scholarly journals A Mechanism-Based Approach to Anti-Aggression Psychotherapy in Borderline Personality Disorder: Group Treatment Affects Amygdala Activation and Connectivity

2021 ◽  
Vol 11 (12) ◽  
pp. 1627
Author(s):  
Corinne Neukel ◽  
Katja Bertsch ◽  
Marc Wenigmann ◽  
Karen Spieß ◽  
Marlene Krauch ◽  
...  

Aggression is highly prevalent in borderline personality disorder (BPD). Previous studies have identified specific biobehavioral mechanisms underlying aggression in BPD, threat sensitivity being among them. We composited the mechanism-based anti-aggression psychotherapy (MAAP) in order to target these specific mechanisms, and MAAP was found to be superior to non-specific supportive psychotherapy (NSSP) in reducing aggressive behavior. In the present study, we investigated whether underlying brain mechanisms expected to be involved were affected by MAAP. To this end, n = 33 patients with BPD and overt aggressive behavior (n = 20 in MAAP, n = 13 in NSSP) and n = 25 healthy participants took part in a functional magnetic resonance imaging emotional face-matching task before and after treatment, or at a similar time interval for controls. Overt aggressive behavior was assessed using the overt aggression scale, modified. Results showed a decrease in amygdala activation in response to facial stimuli after MAAP, whereas an increase in amygdala activation was found after NSSP. Furthermore, in the MAAP group, connectivity between amygdala and dorsomedial prefrontal cortex increased from pre- to post-treatment compared to the NSSP group. Hence, the results suggest an impact of MAAP on brain mechanisms underlying the salience circuit in response to threat cues.

Author(s):  
Pamela L. Holens ◽  
Jeremiah N. Buhler ◽  
Stephanie Yacucha ◽  
Alyssa Romaniuk ◽  
Brent Joyal

LAY SUMMARY This study looked at the use of a group treatment known as dialectical behaviour therapy skills group (DBT-SG) to see if it was helpful for military personnel and veterans who had a variety of mental health disorders related to their service. The results of the study showed improvements in symptoms of borderline personality disorder, reductions in negative thoughts and feelings, and reductions in unhelpful behaviours. Results also showed improvements in all examined areas of functioning among participants, with the largest change occurring in the area of social functioning. The presence of posttraumatic stress disorder (PTSD), depression, or chronic pain did not impact results, but the presence of a substance abuse disorder did. Overall, the results provide preliminary support for DBT-SG as an intervention for borderline personality disorder symptoms among military and veterans, and perhaps particularly for persons who also have other mental health challenges, or persons considered inappropriate for other treatment.


2017 ◽  
Vol 249 ◽  
pp. 321-326 ◽  
Author(s):  
Laura Terzi ◽  
Francesca Martino ◽  
Domenico Berardi ◽  
Biancamaria Bortolotti ◽  
Anna Sasdelli ◽  
...  

Author(s):  
Anthony W. Bateman ◽  
Roy Krawitz

Chapter 2 discusses generalist psychiatric treatments for borderline personality disorder (BPD). It introduces the rationale for seeking common factors in treatment and provide a brief overview of some relevant literature, outlines the four generalist treatments that have been shown to be effective (structured clinical management (SCM), general psychiatric management (GPM), good clinical care (GCC), and supportive psychotherapy (SP)), describes the outcome studies of the four treatments, and reviews commonalities of the treatments.


Author(s):  
Lori N. Scott ◽  
Paul A. Pilkonis

Interpersonal problems are among the most severely impairing, difficult-to-manage, and intransigent of borderline personality disorder (BPD) features and therefore require special attention in treatment. Emotion dysregulation and related mood-dependent behaviors among individuals with BPD typically occur in the context of interpersonally relevant events or stressors, signifying the central role of interpersonal and attachment-related concerns for these patients. Two prominent interpersonal themes in those with BPD are discussed: interpersonal hypersensitivity and angry or aggressive behavior. The chapter provides a brief case illustration of how these themes might emerge in psychotherapy and recommends explicit assessment of interpersonal problems and aggression to enhance risk evaluation, case formulation, treatment planning, and monitoring progress in treatment.


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