Autobiographical Memory Impairment in Borderline Personality Disorder: A Quantitative Meta-Analysis Interpreted in Terms of the CaR-FA-X Model

2019 ◽  
Vol 33 (6) ◽  
pp. 818-831 ◽  
Author(s):  
Eszter Beran ◽  
Mara J. Richman ◽  
Zsolt Unoka
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Autobiographical Memory ◽  
Executive Control ◽  
Memory Impairment ◽  
Memory Performance ◽  
Meta Analysis ◽  
Demographic Variables ◽  
Borderline Personality ◽  
Effect Sizes

Borderline personality disorder (BPD) is characterized by impaired functioning of autobiographical memory (AM). We use a quantitative meta-analysis to assess AM performance in adults diagnosed with BPD as compared to healthy controls (HC). Moderator variables included type of autobiographical memory as well as clinical and demographic variables. Large significant deficits were seen in the BPD group in comparison to the HC group. In the BPD group, effect sizes were large for overgenerality, omission, and specific memories, while not significant for recall. Age influenced the performance of the BPD group; in addition, there was a significant interaction between age and specificity of memory. Gender and IQ did not influence memory performance. Our results confirm that BPD patients show impairment in AM. We explain these impairments in terms of the CaR-FA-X model, based on mechanisms of capture and rumination, functional avoidance, and impaired executive control.

scholarly journals Effectiveness of Psychological Treatments for Borderline Personality Disorder and Predictors of Treatment Outcomes: A Multivariate Multilevel Meta-Analysis of Data from All Design Types

2021 ◽  
Vol 10 (23) ◽  
pp. 5622
Author(s):  
Sophie A. Rameckers ◽  
Rogier E. J. Verhoef ◽  
Raoul P. P. P. Grasman ◽  
Wouter R. Cox ◽  
Arnold A. P. van Emmerik ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Dialectical Behavior Therapy ◽  
Treatment Effectiveness ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Effect Sizes ◽  
Sensitivity Analyses ◽  
Treatment As Usual ◽  
Logarithmic Relationship

We examined the effectiveness of psychotherapies for adult Borderline Personality Disorder (BPD) in a multilevel meta-analysis, including all trial types (PROSPERO ID: CRD42020111351). We tested several predictors, including trial- and outcome type (continuous or dichotomous), setting, BPD symptom domain and mean age. We included 87 studies (N = 5881) from searches between 2013 and 2019 in four databases. We controlled for differing treatment lengths and a logarithmic relationship between treatment duration and effectiveness. Sensitivity analyses were conducted by excluding outliers and by prioritizing total scale scores when both subscale and total scores were reported. Schema Therapy, Mentalization-Based Treatment and reduced Dialectical Behavior Therapy were associated with higher effect sizes than average, and treatment-as-usual with lower effect sizes. General severity and affective instability showed the strongest improvement, dissociation, anger, impulsivity and suicidality/self-injury the least. Treatment effectiveness decreased as the age of participants increased. Dichotomous outcomes were associated to larger effects, and analyses based on last observation carried forward to smaller effects. Compared to the average, the highest reductions were found for certain specialized psychotherapies. All BPD domains improved, though not equally. These findings have a high generalizability. However, causal conclusions cannot be drawn, although the design type did not influence the results.

scholarly journals Higher Executive Control and Visual Memory Performance Predict Treatment Completion in Borderline Personality Disorder

2012 ◽  
Vol 81 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Eric A. Fertuck ◽  
John Keilp ◽  
Inkyung Song ◽  
Melissa C. Morris ◽  
Scott T. Wilson ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Executive Control ◽  
Visual Memory ◽  
Memory Performance ◽  
Treatment Completion ◽  
Borderline Personality

Rumination in Borderline Personality Disorder: Meta-Analysis

2018 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Zsolt Demetrovics
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Sample Type ◽  
Moderator Variables ◽  
Analytic Review ◽  
Self Harm

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with BPD symptoms. Moreover, no meta-analytic review has been performed to date on rumination in BPD. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, co-morbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation between BPD symptoms and rumination. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

Shame in Borderline Personality Disorder: Meta-Analysis

2021 ◽  
Vol 35 (Supplement A) ◽  
pp. 149-161
Author(s):  
Tzipi Buchman-Wildbaum ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Gabriella Vizin ◽  
Zsolt Demetrovics ◽  
...  
Keyword(s):  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Meta Analysis ◽  
Education Level ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Moderator Variables ◽  
Core Feature ◽  
Ptsd Symptomatology

Shame has been found to be a core feature of borderline personality disorder (BPD). To date, there is no existing systematic review or meta-analysis examining shame in individuals with BPD as compared to healthy controls (HCs). A meta-analysis of 10 studies comparing reported shame in BPD patients to HCs was carried out. Demographic and clinical moderator variables were included to see if they have a relationship with the effect size. Results showed that those with BPD had more reported shame than healthy controls. In addition, in BPD patients and HCs, higher education level was related to lower reported shame. In HCs, it was found that those who were younger reported a higher level of shame. Finally, among BPD patients, there was a relationship between levels of reported shame and elevated PTSD symptomatology. These findings emphasize the clinical relevance of shame in individuals with BPD and the need to formulate psychotherapeutic strategies that target and decrease shame.

A meta-analysis of theory of mind and ‘mentalization’ in borderline personality disorder: a true neuro-social-cognitive or meta-social-cognitive impairment?

2021 ◽  
pp. 1-11
Author(s):  
Emre Bora
Keyword(s):  
Cognitive Impairment ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Theory Of Mind ◽  
Cognitive Style ◽  
Social Cognitive ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Meta Analyses

Abstract Background It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it is important to distinguish neuro-social cognitive impairment from the abnormal meta-social-cognitive style of patients. Methods The current systematic review aimed to conduct separate meta-analyses of ‘mentalization’ [reflective functioning (RF] and different aspects of ToM in BPD. A literature search was conducted to locate relevant articles published between January 1990 to July 2021. Random-effect meta-analyses were conducted in 34 studies involving 1448 individuals with BPD and 2006 healthy controls. Results A very large impairment in RF was evident in BPD [d = 1.68, confidence interval (CI) = 1.17–2.19]. In contrast, ToM impairment was modest (d = 0.36, CI = 0.24–0.48). BPD patients underperformed healthy controls in ToM-reasoning (d = 0.44, CI = 0.32–0.56) but not ToM-decoding. Increased HyperToM (d = 0.60, CI = 0.41–0.79) and faux pas recognition (d = 0.62, CI = 0.35–0.90) errors in BPD compared to healthy controls were most robust ToM findings in this meta-analysis. Conclusions BPD is characterized by very severe deficits in RF and modest and selective abnormalities in ToM. Interpersonal problems and difficulties in processing social information in BPD can be best explained by patients' maldaptive meta-social cognitive style and top-down effects of these abnormalities rather than having a primary neuro-social cognitive deficit.

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