Key themes in recent research on interpersonal functioning in borderline personality disorder

The 11th revision of the International Classification of Diseases for Mortality and Morbidity Statistics (ICD-11) defines personality disorder according to personality functioning, which relates to self- and interpersonal functioning. The aim of the present study was to assess the relationship between mentalizing and personality functioning in patients with subthreshold or diagnosed borderline personality disorder. A total of 116 eligible participants were included. Mentalizing was assessed using the Mentalization Questionnaire (MZQ), personality functioning (self- and interpersonal functioning) was assessed using the Level of Personality Functioning Scale-Brief Form 2.0 (LPFS-BF), and borderline severity was assessed using the Zanarini Rating Scale (ZAN-BPD). Mediation analysis was employed to test if mentalizing accounted for the relationship between borderline severity and self- and interpersonal functioning. We found a significant relationship between borderline severity and both subscales of the LPFS-BF. Mentalizing fully and significantly mediated the relationship between borderline severity and interpersonal functioning. However, mentalizing only partly mediated the relationship between borderline severity and self-functioning. Controlling for the covariates gender and age did not impact the results. Mentalizing is likely to be involved in the ICD-11 model of personality functioning, especially interpersonal functioning. This could emphasize the relevance of therapy aimed at strengthening mentalizing abilities when treating personality pathology in general and people with borderline personality disorder in particular. However, self-functioning may be more nuanced, as aspects other than mentalizing also influence self-functioning. The study is explorative in nature and has methodological limitations that require caution in the interpretation and generalizability.

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Change in interpersonal functioning during psychological interventions for borderline personality disorder-a systematic review of measures and efficacy

Personality and Mental Health ◽

10.1002/pmh.1296 ◽

2015 ◽

Vol 9 (3) ◽

pp. 173-194 ◽

Cited By ~ 7

Author(s):

Roland Sinnaeve ◽

Louisa M. C. van den Bosch ◽

Kirsten M. van Steenbergen-Weijenburg

Keyword(s):

Systematic Review ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Interpersonal Functioning ◽

Psychological Interventions

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Mentalization in Adolescents With Borderline Personality Disorder: A Comparison With Healthy Controls

Journal of Personality Disorders ◽

10.1521/pedi_2018_32_336 ◽

2019 ◽

Vol 33 (2) ◽

pp. 145-163 ◽

Cited By ~ 4

Author(s):

Jeremy Quek ◽

Glenn A. Melvin ◽

Clair Bennett ◽

Michael S. Gordon ◽

Naysun Saeedi ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Interpersonal Functioning ◽

Healthy Controls ◽

Treatment Target ◽

Interpersonal Relatedness

Mentalization is proposed to underlie the disturbed interpersonal relatedness that is a hallmark of borderline personality disorder (BPD). Despite growing evidence of BPD in adolescents, studies examining mentalization in relation to adolescent BPD have remained limited. Given contradictory findings of this relationship, particularly with adults, further research of mentalization in adolescents with BPD is warranted. The current study further clarifies the nature of mentalizing impairments, related to BPD, by examining different aspects of mentalization between adolescents with BPD (n = 26) and a group of healthy controls (n = 25). Findings support studies that suggest that mentalization may be an important treatment target, influencing BPD symptoms and interpersonal functioning in adolescents with BPD. They also support the importance of examining mentalizing abilities in relation to varying levels of complexity, interpersonal contexts, and levels of arousal. Limitations and further research are discussed.

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Facial Emotion Perception in Borderline Personality Disorder: Differential Neural Activation to Ambiguous and Threatening Expressions and Links to Impairments in Self and Interpersonal Functioning

Journal of Affective Disorders ◽

10.1016/j.jad.2021.01.042 ◽

2021 ◽

Vol 284 ◽

pp. 126-135

Author(s):

Johannes S Wrege ◽

Anthony C Ruocco ◽

Dean Carcone ◽

Undine E Lang ◽

Andy C H Lee ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Emotion Perception ◽

Borderline Personality ◽

Interpersonal Functioning ◽

Facial Emotion ◽

Neural Activation ◽

Facial Emotion Perception

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TFP Extended: Development and Recent Advances

Psychodynamic Psychiatry ◽

10.1521/pdps.2021.49.2.188 ◽

2021 ◽

Vol 49 (2) ◽

pp. 188-214

Author(s):

John F. Clarkin ◽

Eve Caligor ◽

Julia Sowislo

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Full Range ◽

Clinical Intervention ◽

Borderline Personality ◽

Personality Pathology ◽

Interpersonal Functioning ◽

The Core ◽

Empirically Supported ◽

Recent Advances

Recent advances in the understanding of personality pathology have contributed to an emphasis on the core of personality pathology as deficits in self-functioning and interpersonal functioning at different levels of severity that must be assessed for clinical intervention. In concert with these conceptual and empirical advances, transference-focused psychotherapy (TFP), an empirically supported psychodynamic treatment for borderline personality disorder, has been in constant development with extensive clinical use. This article describes an object relations model for conceptualizing and assessing levels of personality organization, a transdiagnostic approach to personality pathology, and related treatment modifications, thus expanding the utilization of TFP beyond borderline personality disorder to the full range of personality dysfunction. The core of this treatment approach is a sequential interpretive process between patient and therapist. This process takes place within the context of a structured treatment frame tailored to the unique individual with problems in self-functioning and interpersonal functioning in his/her particular environment.

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