Change in Emotional and Theory of Mind Processing in Borderline Personality Disorder

et al. 2020

Trials

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Background: Borderline personality disorder (BPD) is one of the most frequent, most debilitating and lethal mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy, and may involve brief psychiatric treatment as first-line intervention. No controlled study has assessed the effectiveness of such brief intervention. Whereas most psychotherapy studies in patients with BPD focus on the effectiveness of the intervention, we still lack an understanding of how and why these effects are produced from a patient process perspective. It is therefore of utmost importance to study the treatmentunderlying mechanisms of change. The present study plans to apply novel measurement methods for assessing change in two central psychobiological processes in BPD: emotion and socio-cognitive processing. The study uses theory-driven and ecologically valid experimental tasks, which take the patient's individual experience as the anchor, by integrating methodology from psychotherapy process and neurofunctional imagery research.Methods: The aim of this two-arm, randomized controlled study is to test the effects (i.e., symptom reduction) and the underlying mechanisms of change associated with a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants (N = 80 patients with BPD) undergo assessments at four points (intake, 2 months, discharge, and 12-month follow up). In addition to symptom measures, individuals undergo a 2step assessment for the potential mechanisms of change (i.e., emotion and socio-cognitive processing): (1) behavioral and (2) (for a sub-sample) neurofunctional. We hypothesize that change in the mechanisms explains the treatment effects. Discussion: This study uses an easy-to-implement treatment of BPD, and a sophisticated assessment procedure to demonstrate the critical role of psychobiological change in emotion and socio-cognitive processing in brief treatments. It will help increase the effectiveness of brief treatment for BPD and help diminish the societal burden of disease related to BPD, in these early stages of treatment.(Continued on next page)

Section: Feasibility: Results From the Pilot Studymentioning

confidence: 93%

Mechanisms of change in brief treatments for borderline personality disorder: a protocol of a randomized controlled trial

Kramer

et al. 2020

Trials

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“…We demonstrated feasibility of the pre-post design (50). We demonstrated for N = 8 medication-free right-handed female patients with BPD undergoing a 10-session psychiatric treatment that hypotheses 1 and 2 may be confirmed (due to the small sample size, the analyses for hypotheses 3 and 4 were not tested).…”

Section: Feasibility: Results From the Pilot Studymentioning

confidence: 93%

Mechanisms of change in brief treatments for borderline personality disorder: a randomized controlled trial

Kramer

et al. 2020

Preprint

Self Cite

Background Borderline Personality Disorder (BPD) is one of the most frequent, most debilitating and lethal mental conditions and is associated with a serious burden of disease. Treatment for patients with BPD involves structured psychotherapy, and may involve brief psychiatric treatment as first-line intervention. No controlled study has assessed the effectiveness of such brief intervention. Whereas most psychotherapy studies with patients with BPD focus on the effectiveness of the intervention, we still lack an understanding of how and why these effects are produced from a patient process perspective. It is therefore of utmost importance to study the treatment-underlying mechanisms of change . The present study plans to apply novel measurement methods for assessing change in two central psychobiological processes in BPD: emotion and socio-cognitive processing. The study uses theory-driven and ecologically valid experimental tasks which take as anchor the patient’s individual experience, by integrating methodology from psychotherapy process and neurofunctional imagery research. Methods and study design The present two-arm randomized controlled study aims at testing the effects (i.e., symptom reduction) and the underlying mechanisms of change associated with a brief psychiatric treatment (10 sessions over 4 months), compared with treatment as usual. Participants ( N = 80 patients with BPD) undergo assessments at four points (intake, 2 months, discharge, and 12 month follow-up). In addition to symptom measures, individuals undergo a two-step assessment for the potential mechanisms of change (i.e., emotion and socio-cognitive processing): a) behavioural and b) (for a sub-sample) neurofunctional. We hypothesize that change in the mechanisms explains the treatment effects. Discussion The present study uses an easy-to-implement treatment of BPD, as well as a sophisticated assessment procedure to demonstrate the critical role of psychobiological change in emotion and socio-cognitive processing in brief treatments. It will help increase the effectiveness of brief treatment for BPD and help diminish the societal burden of disease related with BPD, in these early stages of treatment. Trial registration : Clinical Trials NCT0317818 (date of registration of Abstract October 24 th , 2018). Protocol version number 2 from February 9 th , 2018.

“…Both clients were diagnosed with BPD and received a brief 10‐session treatment as part of the study. More details on the study design, the treatment and the sample of this pilot study can be found in the original study that took place in a French‐speaking university environment (Kramer et al, ). We chose Linda and Suzan (names were changed in order to protect their identity) because of their marked between‐person differences in relationship patterns as reflected in their individualised stimuli (see Table ).…”

Section: Illustration Of a Study Applying This Methodology In The Conmentioning

confidence: 99%

Integrating core conflictual relationship themes in neurobiological assessment of interpersonal processes in psychotherapy

Couns and Psychother Res

Gyger

et al. 2020

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Interpersonal processes are a key target in counselling and psychotherapy. It is of paramount importance to sharpen their assessment using integrated methods. Hence, this methodological paper describes how fields of research in psychotherapy and neuroimaging can be integrated into one novel complementary neurobehavioural paradigm that can be applied to enhance our understanding of interpersonal processes in psychotherapy. To illustrate this integration, we present selected data from a pre–post pilot study where the authors assessed interpersonal processes in brief treatment for borderline personality disorder using the core conflictual relationship theme, functional magnetic resonance imaging (fMRI) and outcome questionnaires. To do so, they measured individual changes in neural activity using an fMRI task pre‐ and post‐treatment where clients gave feedback on the emotional valence of sentences extracted from their own Relationship Anecdotes Paradigm interviews mixed with neutral ones. In this paper, using data from two participants of said study, we discuss how to implement this methodology and what can be achieved in terms of results.