scholarly journals Impaired mentalizing in depression and the effects of borderline personality disorder on this relationship

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
R. P. Rifkin-Zybutz ◽  
◽  
P. Moran ◽  
T. Nolte ◽  
Janet Feigenbaum ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Multivariate Regression ◽  
Mental States ◽  
Borderline Personality ◽  
The Self ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Regression Modelling

Abstract Background Mentalizing, the ability to understand the self and others as well as behaviour in terms of intentional mental states, is impaired in Borderline Personality Disorder (BPD). Evidence for mentalizing deficits in other mental disorders, such as depression, is less robust and these links have never been explored while accounting for the effects of BPD on mentalizing. Additionally, it is unknown whether BPD symptoms might moderate any relationship between depressive symptoms and mentalizing. Methods Using multivariate regression modelling on cross-sectional data obtained from a sample of 274 participants recruited from clinical settings, we investigated the association between mentalizing impairment and depression and examined whether this was moderated by the presence and number of concurrent BPD symptoms, while adjusting for socio-demographic confounders. Results Impaired mentalizing was associated with depressive symptoms, after adjustment for socio-demographic confounders and BPD symptoms (p = 0.002, β = − 0.18). BPD symptoms significantly moderated the association between impaired mentalizing and depressive symptoms (p = 0.003), with more severe borderline symptoms associated with a stronger effect of poor mentalization on increased depressive symptoms. Conclusion Mentalizing impairments occur in depression even after adjusting for the effect of BPD symptoms. Our findings help further characterise mentalizing impairments in depression, as well as the moderating effect of BPD symptoms on this association.. Further longitudinal work is required to investigate the direction of association.

scholarly journals Problems with transparency estimation reveal impairments in self-other mentalizing in individuals with borderline personality disorder features

2020 ◽  
Author(s):  
Celine De Meulemeester ◽  
Benedicte Lowyck ◽  
Bart Boets ◽  
Stephanie Van der Donck ◽  
Patrick Luyten
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotional Experience ◽  
Mental States ◽  
Individual Variability ◽  
Borderline Personality ◽  
The Self ◽  
Clinical Samples ◽  
Multiple Perspectives ◽  
Embodied Self

Transparency estimation, i.e. estimating the extent to which one’s mental states are observable to others, requires the simultaneous representation of the self and of others’ perspective on the self. Individuals with borderline personality disorder (BPD) have difficulty integrating multiple perspectives when mentalizing, which may be reflected in impaired transparency estimation. Sixty-two participants high and low in BPD features watched emotionally evocative video clips, and estimated the transparency of their emotional experience while facial expression coding software (FaceReader) quantified their objective transparency. Whilst estimated transparency predicted objective transparency in individuals without BPD features, individuals high in BPD features both over- and underestimated their transparency. Moreover, the ability to estimate intra-individual variability in one’s objective transparency was moderated by self-reported arousal in the participants high in BPD features. Although replication in clinical samples of BPD patients is needed, the present study provides evidence for problems in mentalizing the (embodied) self from another person’s perspective in BPD.

Primary care and suicidality among psychiatric outpatients: The patient-doctor relationship matters

2020 ◽  
pp. 009121742097799
Author(s):  
Krista Schultz ◽  
Sharan Sandhu ◽  
David Kealy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Primary Care Physician ◽  
Population Based ◽  
Borderline Personality ◽  
Care Physician ◽  
Cross Sectional

Objective The purpose of the current study is to examine the relationship between the quality of the Patient-Doctor Relationship and suicidality among patients seeking mental health care; specifically, whether patients who perceive having a more positive relationship with primary care physician will have lower levels of suicidality. Method Cross-sectional population-based study in Greater Vancouver, Canada. One-hundred ninety-seven participants were recruited from three Mental Health Clinics who reported having a primary care physician. Participants completed a survey containing questions regarding items assessing quality of Patient-Doctor Relationship, general psychiatric distress (K10), borderline personality disorder, and suicidality (Suicidal Behaviours Questionnaire-Revised-SBQ-R). Zero-order correlations were computed to evaluate relationships between study variables. Hierarchical regression analysis was used to control for confounding variables. Results The quality of the patient doctor relationship was significantly negatively associated with suicidality. The association between the quality of the patient-doctor relationship and suicidality remained significant even after controlling for the effects of psychiatric symptom distress and borderline personality disorder features. Conclusions The degree to which patients’ perceive their primary care physician as understanding, reliable, and dedicated, is associated with a reduction in suicidal behaviors. Further research is needed to better explicate the mechanisms of this relationship over time.

Failures to Imagine

2016 ◽  
Vol 36 (3) ◽  
pp. 270-300 ◽  
Author(s):  
Reed Maxwell ◽  
Steven Jay Lynn ◽  
Scott Lilienfeld
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Imagery ◽  
Emotional Regulation ◽  
Preliminary Evidence ◽  
Borderline Personality ◽  
Self Report ◽  
Future Research ◽  
Cross Sectional ◽  
Visual Mental Imagery

Although interest in the relationship between mental imagery and psychopathology has increased greatly over the last decade, few publications to date have examined relationships between personality-related psychopathology and mental imagery use, abilities, or both. However, we have reason to expect that substantive relationships may exist. For example, studies have consistently linked psychopathy and borderline personality disorder to problems in emotion experience and emotion regulation, and a growing number of studies indicate that deficits in visual mental imagery use and ability in particular may contribute to such problems. Using correlational data from multiple self-report measures of normal and pathological personality functioning and visual mental imagery, our study presents preliminary evidence for lower levels of self-reported visual mental imagery use, abilities, or both among noncriminal individuals with higher levels of self-reported psychopathy and individuals with greater emotional regulation difficulties, a core feature of borderline personality disorder. We also found significant relationships among self-reported visual mental imagery use, ability, or both, and personality variables shown to strongly predict psychopathy and emotional regulation difficulties. Limitations of the study, especially its reliance on a correlational, cross-sectional design, are discussed, and implications for future research are explored.

Impact of Childhood Maltreatment in Borderline Personality Disorder on Treatment Response to Intensive Dialectical Behavior Therapy

2019 ◽  
pp. 1-19 ◽  
Author(s):  
Sebastian Euler ◽  
Esther Stalujanis ◽  
Hannah J. Lindenmeyer ◽  
Rosetta Nicastro ◽  
Ueli Kramer ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Treatment Response ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Childhood Maltreatment ◽  
Emotional Abuse ◽  
Borderline Personality ◽  
The Impact

Childhood maltreatment (CM), including emotional, physical, and sexual abuse and emotional and physical neglect, is associated with severity of borderline personality disorder (BPD). However, knowledge on the impact of CM on treatment response is scarce. The authors investigated whether self-reported CM or one of its subtypes affected treatment retention, depressive symptoms, and impulsivity throughout short-term intensive dialectical behavior therapy (I-DBT) in 333 patients with BPD. Data were analyzed with linear and logistic regressions and linear mixed models, using a Bayesian approach. Patients who reported childhood emotional abuse had a higher dropout rate, whereas it was lower in patients who reported childhood emotional neglect. Emotional neglect predicted a greater decrease of depressive symptoms, and global CM predicted a greater decrease of impulsivity. The authors concluded that patients with BPD who experienced CM might benefit from I-DBT in specific symptom domains. Nonetheless, the impact of emotional abuse on higher dropout needs to be considered.

scholarly journals Mentalizing Based on External Features in Borderline Personality Disorder Compared With Healthy Controls: The Role of Attachment Dimensions and Childhood Trauma

2019 ◽  
Vol 33 (6) ◽  
pp. 736-750 ◽  
Author(s):  
Martijn Van Heel ◽  
Patrick Luyten ◽  
Celine De Meulemeester ◽  
Dominique Vanwalleghem ◽  
Rudi Vermote ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Trauma ◽  
Mental States ◽  
Borderline Personality ◽  
Control Group ◽  
Healthy Controls ◽  
Avoidant Attachment ◽  
The Mind ◽  
Attachment Dimensions

Extant research suggests that borderline personality disorder (BPD) is associated with impairments in mentalizing, that is, comprehending behavior in terms of underlying mental states. However, the precise nature of these impairments remains unclear. The literature is mixed concerning mental-izing based on external features of others, and specifically facial emotion recognition (FER) in BPD patients. This study investigated FER differences in 79 BPD patients and 79 matched healthy controls using the Reading the Mind in the Eyes Test (RMET). The authors also investigated attachment dimensions and childhood trauma in relation to mentalizing based on external features. Results showed that BPD patients performed worse on positive and negative emotions. Furthermore, avoidant attachment was negatively related to FER for neutral emotions, particularly in the control group. Trauma was negatively related to FER at trend level, particularly in BPD patients. The implications for this understanding of mentalizing based on external features in BPD are discussed.

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