Rumination as a widespread emotion‐based cognitive vulnerability in borderline personality disorder: A meta‐analytic review

Cavicchioli, Marco; Maffei, Cesare

doi:10.1002/jclp.23281

Cited by 10 publications

(10 citation statements)

References 117 publications

(135 reference statements)

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“…A meta‐analysis of 3,543 participants 173 found that BPD symptomatology was associated with less frequent use of adaptive emotion regulation strategies (i.e., cognitive reappraisal, problem solving, and acceptance) and more frequent use of maladaptive ones (i.e., suppression, rumination, and avoidance). The role of rumination as a dysfunctional emotion regulation strategy in BPD was also confirmed by two recent meta‐analyses 174,175 . Furthermore, a meta‐analysis found stronger self‐report of experienced shame in comparison to healthy controls, with a large effect size of d=1.44 (n=10, N=3,543) 176 .…”

Section: Social Cognition and Neurocognitionmentioning

confidence: 70%

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Leichsenring,

Fonagy,

Heim

et al. 2024

World Psychiatry

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Borderline personality disorder (BPD) was introduced in the DSM‐III in 1980. From the DSM‐III to the DSM‐5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self‐image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self‐mutilation behavior, and transient stress‐related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi‐structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self‐mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in outpatient and 22% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post‐traumatic stress disorder, attention‐deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various approaches have been empirically supported in randomized controlled trials, including dialectical behavior therapy, mentalization‐based therapy, transference‐focused therapy, and schema therapy. No approach has proved to be superior to others. Compared to treatment as usual, psychotherapy has proved to be more efficacious, with effect sizes between 0.50 and 0.65 with regard to core BPD symptom severity. However, almost half of the patients do not respond sufficiently to psychotherapy, and further research in this area is warranted. It is not clear whether some patients may benefit more from one psychotherapeutic approach than from others. No evidence is available consistently showing that any psychoactive medication is efficacious for the core features of BPD. For discrete and severe comorbid anxiety or depressive symptoms or psychotic‐like features, pharmacotherapy may be useful. Early diagnosis and treatment of BPD can reduce individual suffering and societal costs. However, more high‐quality studies are required, in both adolescents and adults. This review provides a comprehensive update of the BPD diagnosis and clinical characterization, risk factors, neurobiology, cognition, and management. It also discusses the current controversies concerning the disorder, and highlights the areas in which further research is needed.

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Section: Social Cognition and Neurocognitionmentioning

confidence: 70%

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Leichsenring,

Fonagy,

Heim

et al. 2024

World Psychiatry

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“…Moreover, people who engage in NSSI frequently have genetic predispositions toward higher emotional reactivity to negative emotions (Groschwitz & Plener, 2012). Disorders such as depression and BPD that are associated with high levels of rumination (Cavicchioli & Maffei, 2021;Mor & Winquist, 2002) are also associated with poorer impulse control due to impaired frontal lobe function (Husain et al 2019). It is possible that neuroticism is the common factor underlying the relationship between rumination and engagement in NSSI.…”

Section: Discussionmentioning

confidence: 99%

“…For example, rumination‐focused cognitive‐behavioral therapy (RF‐CBT; Watkins et al, 2007 ) was created to help clients recognize and find strategies to quell ruminative thinking patterns. Future research should investigate whether one mechanism by which treatments shown to be effective at decreasing NSSI (such as DBT; Chen et al, 2021 ) do so is through reducing rumination. Additionally, future research should examine whether rumination‐focused treatments like RF‐CBT are effective in decreasing instances of NSSI.…”

Section: Discussionmentioning

confidence: 99%

Nonsuicidal self‐injury and rumination: A meta‐analysis

2022

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Trait rumination is the tendency to overthink and focus on negative emotions and events and is related to a number of psychological disorders and maladaptive behaviors including nonsuicidal self-injury (NSSI). The purpose of this study was to conduct a meta-analysis of the relationship between trait rumination and NSSI behaviors. Results from 60 samples showed small effect sizes between trait rumination and NSSI engagement, NSSI frequency, and the number of methods used to self-injure in cross-sectional samples.Results from 13 samples showed small effect sizes between trait rumination and NSSI engagement and NSSI frequency in longitudinal samples. Moderator analyses indicated that this relationship is similar whether the type of rumination is depressive or not and is generally consistent across different ages, genders, and ethnicities. These results help clarify the role of trait rumination as a risk factor for NSSI.

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“…Although the results and psychometric properties are promising, future studies should evaluate the psychometric properties of these items in clinical samples. Indeed, given the transdiagnostic nature of rumination across many different disorders (Aldao et al, 2010;Cavicchioli & Maffei, 2021;Hsu et al, 2015;Smith et al, 2018;Szabo et al, 2017), it is essential to verify that the ESM items perform similarly in various clinical samples. Moreover, this study only investigated the psychometric properties of the French ESM protocol with native French-speaking participants.…”

Section: Discussionmentioning

confidence: 99%