linked with more negative evaluations of wearing masks in the BPD group.</p><p><strong>Trial registration: </strong>The aims and hypotheses were preregistered together with the design and planned analyses ( https://aspredicted.org/f5du7.pdf ). For findings of an additionally preregistered research question on the impact of adverse childhood experiences see supplementary material.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"27"},"PeriodicalIF":4.1,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40661562","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":"Effect of comorbid ADHD on mortality in women with borderline personality disorder.","authors":"Efthymios Kouppis,&nbsp;Bengt Gerdin,&nbsp;Charlotte Björkenstam,&nbsp;Emma Björkenstam,&nbsp;Lisa Ekselius","doi":"10.1186/s40479-022-00196-8","DOIUrl":"https://doi.org/10.1186/s40479-022-00196-8","url":null,"abstract":"<p><strong>Background: </strong>Many similarities exist between borderline personality disorder (BPD) and attention-deficit/hyperactivity disorder (ADHD), more so in women than in men. People with comorbid ADHD and BPD represent a subgroup of BPD patients with distinct symptom expression and, consequently, a different prognosis. We used Swedish national high quality registers to assess whether such comorbidity is related to increased mortality risk. The study focused on women with BPD because they are more likely than men to be clinically diagnosed with BPD and present a higher mortality risk, especially for unnatural causes of death, including suicide.</p><p><strong>Findings: </strong>In a cohort of 15 847 women diagnosed with BPD a subsequent clinical diagnosis of ADHD did not influence the overall risk of mortality, including suicide.</p><p><strong>Conclusions: </strong>Women with comorbid ADHD and BPD have a similar mortality risk as those only diagnosed with BPD.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"25"},"PeriodicalIF":4.1,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9623906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40447263","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":"Personality pathology in adolescence: relationship quality with parents and peers as predictors of the level of personality functioning.","authors":"Gabriele Skabeikyte-Norkiene,&nbsp;Carla Sharp,&nbsp;Paulina Anna Kulesz,&nbsp;Rasa Barkauskiene","doi":"10.1186/s40479-022-00202-z","DOIUrl":"https://doi.org/10.1186/s40479-022-00202-z","url":null,"abstract":"<p><strong>Background: </strong>The dimensional approach to personality pathology opens up the possibility to investigate adolescence as a significant period for the development of personality pathology. Recent evidence suggests that symptoms of personality pathology may change during adolescence, but the negative consequences such as impaired social functioning persist later on in life. Thus, we think that problems in social functioning may further predict personality impairments. The current study aimed at investigating the role of relationship quality with parents and peers for the prediction of the level of personality functioning across adolescence. We hypothesized that 1) relationship quality with both parents and peers will significantly account for the level of personality functioning in adolescence and 2) the importance of relationship quality with peers for the relation to impairments in personality functioning will increase with age.</p><p><strong>Methods: </strong>A community sample consisting of 855 adolescents aged 11-18 (M = 14.44, SD = 1.60; 62.5% female) from different regions in Lithuania participated in this study. Self-report questionnaires included the Levels of Personality Functioning Questionnaire to investigate personality impairments and the Network of Relationships Questionnaire to assess the quality of dyadic relationships.</p><p><strong>Results: </strong>Discord in the parent, but not peer relationships, was related to a more severe level of personality functioning across adolescence. Lower levels of closeness with parents accounted for higher impairments in personality functioning. The importance of closeness with peers for the explanation of the level of personality functioning increased with age.</p><p><strong>Conclusions: </strong>During the sensitive period for the development of a personality disorder, relationship quality with the closest adults and peers both remain important for the explanation of impairments in personality functioning.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"31"},"PeriodicalIF":4.1,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9579636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40339106","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":"Anger instability and aggression in Borderline Personality Disorder - an ecological momentary assessment study.","authors":"Corinne Neukel,&nbsp;Robin Bullenkamp,&nbsp;Markus Moessner,&nbsp;Karen Spiess,&nbsp;Christian Schmahl,&nbsp;Katja Bertsch,&nbsp;Sabine C Herpertz","doi":"10.1186/s40479-022-00199-5","DOIUrl":"https://doi.org/10.1186/s40479-022-00199-5","url":null,"abstract":"<p><strong>Background: </strong>Anger and aggression are core features of Borderline Personality Disorder (BPD), contributing strongly to the individual as well as the societal burden caused by the disorder. Across studies, patients with BPD have shown increased, more frequent and prolonged episodes of anger and reported an increased prevalence of reactive aggression. However, only a few studies have investigated anger and aggression in the patients' everyday lives and did not consider anger instability. In order to contribute knowledge about aggression and its association with anger intensity and anger instability in real-life in BPD the aim of the present study was to better characterize days with and without aggressive behaviors with regard to the patients' experienced anger.</p><p><strong>Methods: </strong>Patients with BPD and high aggression as well as healthy participants took part in an ecological momentary assessment (EMA) study assessing state anger and aggression three times per day over two weeks. Multilevel modeling was conducted and anger instability was operationalized by squared successive differences.</p><p><strong>Results: </strong>As expected, patients with BPD reported greater instability in their experienced anger compared to healthy participants. Most interestingly, in the BPD group the occurrence of aggressive behavior was significantly associated with anger intensity as well as anger instability. More precisely, on days when patients with BPD acted out aggressively, they reported higher anger intensity as well as greater anger instability than on days when they did not act out aggressively.</p><p><strong>Conclusion: </strong>Knowledge about what characterizes days with aggressive behaviors may help to improve interventions to reduce aggressive behavior and thus relieve the burden aggression causes for patients with BPD, their surroundings and society.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"29"},"PeriodicalIF":4.1,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33541464","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 self-efficacy in distress tolerance scale (SE-DT): a psychometric evaluation.","authors":"Sven Alfonsson,&nbsp;Karolina Mardula,&nbsp;Christine Toll,&nbsp;Martina Isaksson,&nbsp;Martina Wolf-Arehult","doi":"10.1186/s40479-022-00195-9","DOIUrl":"https://doi.org/10.1186/s40479-022-00195-9","url":null,"abstract":"<p><strong>Background: </strong>Skills training is believed to be essential in dialectical behavior therapy (DBT) and is also offered as a standalone intervention. There is a need to better understand each skills module's separate contribution to treatment outcomes. Several assessment instruments are available, but none of them provides specific information about patients' perceived ability to use skills promoting distress tolerance. The aim of the present study was to develop and evaluate the psychometric properties of a Swedish adaptation of the General Self-Efficacy scale (GSE) for skills use in distress tolerance - the Self-Efficacy in Distress Tolerance scale (SE-DT).</p><p><strong>Methods: </strong>Cross-sectional and longitudinal data were gathered in a non-clinical (NC) community sample (n = 407) and a clinical psychiatric (CP) sample (n = 46). Participants in the NC sample were asked to complete a set of 19 self-report instruments, including the SE-DT, and 45 participants repeated the assessment after 2 weeks. The patients in the CP sample filled out a subset of eight instruments; twenty patients repeated the assessment after completing a treatment intervention including mindfulness skills and distress tolerance skills or emotion regulation skills.</p><p><strong>Results: </strong>The analyses showed that the SE-DT is unidimensional with high internal consistency (Cronbach's alpha = .92) and good test-retest reliability (intraclass correlation = .74). The SE-DT also showed good convergent and divergent validity, demonstrating positive correlations with general self-efficacy and self-compassion, and negative correlations with difficulties in emotion regulation, psychiatric symptoms, and borderline symptoms. The SE-DT showed sensitivity to change, when pre- and post-treatment assessments were compared (Cohen's d = 0.82).</p><p><strong>Discussion: </strong>This is preliminary evidence that the SE-DT has adequate to good psychometric properties, supporting the use of a total sum score. The results indicate that the SE-DT can adequately measure the construct of self-efficacy with regard to dealing with distress and emotional crises. The instrument enables continued investigation of standalone skills training and the specific contribution of distress tolerance skills to treatment outcomes in DBT. Further studies are needed to investigate whether these results are valid in other populations. In addition, the field would benefit from a common definition of distress tolerance.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"23"},"PeriodicalIF":4.1,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9549621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33494953","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":"Identifying moderating factors during the preschool period in the development of borderline personality disorder: a prospective longitudinal analysis.","authors":"Kiran Boone,&nbsp;Alecia C Vogel,&nbsp;Rebecca Tillman,&nbsp;Amanda J Wright,&nbsp;Deanna M Barch,&nbsp;Joan L Luby,&nbsp;Diana J Whalen","doi":"10.1186/s40479-022-00198-6","DOIUrl":"https://doi.org/10.1186/s40479-022-00198-6","url":null,"abstract":"<p><strong>Background: </strong>Despite a growing literature detailing early childhood risk factors for borderline personality disorder (BPD), few studies have examined moderating factors that might mitigate or exacerbate the effects of those risk factors. The current study examined whether three preschool-age characteristics-impulsivity, emotional lability, and initiative-taking-moderated the relationship between known preschool-age risk factors and adolescent BPD symptoms.</p><p><strong>Methods: </strong>We performed multilevel modeling analyses in a sample (n = 151) from the Preschool Depression Study, a prospective longitudinal study with assessments from preschool through adolescence. Preschool risk factors included adverse childhood experiences, internalizing symptoms, and externalizing symptoms measured with parent clinical interviews. Preschool moderating factors were assessed via parent report and observational coding of temperament and behavior. The Borderline Personality Features Scale for Children measured BPD symptoms in adolescence.</p><p><strong>Results: </strong>We found that observed initiative-taking moderated the relationship between preschool internalizing symptoms and adolescent BPD symptoms (b = 0.57, p = .011) and moderated the relationship between preschool externalizing symptoms and adolescent BPD symptoms (b = 1.42, p = .013). Greater initiative-taking was associated with lower BPD risk for children with high internalizing or externalizing symptoms. Conversely, for children with low internalizing or externalizing symptoms, greater initiative-taking was associated with increased BPD risk.</p><p><strong>Conclusions: </strong>We identify a potential moderating factor in BPD development, offer novel targets for screening and intervention, and provide a framework for using early childhood observational assessments in BPD research. Our findings suggest the need for future research on early moderating factors in BPD development, which could inform early childhood interventions targeting those factors to mitigate the effects of potentially less malleable risk factors.</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":" ","pages":"26"},"PeriodicalIF":4.1,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9479250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360589","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}