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Coma Gonzalez AA, Vilella E, Gutiérrez-Zotes A. Social cognition in women with borderline personality disorder based on an exhaustive analysis of the Movie for Assessment of Social Cognition (MASC) categories. J Clin Psychol 2024; 80:1231-1242. [PMID: 38363876 DOI: 10.1002/jclp.23661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/21/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
A significant number of borderline personality disorder (BPD) symptoms are manifested in the interpersonal context. This can be explained by the difficulties in attributing the mental states of oneself and others, which constitutes social cognition. Errors in social cognition are interrelated with the affective, cognitive, impulsive, and interpersonal areas of the person with BPD. The aims of this study was to analyze social cognition in women with BPD compared with a control group and to analyze social cognition in BPD based on BPD symptoms and its severity. To assess social cognition, we used a full range of social cognition categories provided by the Movie for the Assessment of Social Cognition (MASC): correct theory of mind (ToM); attribution of mental states (thoughts, emotions, or intentions); errors of mentalization; types of ToM; and attribution of mental states through perceptive or cognitive cues and through hot or cold emotions. The MASC has high ecological validity and has been validated in Spanish. The sample comprised 79 women, including 47 women with BPD and 32 healthy women. Worse social cognition performance was observed in women with BPD. More severe borderline symptoms were related to worse functioning in the correct ToM and to errors of no mentalization. Involvement of the cognitive area in borderline symptoms was associated with worse functioning in correct ToM and worse social cognition in cognitive areas as well as with hypermentalization. This is the first study that uses all the MASC categories and considers BPD heterogeneity and its severity to study social cognition.
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Affiliation(s)
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)-CERCA, Tarragona, Spain
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Centro deinvestigación biomédica en red en salud mental (CIBERSAM), Salamanca, Spain
| | - Alfonso Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV)-CERCA, Tarragona, Spain
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), Tarragona, Spain
- Centro deinvestigación biomédica en red en salud mental (CIBERSAM), Salamanca, Spain
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Marrocu A, Kettner H, Weiss B, Zeifman RJ, Erritzoe D, Carhart-Harris RL. Psychiatric risks for worsened mental health after psychedelic use. J Psychopharmacol 2024; 38:225-235. [PMID: 38491857 PMCID: PMC10944581 DOI: 10.1177/02698811241232548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND Resurgent psychedelic research has largely supported the safety and efficacy of psychedelic therapy for the treatment of various psychiatric disorders. As psychedelic use and therapy increase in prevalence, so does the importance of understanding associated risks. Cases of prolonged negative psychological responses to psychedelic therapy seem to be rare; however, studies are limited by biases and small sample sizes. The current analytical approach was motivated by the question of whether rare but significant adverse effects have been under-sampled in psychedelic research studies. METHODS A "bottom margin analysis" approach was taken to focus on negative responders to psychedelic use in a pool of naturalistic, observational prospective studies (N = 807). We define "negative response" by a clinically meaningful decline in a generic index of mental health, that is, one standard error from the mean decrease in psychological well-being 4 weeks post-psychedelic use (vs pre-use baseline). We then assessed whether a history of diagnosed mental illness can predict negative responses. RESULTS We find that 16% of the cohort falls into the "negative responder" subset. Parsing the sample by self-reported history of psychiatric diagnoses, results revealed a disproportionate prevalence of negative responses among those reporting a prior personality disorder diagnosis (31%). One multivariate regression model indicated a greater than four-fold elevated risk of adverse psychological responses to psychedelics in the personality disorder subsample (b = 1.425, p < 0.05). CONCLUSION We infer that the presence of a personality disorder may represent an elevated risk for psychedelic use and hypothesize that the importance of psychological support and good therapeutic alliance may be increased in this population.
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Affiliation(s)
- Alessia Marrocu
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Hannes Kettner
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Brandon Weiss
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Richard J Zeifman
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - David Erritzoe
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Robin L Carhart-Harris
- Centre for Psychedelic Research, Division of Psychiatry, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- Carhart-Harris Lab, Departments of Neurology and Psychiatry, University of California San Francisco, San Francisco, CA, USA
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Belli GM, Law C, Obisie-Orlu IC, Eisen JL, Rasmussen SA, Boisseau CL. Course and clinical correlates of obsessive-compulsive disorder with or without comorbid personality disorder. J Affect Disord 2024; 348:218-223. [PMID: 38145841 PMCID: PMC10939496 DOI: 10.1016/j.jad.2023.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/13/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Personality disorders (PDs) are often comorbid with obsessive-compulsive disorder (OCD) which may influence symptom presentation and course. This investigation sought to examine the impact of comorbid PDs on clinical presentation and symptom chronicity in a large, prospective longitudinal OCD study. METHODS Participants (n = 263) were treatment-seeking adults with a primary diagnosis of OCD separated into two groups: individuals with and without a co-occurring PD. We conducted two-tailed t-tests to compare symptom severity, functioning, and quality of life between the OCD + PD group (n = 117) and the OCD w/o PD group (n = 146). Chronicity analyses were conducted to compare the amount of time in-episode for OCD and major depressive disorder (MDD) between the two groups. RESULTS The OCD + PD group reported greater OCD and depression severity, lower levels of psychosocial functioning and worse quality of life than the OCD w/o PD group. The OCD + PD group exhibited greater OCD and MDD symptom chronicity; over 5 years the OCD + PD group spent 16.2 % weeks longer at full criteria for OCD and three times as many weeks in episode for MDD than the OCD w/o PD group. LIMITATIONS Focusing on PDs as a group limited our ability to make observations about specific PDs. Further, the participants in our sample were predominantly White and all were treatment seeking which limits the generalizability of our findings. CONCLUSIONS Our results suggest that those with OCD and comorbid PDs present with greater overall impairment and may require additional considerations during treatment conceptualization and planning.
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Affiliation(s)
- Gina M Belli
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Clara Law
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Immanuela C Obisie-Orlu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jane L Eisen
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA
| | - Christina L Boisseau
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Chen H, Hong L, Tong S, Li M, Sun S, Xu Y, Liu J, Feng T, Li Y, Lin G, Lu F, Cai Q, Xu D, Zhao K, Zheng T. Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study. BMC Psychiatry 2023; 23:247. [PMID: 37046299 PMCID: PMC10099683 DOI: 10.1186/s12888-023-04726-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempts (SAs) by adolescent patients with depression have become serious public health problems. There is still insufficient research evidence on the effects of NSSI and SAs on neurocognitive functioning in adolescents. Cognitive function alterations may be associated with SAs and self-injury. NSSI and SAs have different influencing factors. METHODS Participants were recruited from outpatient clinics and included 142 adolescent patients with depression (12-18 years old). This cohort included the SAs group (n = 52), NSSI group (n = 65), and depression without SAs/NSSI control group (n = 25). All participants underwent a clinical interview and neuropsychological assessment for group comparisons, and post-hoc tests were performed. Finally, partial correlation analysis was used to explore factors related to changes in cognitive function. RESULTS The SAs group performed significantly worse than the control group in executive function and working memory. The depression score was directly proportional to the executive function of the SAs group, whereas cognitive functioning in the NSSI group was associated with borderline traits and rumination. CONCLUSIONS These findings suggest that impairment of executive function and working memory may be a common pattern in adolescent depressed patients with SAs. However, borderline traits and rumination may be indicative of NSSI but not SAs.
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Affiliation(s)
- Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, 325035, Wenzhou, China
| | - Lan Hong
- The Third Hospital of QuZhou, 324000, Quzhou, China
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Mengjia Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Tianqi Feng
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Yuting Li
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China
| | - Guangyao Lin
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Fanfan Lu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Qiaole Cai
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China
| | - Dongwu Xu
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Ke Zhao
- Lishui Second People's Hospital Afliated to Wenzhou Medical University, 323000, Lishui, China.
- School of Mental Health, Wenzhou Medical University, 325035, Wenzhou, China.
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, 325035, Wenzhou, China.
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Wang Q, An S, Shao Z. Psychological intervention for negative emotions aroused by COVID-19 pandemic in university students: A systematic review and meta-analysis. PLoS One 2023; 18:e0283208. [PMID: 37167313 PMCID: PMC10174553 DOI: 10.1371/journal.pone.0283208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 03/03/2023] [Indexed: 05/13/2023] Open
Abstract
The COVID-19 pandemic has been suggested to cause psychological problems such as anxiety, depression, panic, and insomnia. This systematic review and meta-analysis aims to assess the efficacy of psychological interventions (including CBT, DBT, and mindfulness based interventions) in reducing distressing feelings in college students during the COVID-19 pandemic. Randomized controlled trials (RCTs) on psychological interventions for reducing negative emotions among college students during the COVID-19 epidemic were searched in databases Web of Science, PubMed, Cochrane Library, Embase, Scopus, PsychInfo, CNKI, WanFang, and VIP. We utilized Cochrane risk of bias assessment technique to assess the quality of included RCTs. The data were analyzed using RevMan 5.4. Eight RCTs were finally included involving 1,496 participants. According to the meta-analysis results, psychotherapies could significantly alleviate anxiety, depression, and stress symptoms among university students, [MD = -0.98, 95%CI (-1.53, -0.43), p<0.001] [SMD = -0.47, 95%CI (-0.77, -0.16), p = 0.003] [MD = -1.53, 95%CI (-2.23, -0.83), p <0.001]. The difference in attenuation of somatization symptoms between the two groups was not statistically significant [SMD = -0.42, 95%CI (-1.41, 0.56), p = 0.40]. Psychotherapy might effectively alleviate anxiety, depression, and stress in university students caused by the COVID-19 pandemic. It could be considered the preferred strategy for reducing negative emotions and improving the quality of life of university students.
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Affiliation(s)
- Qing Wang
- School of Education Science, Nanjing Normal University, Nanjing, China
| | - Senbo An
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zebin Shao
- School of Education Science, Nanjing Normal University, Nanjing, China
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Moyes E, Nutman G, Mirman JH. The Efficacy of Targeted Mindfulness-Based Interventions for Improving Mental Health and Cognition Among Youth and Adults with ACE Histories: A Systematic Mixed Studies Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1165-1177. [PMID: 36439656 PMCID: PMC9684378 DOI: 10.1007/s40653-022-00454-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 06/16/2023]
Abstract
Mindfulness-based interventions (MBIs) are associated with increased psychological wellbeing. The literature suggests that individuals exposed to adverse childhood experiences (ACEs) may benefit greatly from MBIs. However, research has tended to focus on universal MBIs for this population with less attention on the effectiveness of targeted approaches. Moreover, there is growing concern regarding the methodological rigor of MBI research. This systematic mixed studies review (SMRS) reports the effectiveness of MBIs for improving mental health and cognition among individuals with ACE histories. Additionally, the review reports the quality and rigor of the included research. Systematic searches of PsycInfo, EMBASE, MEDLINE, ProQuest Dissertations and Theses, ProQuest Social Science database and the Child Development and Adolescent Studies database were conducted. Results were screened and data were extracted then synthesized using a data-based convergent synthesis design. Thirteen studies were included in the final review. Six prominent themes emerged. Themes indicated that MBIs were effective for improving mental health and cognition for individuals with ACEs. For example, improvements in mood and anxieties, as well as a better ability to manage emotions. Shortcomings in the quality of MBI research included lack of reporting of methodological details (e.g., randomization procedures) and not systematically reporting adverse event evaluations. Recommendations are made for future research to strengthen the evidence base for MBIs for individuals with ACEs. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-022-00454-5.
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Affiliation(s)
- Ellie Moyes
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - George Nutman
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - Jessica Hafetz Mirman
- Department of Clinical and Health Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
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Haslam R, Heiderscheit A, Himmerich H. A Systematic Review of Scientific Studies on the Effects of Music in People with Personality Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315434. [PMID: 36497510 PMCID: PMC9741013 DOI: 10.3390/ijerph192315434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/12/2022] [Accepted: 11/19/2022] [Indexed: 05/28/2023]
Abstract
Personality Disorders (PDs) are psychiatric conditions involving maladaptive personality traits and behaviours. Previous research has shown that musical preferences and the use of music may be related to personality traits. Additionally, music therapy is increasingly being used as a treatment option for people with PDs. Using the PRISMA guidelines, a systematic literature search was undertaken using three databases: PubMed, Web of Science, and PsycInfo. The following search terms were used: PubMed: "personality disorder" AND (music OR "music therapy"); Web of Science (advanced search): TS = (personality disorder) AND TS = (music or "music therapy"); PsycInfo: "personality disorder" AND (music OR "music therapy"). A total of 24 studies were included in this review and summarised into four categories: music preference, music therapy, music performance, and music imagery, all in relation to PDs or traits associated with PDs. The analysis found that individuals with personality traits associated with PDs may prefer different types or genres of music or interact with music differently than those without these traits. Additionally, music therapy (MT) was found to offer a potentially useful treatment option for PDs. The power of these findings was limited by the small number of included studies. This review offers a useful foundation upon which further research looking at MT as a potential treatment option for PDs can be built.
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Affiliation(s)
- Rowan Haslam
- Mental Health Studies Programme, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
| | - Annie Heiderscheit
- Department of Music Therapy, Augsburg University, Minneapolis, MN 55454, USA
| | - Hubertus Himmerich
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
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8
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Stone BM. The Pathogenesis of Borderline Personality Disorder: Evolution of Evidence and Treatment Implications for Two Prominent Models. Psychol Rep 2022:332941221127618. [PMID: 36112891 DOI: 10.1177/00332941221127618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Since Stern first started his work in 1938, the field has recognized several empirically supported models of the etiology of borderline personality disorder (BPD). Two such models are the Tripartite Model of the Development of BPD and the Biosocial Development Model of BPD. The Tripartite Model of the Development of BPD suggests that it is a combination of a hyperbolic temperament, traumatic childhood experiences, and an event or series of events that trigger the onset of BPD. Whereas the Biosocial Development Model of BPD elaborates on the work of Linehan's Biosocial Theory. This model suggests a combination of an emotionally vulnerable temperament and an invalidating environment cause BPD. Over 70 years of research support these models. This article covers a detailed description of each of these models, the decades of research supporting these models, similarities, differences, treatment implications, the latest research, and future directions.
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Romeu-Labayen M, Tort-Nasarre G, Rigol Cuadra MA, Giralt Palou R, Galbany-Estragués P. The attitudes of mental health nurses that support a positive therapeutic relationship: The perspective of people diagnosed with BPD. J Psychiatr Ment Health Nurs 2022; 29:317-326. [PMID: 33938079 DOI: 10.1111/jpm.12766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/19/2021] [Accepted: 04/23/2021] [Indexed: 01/29/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Some nurses develop positive relationships with people diagnosed with borderline personality disorder (BPD), while others have negative emotional reactions to people diagnosed with this disorder. The therapeutic relationship is key in the practice of mental health nursing. Enhanced knowledge of BPD allows mental health nurses to develop improved self-awareness, knowledge and understanding of the individuals and insight into the therapeutic challenges, which can improve attitudes towards people with this diagnosis. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We are lacking knowledge about the perspective of people diagnosed with BPD on the attitudes of mental health nurses that facilitate a positive therapeutic relationship. The perspective of people with a BPD diagnosis on the therapeutic relationship offers key information about the attitudes that they credit with supporting their recovery. The participants-people diagnosed with BPD-perceived that the following attitudes of mental health nurses reinforced the therapeutic relationship: confidence in the person's recovery, non-judgement, sense of humour, availability and humanity. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study highlights mental health nurses' attitudes that participants perceived as having a positive effect on the therapeutic relationship. The recognition among people diagnosed with BPD of the constructive attitudes of mental health nurses may improve nurses' motivation to improve care for these patients. This study will allow mental health nurses to increase their awareness of the importance of attitude in the therapeutic relationship with people diagnosed with BPD. ABSTRACT: Introduction The therapeutic relationship between mental health nurses and people diagnosed with borderline personality disorder (BPD) is essential to successful treatment, and nurses' attitudes are a key component of this relationship. Some nurses develop positive therapeutic relationships with people diagnosed with BPD, while others have negative emotional reactions which in turn limit their ability to develop a positive therapeutic relationship. There is a gap in the literature with respect to how people diagnosed with BPD perceive the attitudes of mental health nurses that foster a positive therapeutic relationship. Aim To describe how people diagnosed with BPD who have experienced an improvement perceive the role of the attitudes of mental health nurses in building a positive therapeutic relationship. Method Qualitative descriptive design with 12 interviews; thematic content analysis. Results Participants identified five attitudes of mental health nurses as contributing to a positive therapeutic relationship: confidence in their ability to recover, non-judgement, humour, availability and humanity. Discussion Nurses' attitudes are key to the therapeutic relationship. It may be possible for nurses to improve their attitudes towards patients diagnosed with BPD through self-reflection. Implications for practice Mental health nurses should incorporate methods that explore attitudes and attitudinal development of the workforce.
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Affiliation(s)
- Maria Romeu-Labayen
- Adult Mental Health Center Horta Guinardó, Barcelona, Spain.,Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain
| | - Glòria Tort-Nasarre
- GREpS. Health Education Research Group, University of Lleida, Lleida, Spain.,Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - M Assumpta Rigol Cuadra
- Department of Public Health, Mental Health and Mother-Infant Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, L'Hospitalet del Llobregat, Spain.,AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain
| | - Rosa Giralt Palou
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.,Division of Mental Health, CNS, MSN, Althaia Foundation, Manresa, Spain
| | - Paola Galbany-Estragués
- AFIN Research Group, Autonomus University of Barcelona, Bellaterra, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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10
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Ho W, Kolla NJ. The endocannabinoid system in borderline personality disorder and antisocial personality disorder: A scoping review. BEHAVIORAL SCIENCES & THE LAW 2022; 40:331-350. [PMID: 35575169 DOI: 10.1002/bsl.2576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/06/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Individuals with borderline personality disorder (BPD) or antisocial personality disorder (ASPD) are overrepresented in forensic settings. Yet, despite the burden these disorders place on healthcare and criminal justice systems, there remains a lack of evidence-based pharmacological treatments. Epidemiological data have shown that comorbid cannabis use disorders are common in BPD and ASPD. ∆9 -Tetrahydrocannabinol, the primary psychoactive constituent of cannabis, is an exogenous cannabinoid that stimulates the endocannabinoid system (ECS). Hence, an investigation of the ECS in these conditions is warranted. This scoping review screened 105 records and summarized the extant research on the ECS in ASPD (n = 69) and BPD (n = 61) participants. Preliminary results suggest that alterations of the ECS may be present in these disorders. Although research examining the ECS in personality disorders is still in its infancy, more research is warranted given initial positive findings.
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Affiliation(s)
- Wilson Ho
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nathan J Kolla
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
- Waypoint/University of Toronto Research Chair in Forensic Mental Health Science, Penetanguishene, ON, Canada
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11
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Zhuo C, Chen G, Lin C, Jia F, Yang L, Zhang Q, Chen J, Tian H, Jiang D. A borderline personality assessment for adolescents: Validity and reliability of the Chinese languages borderline personality features scale (short form version) for adolescents/children. Front Psychiatry 2022; 13:1050559. [PMID: 36590618 PMCID: PMC9798434 DOI: 10.3389/fpsyt.2022.1050559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is characterized by behavioral patterns that promote suffering in many adolescents and their guardians. Currently, early diagnosis of BPD mainly depends on the effective assessment of pathological personality traits (i.e., borderline personality features) and using the indicated scales. The Borderline Personality Features Scale for Children-Short Form (BPFSC-SF) is widely used and the introduction of a Chinese version of the BPFSC-SF, can improve the diagnosis and prognosis of Chinese patients with BPD. OBJECTIVE The aim of the present study was to assess the validity and reliability of the Chinese version of the BPFSC-SF. METHOD 120 adolescents with BPD were enrolled in the present study and completed the BPFSC-SF and the Personality Belief Questionnaire-Short Form (PBQ-SF) assessments. Confirmatory factor analysis (CFA) was used to test assessment validity. Test-retest correlations and the Cronbach's α coefficients were used to determine reliability. RESULTS CFA analysis identified primary factors of BPFSC, with each item ranging from 0.597~0.899. The Spearman rank correlation coefficient was 0.877 between CL-BFSFC-SF and the state vs. trait loneliness scale. The Cronbach's α of the scale was 0.854 in the clinical group. The test-retest reliability correlation coefficient (interclass correlation coefficients.ICC) was 0.937. CONCLUSION The Chinese version of BPFSC-SF is a valid and reliable tool for adolescent Chinese patients with BPD.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China.,Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,PNGC_Lab, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Feng Jia
- PNGC_Lab, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Lei Yang
- Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Qiuyu Zhang
- Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Jiayue Chen
- Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Hongjun Tian
- Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
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12
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Saini AK, Wal P, Wal A, Pal RS, Verma OP. A Narrative Review on Dialectical Behavior Therapy for Patients with Depressive Difficulties. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2021. [DOI: 10.2174/2666082218666211220153312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy (CBT) that was earlier intended to treat only patients with borderline personality disorder (BPD), but researchers have found DBT to treat several psychological disorders, including depression.
Aim:
The article aims to review the clinical shreds of evidence regarding the use of DBT to treat depression.
Methods:
PubMed literature search was done by applying the year filter range, 2010 to 2021. Another filter applied was "Randomized controlled trial", so that the strength of evidence could be enhanced. The keywords used were "Dialectical Behavior Therapy" AND "Depression
Results:
33 articles were found, out of which only 20 relevant articles were reviewed. DBT was found to alleviate depressive symptoms associated with different psychological disorders like bipolar disorder and BPD but the number of studies that validated the afore-mentioned were less than those studies which showed that DBT had no significant effect on the patients with depressive difficulties. The long-term effect of DBT for treating depression is under a suspect, as studies showed DBT got ineffective during the follow-ups
Conclusion:
DBT shows benefits in depression but further studies are still required to validate this concretely as DBT did not show a significant effect when compared to its control counterparts. There is much need for future studies which can evaluate the long-term efficacy of DBT in depression is another challenging area because follow-up data did not favor DBT.
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Affiliation(s)
- Aryendu Kumar Saini
- Department of Psychology, Indira Gandhi National Open University, Banaras Hindu University (B.H.U.) Regional Centre, Varanasi, India
| | - Pranay Wal
- Department of Pharmacy, Pranveer Singh Institute of Technology, Kanpur, India
| | - Ankita Wal
- Department of Pharmacy, Pranveer Singh Institute of Technology, Kanpur, India
| | - Rashmi Saxena Pal
- Department of Pharmacy, Pranveer Singh Institute of Technology, Kanpur, India
| | - Om Prakash Verma
- Department of Pharmacy, Pranveer Singh Institute of Technology, Kanpur, India
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13
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Chen SY, Cheng Y, Zhao WW, Zhang YH. Effects of dialectical behaviour therapy on reducing self-harming behaviours and negative emotions in patients with borderline personality disorder: A meta-analysis. J Psychiatr Ment Health Nurs 2021; 28:1128-1139. [PMID: 34519138 DOI: 10.1111/jpm.12797] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/26/2021] [Accepted: 09/07/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Dialectical behaviour therapy(DBT) has been widely used for borderline personality disorder(BPD). Existing studies are limited to behaviours such as self-harm, and the results for reducing self-harm were controversial. Few have systematically evaluated the effect of DBT on self-harming behaviours and negative emotions. AIM This study aims to evaluate the effects of DBT on self-harming behaviours and negative emotions in patients with BPD. METHODS RCTs on DBT for BPD were searched from PubMed, Embase, etc., and the results were performed by RevMan 5.3. RESULTS The meta-analysis demonstrated that DBT reduced self-harming behaviours, and alleviated depression, but had a negligible effect on suicidal ideation and anger. One subgroup revealed that standard DBT improved depression significantly, but DBT skills training improved poorly. Another subgroup revealed that there was a significant reduction in depression among patients receiving DBT for 4 months to 14 months, but not at 4 months. DISCUSSION AND IMPLICATIONS FOR PRACTICE Findings indicate that DBT can reduce self-harming behaviours and improve depression, but effects on suicidal ideation and anger are insignificant. Subgroup analysis suggests that standard DBT and DBT-ST lasting beyond 4 months benefits on BPD. Given the quality and quantity restrictions of RCTs, more high-quality RCTs need to verify these effects.
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Affiliation(s)
- Shu-Yan Chen
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yin Cheng
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Wei-Wei Zhao
- School of Nursing, Nanjing Medical University, Nanjing, China.,Department of Nursing, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yan-Hong Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China.,Department of Nursing, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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14
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Laursen SL, Helweg-Jørgensen S, Langergaard A, Søndergaard J, Sørensen SS, Mathiasen K, Lichtenstein MB, Ehlers LH. Mobile Diary App Versus Paper-Based Diary Cards for Patients With Borderline Personality Disorder: Economic Evaluation. J Med Internet Res 2021; 23:e28874. [PMID: 34762057 PMCID: PMC8663638 DOI: 10.2196/28874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 01/27/2023] Open
Abstract
Background The cost-effectiveness of using a mobile diary app as an adjunct in dialectical behavior therapy (DBT) in patients with borderline personality disorder is unknown. Objective This study aims to perform an economic evaluation of a mobile diary app compared with paper-based diary cards in DBT treatment for patients with borderline personality disorder in a psychiatric outpatient facility. Methods This study was conducted alongside a pragmatic, multicenter, randomized controlled trial. The participants were recruited at 5 Danish psychiatric outpatient facilities and were randomized to register the emotions, urges, and skills used in a mobile diary app or on paper-based diary cards. The participants in both groups received DBT delivered by the therapists. A cost-consequence analysis with a time horizon of 12 months was performed. Consequences included quality-adjusted life years (QALYs), depression severity, borderline severity, suicidal behavior, health care use, treatment compliance, and system usability. All relevant costs were included. Focus group interviews were conducted with patients, therapists, researchers, and industry representatives to discuss the potential advantages and disadvantages of using a mobile diary app. Results A total of 78 participants were included in the analysis. An insignificantly higher number of participants in the paper group dropped out before the start of treatment (P=.07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and recorded an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. Participants in both groups had a QALY gain and a decrease in depression severity, borderline severity, and suicidal behavior. Significant differences were found in favor of the paper group for both QALY gain (adjusted difference −0.054; SE 0.03) and reduction in depression severity (adjusted difference −1.11; SE 1.57). The between-group difference in total costs ranged from US $107.37 to US $322.10 per participant during the 12 months. The use of services in the health care sector was similar across both time points and groups (difference: psychiatric hospitalization <5 and <5; general practice −1.32; SE 3.68 and 2.02; SE 3.19). Overall, the patients showed high acceptability and considered the app as being easy to use. Therapists worried about potential negative influences on the therapist-patient interaction from new work tasks accompanying the introduction of the new technology but pointed at innovation potential from digital database registrations. Conclusions This study suggests both positive and negative consequences of mobile diary apps as adjuncts to DBT compared with paper diary cards. More research is needed to draw conclusions regarding its cost-effectiveness. Trial Registration ClinicalTrials.gov NCT03191565; http://clinicaltrials.gov/ct2/show/NCT03191565 International Registered Report Identifier (IRRID) RR2-10.2196/17737
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Affiliation(s)
- Sidsel Lund Laursen
- Department of Clinical Medicine, Danish Center for Healthcare Improvements, Aalborg University, Aalborg Oest, Denmark
| | - Stig Helweg-Jørgensen
- Research Unit for Telepsychiatry and E-mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Astrid Langergaard
- Department of Clinical Medicine, Danish Center for Healthcare Improvements, Aalborg University, Aalborg Oest, Denmark
| | - Jesper Søndergaard
- Department of Clinical Medicine, Danish Center for Healthcare Improvements, Aalborg University, Aalborg Oest, Denmark
| | - Sabrina Storgaard Sørensen
- Department of Clinical Medicine, Danish Center for Healthcare Improvements, Aalborg University, Aalborg Oest, Denmark
| | - Kim Mathiasen
- Research Unit for Telepsychiatry and E-mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mia Beck Lichtenstein
- Research Unit for Telepsychiatry and E-mental Health, Mental Health Services in the Region of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Holger Ehlers
- Department of Clinical Medicine, Danish Center for Healthcare Improvements, Aalborg University, Aalborg Oest, Denmark
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15
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O Donnell R, Savaglio M, Vicary D, Skouteris H. Effect of community mental health care programs in Australia: a systematic review. Aust J Prim Health 2020; 26:443-451. [PMID: 33038938 DOI: 10.1071/py20147] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
Although numerous studies have examined the effects of community-based mental health care programs in Australia, no synthesis of this literature exists. This systematic review of peer-reviewed and grey literature described the types of community-based mental health care programs delivered and evaluated in Australia in the past 20 years, and evaluated their impact in improving outcomes for those with a serious mental illness (SMI). Articles were included if they evaluated the extent to which the programs delivered in Australia improved individual outcomes, including hospitalisations, psychiatric symptoms, substance misuse or psychosocial outcomes, for individuals with an SMI. Forty studies were included. Community-based mental health care programs were categorised into three types: case management (n=23), therapeutic (n=11) and lifestyle (n=6). Therapeutic programs were most effective in reducing psychiatric symptoms. Case management approaches yielded significant improvements in psychosocial outcomes. Lifestyle programs were inconclusive in improving individual outcomes. This review provides support for the implementation of community-based mental health care programs that are informed by both therapeutic and case management principles. A multidisciplinary team that can facilitate the provision of therapeutic and psychosocial support may be most beneficial for those with an SMI within the Australian community.
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Affiliation(s)
- Renee O Donnell
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Locked Bag 29, Clayton, Vic. 3168, Australia
| | - Melissa Savaglio
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Locked Bag 29, Clayton, Vic. 3168, Australia
| | - Dave Vicary
- Baptcare, Level 1/1193 Toorak Road, Camberwell, Vic. 3124, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, Level 1, 43-51 Kanooka Grove, Locked Bag 29, Clayton, Vic. 3168, Australia; and Warwick Business School, University of Warwick, Scarman Road, Coventry CV4 7AL, UK; and Corresponding author.
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16
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Wasmuth S, Mokol E, Szymaszek K, Gaerke KJ, Manspeaker T, Lysaker P. Intersections of occupational participation and borderline personality disorder: A grounded theory approach. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1803580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sally Wasmuth
- Department of Occupational Therapy, School of Health & Human Sciences, Indiana University, Purdue University (IUPUI), Indianapolis, IN, USA
| | - Emily Mokol
- School of Occupational Therapy, College of Health Sciences, University of Indianapolis, Indianapolis, IN, USA
| | | | | | | | - Paul Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, USA
- Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, IN, USA
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17
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Austin SF, Jansen JE, Petersen CJ, Jensen R, Simonsen E. Mobile App Integration Into Dialectical Behavior Therapy for Persons With Borderline Personality Disorder: Qualitative and Quantitative Study. JMIR Ment Health 2020; 7:e14913. [PMID: 32525488 PMCID: PMC7317633 DOI: 10.2196/14913] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/18/2019] [Accepted: 03/19/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The advancement of and access to technology such as smartphones has implications for psychotherapeutic health care and how interventions for a range of mental health disorders are provided. OBJECTIVE The objective of this study was to describe the experiences of participants while using a mobile phone app that was designed to enhance and support dialectical behavior therapy for personality disorders. METHODS A combination of in-depth interviews and questionnaires were used to capture the experiences of participants who used the app while undergoing dialectical behavior therapy treatment. A mixed methods approach was used; qualitative data from the interviews were analyzed using thematic analysis and were combined with quantitative data from the questionnaires. RESULTS Participants (N=24) who were receiving dialectical behavior therapy used the trial app. Participants (n=20) completed an evaluation questionnaire and a subset of this group (n=8) participated in semistructured interviews. Major themes that were identified from the interviews were (1) an overall positive experience of using the app-participants perceived that the app facilitated access and implementation of dialectical behavior therapy strategies (to regulate mood and behavior in challenging situations)-and (2) that the app provided a common source of information for patient and therapist interactions-app-based interactions were perceived to facilitate therapeutic alliance. Qualitative themes from the interviews were largely congruent with the quantitative responses from the questionnaires. CONCLUSIONS Participants welcomed the integration of technology as a supplement to clinical treatment. The app was perceived to facilitate and support many of the therapeutic techniques associated with dialectical behavior therapy treatment. The incorporation of technology into psychotherapeutic interventions may facilitate the transfer of knowledge and strategies that are learned in therapy to use in real-world settings thereby promoting recovery from mental health problems.
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Affiliation(s)
- Stephen F Austin
- Department of Psychiatric Research, Region Zealand Psychiatry, Slagelse, Denmark
| | | | | | - Rasmus Jensen
- Psychiatry West, Region Zealand Psychiatry, Holbaek, Denmark
| | - Erik Simonsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatric Research, Region Zealand Psychiatry, Slagelse, Denmark
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18
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Quetsch LB, Herschell AD, Kogan JN, Gavin JG, Hale G, Stein BD. Community-based behavioral health administrator perspectives on sustainability of Dialectical Behavior Therapy: a qualitative evaluation. Borderline Personal Disord Emot Dysregul 2020; 7:5. [PMID: 32161650 PMCID: PMC7047370 DOI: 10.1186/s40479-020-0120-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/11/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Substantial resources have been invested in evidence-based practice (EBP) implementation in community settings; however, research suggests that EBPs do not always sustain over time. METHOD This qualitative study explored the perspectives of 13 community behavioral health agency leaders regarding the sustainability of an EBP 25 to 28 months following the original training period. Administrators from 10 agencies were interviewed to understand the complexities of the implementation process, sustainability of Dialectical Behavior Therapy, and their recommendations to enhance implementation and sustainability. RESULTS A content analysis revealed five emergent themes: treatment model opinions, resource concerns, staff selection/ turnover, population characteristics, and recommendations for future implementation. CONCLUSIONS These themes likely would be helpful in informing the design of future implementation and sustainability initiatives sensitive to the challenges of integrating EBPs in community settings.
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Affiliation(s)
| | - Amy D Herschell
- 2Community Care Behavioral Health Organization, UPMC Insurance Services Division, Pittsburgh, USA
| | - Jane N Kogan
- 3UPMC Center for High-Value Health Care, UPMC Insurance Services Division, Pittsburgh, USA
| | - James G Gavin
- 2Community Care Behavioral Health Organization, UPMC Insurance Services Division, Pittsburgh, USA
| | | | - Bradley D Stein
- 2Community Care Behavioral Health Organization, UPMC Insurance Services Division, Pittsburgh, USA.,5RAND Corporation, Pittsburgh, USA
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19
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Melnikov AY. [Acute insomnia: natural course and correction modalities]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:28-35. [PMID: 31317912 DOI: 10.17116/jnevro201911904228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The review describes general patterns of the development of acute (short-term) insomnia, its occurrence and course with the risk of transition to chronic insomnia. Main approaches for pharmacological and psychotherapeutic correction of acute insomnia needed to prevent chronification are indicated. The author suggests an algorithm for the treatment of acute insomnia taking into account its staging.
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Affiliation(s)
- A Yu Melnikov
- Research and Clinical Center of Otorhinolaryngology by Federal Biomedical Agency, Moscow, Russia
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20
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Parkinson TD, Kornelsen J, Smith SD. Trait Mindfulness and Functional Connectivity in Cognitive and Attentional Resting State Networks. Front Hum Neurosci 2019; 13:112. [PMID: 31031607 PMCID: PMC6473082 DOI: 10.3389/fnhum.2019.00112] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/14/2019] [Indexed: 01/31/2023] Open
Abstract
Mindfulness has been described as an orienting of attention to the present moment, with openness and compassion. Individuals displaying high trait mindfulness exhibit this tendency as a more permanent personality attribute. Given the numerous physical and mental health benefits associated with mindfulness, there is a great interest in understanding the neural substrates of this trait. The purpose of the current research was to examine how individual differences in trait mindfulness associated with functional connectivity in five resting-state networks related to cognition and attention: the default mode network (DMN), the salience network (SN), the central executive network (CEN), and the dorsal and ventral attention networks (DAN and VAN). Twenty-eight undergraduate participants completed the Five-Facet Mindfulness Questionnaire (FFMQ), a self-report measure of trait mindfulness which also provides scores on five of its sub-categories (Observing, Describing, Acting with Awareness, Non-judging of Inner Experience, and Non-reactivity to Inner Experience). Participants then underwent a structural MRI scan and a 7-min resting state functional MRI scan. Resting-state data were analyzed using independent-component analyses. An analysis of covariance (ANCOVA) was performed to determine the relationship between each resting state network and each FFMQ score. These analyses indicated that: (1) trait mindfulness and its facets showed increased functional connectivity with neural regions related to attentional control, interoception, and executive function; and (2) trait mindfulness and its facets showed decreased functional connectivity with neural regions related to self-referential processing and mind wandering. These patterns of functional connectivity are consistent with some of the benefits of mindfulness-enhanced attention, self-regulation, and focus on present experience. This study provides support for the notion that non-judgmental attention to the present moment facilitates the integration of regions in neural networks that are related to cognition, attention, and sensation.
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Affiliation(s)
| | | | - Stephen D Smith
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.,Department of Psychology, University of Winnipeg, Winnipeg, MB, Canada
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21
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Candini V, Ghisi M, Bottesi G, Ferrari C, Bulgari V, Iozzino L, Boero ME, De Francesco A, Maggi P, Segalini B, Zuccalli V, Giobbio GM, Rossi G, de Girolamo G. Personality, Schizophrenia, and Violence: A Longitudinal Study. J Pers Disord 2018; 32:465-481. [PMID: 28758886 DOI: 10.1521/pedi_2017_31_304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aims of this study were (a) to investigate the presence of clinically significant personality traits and personality disorders (PD) in patients living in residential facilities, with or without a history of violence (69 and 46, respectively); and (b) to investigate any associations between clinically significant personality traits and PDs, aggression, impulsivity, hostility, and violent behavior during a 1-year follow-up. The most frequent primary diagnoses were schizophrenia (58.3%) and PD (20.9%). Those with a history of violence demonstrated more antisocial and alcohol dependence features and lower depressive PD symptoms than the control group. Hostility levels, antisocial symptoms, and drug dependence, as well as a Structured Clinical Interview for DSM-IV Axis II diagnosis of PD, predicted aggressive and violent behavior during follow-up. The study confirms the relevance of assessing PDs both to evaluate the risk of violent behavior and to plan appropriate preventive and treatment intervention.
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Affiliation(s)
- Valentina Candini
- IRCCS St. John of God Fatebenefratelli, Brescia, Italy.,Department of General Psychology, University of Padua, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padua, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padua, Italy
| | | | - Viola Bulgari
- IRCCS St. John of God Fatebenefratelli, Brescia, Italy.,PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Laura Iozzino
- IRCCS St. John of God Fatebenefratelli, Brescia, Italy.,Department of Neuroscience, Biomedicine, and Movement Science, University of Verona, Italy
| | - Maria Elena Boero
- Rehabilitation Hospital Beata Vergine della Consolata, Torino, Italy
| | | | - Paolo Maggi
- IRCCS St. John of God Fatebenefratelli, Brescia, Italy
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22
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Hill N, Geoghegan M, Shawe-Taylor M. Evaluating the outcomes of the STEPPS programme in a UK community-based population; implications for the multidisciplinary treatment of borderline personality disorder. J Psychiatr Ment Health Nurs 2016; 23:347-56. [PMID: 27353540 DOI: 10.1111/jpm.12315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Individuals with a diagnosis of Borderline Personality Disorder (BPD) now constitute a substantial portion of the caseload for community teams. Specialized treatments for BPD often consume a large portion of available psychology resources and also involve lengthy waiting lists. The STEPPS programme is a treatment approach which is growing in evidence, particularly in the US. However, further evidence for the effectiveness of this programme within the UK healthcare system is needed. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE The results of this study support the preliminary evidence for the effectiveness of STEPPS in a UK community-based population. A reduction in symptom severity was in evidence. Novel measures were used to build on previous evaluations of the STEPPS programme. These measures show a significant reduction in patients' affinity for unhelpful schemas, as well as an increase in patients' self-reported quality of life; an important perspective for a recovery focused approach to treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The STEPPS programme has shown its merit as an effective and more accessible treatment option for the community-based treatment of BPD, though some methodological limitations are noted. Furthermore, the results of this study demonstrate that STEPPS can be delivered effectively by teams of facilitators from different professional backgrounds who do not necessarily have extensive training in psychotherapeutic interventions. The result is a well-rounded and diverse skill set possessed by the team of facilitators, adding to the richness of the patient's recovery journey and leading to a more favourable spread of teams' resources. ABSTRACT Aims & Background Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group treatment for individuals with a diagnosis of Borderline Personality Disorder (BPD) which has a growing evidence base, particularly in the US. Evidence is sparse for its use with UK populations, and this study seeks to assess the reliability of this evidence, whilst adding to existing knowledge through the use of additional measures. Method Thirty patients completed one of four STEPPS groups. Data regarding symptom severity, quality of life and affinity for maladaptive schemas were collected at the start and end of the group to allow pairwise analysis. Results Significant reductions in symptom severity and affinity for maladaptive schemas were in evidence, as well as highly significant increases in patients' self-reported quality of life. Implications The results provide further evidence for the efficacy of STEPPS with a UK sample of patients with a diagnosis of BPD, though limitations with the design of this study warrant caution. They also show that the programme achieves this level of efficacy when delivered by facilitators who are not intensively trained in psychological treatment models. As such, the STEPPS programme provides a resourceful approach to the treatment of BPD in a UK community-based setting.
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Affiliation(s)
- N Hill
- Reigate Community Mental Health Recovery Service, Surrey and Borders Partnership NHS Foundation Trust, Reigate, UK
| | - M Geoghegan
- Dorking Community Mental Health Recovery Service, Surrey and Borders Partnership NHS Foundation Trust, Dorking, UK
| | - M Shawe-Taylor
- Tandridge Community Mental Health Recovery Service, Surrey and Borders Partnership NHS Foundation Trust, Tandridge, UK
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23
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Durand SC, McGuinness TM. Adolescents Who Self-Injure. J Psychosoc Nurs Ment Health Serv 2016; 54:26-9. [DOI: 10.3928/02793695-20160318-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Leppänen V, Vuorenmaa E, Lindeman S, Tuulari J, Hakko H. Association of parasuicidal behaviour to early maladaptive schemas and schema modes in patients with BPD: The Oulu BPD study. Personal Ment Health 2016; 10:58-71. [PMID: 26333517 DOI: 10.1002/pmh.1304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The present study aimed to examine which early maladaptive schemas (EMSs) and schema modes emerged in parasuicidal and non-parasuicidal patients with BPD participating in the Oulu BPD study. The patients' EMSs were assessed using the Young Schema Questionnaire, and schema modes using the Young Atkinson Mode Inventory. Sixty patients with BPD responded to both the schema and schema mode questionnaires; of these, 46 (76.7%) fulfilled the criteria for parasuicidality. In BPD patients with parasuicidality, the EMSs of emotional deprivation, abandonment/instability, mistrust/abuse and social isolation were the most prevalent, and the schema modes of vulnerable child, angry child, detached protector and compliant surrender were prominent. In patients without parasuicidality, the schema modes of healthy adult and happy child were the most prevalent. Significant correlations were observed between the schema modes of detached protector, vulnerable child, punitive parent and angry child and almost every EMS in BPD patients with parasuicidality. Our preliminary findings suggest that associations between certain EMSs and schema modes to parasuicidality in BPD patients may provide valuable information when planning and implementing their treatment.
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Affiliation(s)
- Virpi Leppänen
- City of Oulu, Social and Health Services, Mental Health Services, PO Box 13, 90015, Oulu, Finland.,University of Oulu, Institute of Clinical Medicine, Psychiatry, PO Box 5000, 90014, Oulu, Finland
| | - Elina Vuorenmaa
- University of Oulu, Institute of Clinical Medicine, Psychiatry, PO Box 5000, 90014, Oulu, Finland
| | - Sari Lindeman
- University of Eastern Finland, Department of Clinical Medicine, PO Box 100, 70029 KYS, Kuopio, Finland.,Central Finland Health Care District, Jyväskylä Central Hospital, Matarankatu 6 B, 40100, Jyväskylä, Finland
| | - Jyrki Tuulari
- Southern Ostrobothnia Hospital District, Huhtalantie 53, 60220, Seinäjoki, Finland
| | - Helinä Hakko
- Oulu University Hospital, Department of Psychiatry, PO Box 26, 90029, Oulu, Finland
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25
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Kluwe-Schiavon B, Viola TW, Levandowski ML, Bortolotto VR, Souza LSAE, Tractenberg SG, Soares T. A systematic review of cognitive rehabilitation for bipolar disorder. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015; 37:194-201. [DOI: 10.1590/2237-6089-2015-0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/19/2015] [Indexed: 11/21/2022]
Abstract
Introduction: It has been shown that bipolar disorder (BD) has a direct impact on neurocognitive functioning and behavior. This finding has prompted studies to investigate cognitive enhancement programs as potential treatments for BD, primarily focusing on cognitive reinforcement and daily functioning and not restricted to psychoeducation and coping strategies, unlike traditional psychosocial treatments. Objective: This study presents a systematic review of controlled trials of cognitive rehabilitation (CR) for BD. Our main objective is to describe the results of studies of rehabilitation programs for BD and related methodological issues. Method: Electronic database searches (MEDLINE, Web of Science, and Embase) were conducted to identify articles using terms related to BD and CR. The methodological quality of each article was measured using the 5-item Jadad scale. Results: A total of 239 articles were initially identified, but after application of exclusion criteria, only four were retained for this review. An average of 17 hours of intervention sessions were conducted, distributed as 0.95 hours per week and three of the four studies reported better executive function performance after CR interventions. Conclusions: We did not find robust evidence to support cognitive rehabilitation as an effective treatment for BD, because of: 1) the variety of intervention designs; 2) the methodological limitations of the studies; and 3) the lack of studies in the field.
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Yelland C, Girke T, Tottman C, Williams AS. Clinical characteristics and mental health outcomes for women admitted to an Australian Mother-Baby Unit: a focus on borderline personality disorder and emotional dysregulation? Australas Psychiatry 2015; 23:683-7. [PMID: 26070637 DOI: 10.1177/1039856215590251] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the clinical population of women admitted to a Mother-Baby Unit in Adelaide, South Australia and to evaluate changes during admission in both Axes I and II diagnoses of maternal mental health, and in mother-infant relationships. METHOD Both clinical and self-report assessments of maternal mental health were made at admission and discharge, and self-report comparisons of the mother-infant relationship. RESULTS Depressive illnesses (46.2%) were found to be the most prevalent conditions leading to admission, with rates of psychosis (10.3%) and bipolar disorder (3.4%) being lower. A high incidence of borderline personality disorder (23.1%) was found clinically, with almost half the admitted women showing features of borderline personality disorder on a self-report measure at admission. Significant improvements in maternal mental health and the mother-infant relationship were found at the time of discharge. CONCLUSIONS Admission to this Mother-Baby Unit on mothers' self-report scales showed improvement in mothers' mental health and the relationship that they have with their infant. Given the high prevalence of borderline personality disorder and emotional dysregulation identified within the population, treatment implications and possible consequences for the infant are discussed for this client group.
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Affiliation(s)
- Chris Yelland
- Psychologist, Helen Mayo House, Perinatal and Infant Mental Health Service, Women's and Children's Health Network, Adelaide, SA, and; Clinical Senior Lecturer, University of Adelaide, Adelaide, SA, Australia
| | - Teresa Girke
- Parent-Infant Therapist, Helen Mayo House, Perinatal and Infant Mental Health Service, Women's and Children's Health Network, Adelaide, SA, Australia
| | | | - Anne Sved Williams
- Director, Helen Mayo House, Perinatal and Infant Mental Health Service, Women's and Children's Health Network, Adelaide, SA, Australia
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Lawn S, McMahon J. Experiences of care by Australians with a diagnosis of borderline personality disorder. J Psychiatr Ment Health Nurs 2015; 22:510-21. [PMID: 26122817 PMCID: PMC4755162 DOI: 10.1111/jpm.12226] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2015] [Indexed: 01/17/2023]
Abstract
Borderline personality disorder (BPD) is a complex and challenging mental health condition for the person and service providers who support them. This paper reports on the results of a survey of 153 people with a diagnosis of BPD about their experiences of attempting to receive support in managing this mental health condition. It provides their perceptions of a range of experiences not reported in the existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. People with a diagnosis of BPD continue to experience significant discrimination when attempting to get their needs met within both public and private health services. Further education for nurses and other health professionals is indicated to address pervasive negative attitudes towards people with a diagnosis of BPD. There is limited understanding of the experience of seeking and receiving treatment and care by people with a diagnosis of borderline personality disorder (BPD), their perceptions of barriers to care and the quality of services they receive. This study aimed to explore these experiences from the perspective of Australians with this diagnosis. An invitation to participate in an online survey was distributed across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 153 people with a diagnosis of BPD showed that they experience significant challenges and discrimination when attempting to get their needs met within both public and private health services, including general practice. Seeking help from hospital emergency departments during crises was particularly challenging. Metropolitan and rural differences, and gender differences, were also apparent. Community supports were perceived as inadequate to meet their needs. This study provides data on a range of experiences not reported in existing literature, including general practitioner roles, urban and rural differences, public and private hospital differences, and comparison of usefulness of support across multiple support types. Its findings can help inform better training for health professionals and better care for this population.
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Affiliation(s)
- S Lawn
- Psychiatry, Flinders Human Behaviour and Health Research Unit, Margaret Tobin Centre, Flinders University, Adelaide, SA, Australia
| | - J McMahon
- BPD Ministerial Expert Advisory Group, Adelaide, SA, Australia
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Lawn S, McMahon J. Experiences of family carers of people diagnosed with borderline personality disorder. J Psychiatr Ment Health Nurs 2015; 22:234-43. [PMID: 25857849 DOI: 10.1111/jpm.12193] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2014] [Indexed: 11/27/2022]
Abstract
There is limited understanding of the experience of family carers of people diagnosed with borderline personality disorder (BPD). This study aimed to explore their experiences of being carers, their attempts to seek help for the person diagnosed with BPD and their own carer needs. An invitation to participate in an online survey was distributed to carers across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 121 carers showed that they experience significant challenges and discrimination when attempting to engage with and seek support from health services. Comparison with consumers' experiences (reported elsewhere) showed that these carers have a clear understanding of the discrimination faced by people with this diagnosis, largely because they also experience exclusion and discrimination. Community carer support services were perceived as inadequate. General practitioners were an important source of support; however, they and other service providers need more education and training to support attitudinal change to address discrimination, recognize carers' needs and provide more effective support. This study provides the first detailed account of BPD carers' experiences across a broad range of support needs and interactions with community support and health services.
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Affiliation(s)
- S Lawn
- Psychiatry, Flinders Human Behaviour and Health Research Unit, Flinders University, Adelaide, SA, Australia
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