Technology-Based Psychosocial Interventions for People with Borderline Personality Disorder: A Scoping Review of the Literature

Abstract

Evidence-based psychosocial interventions for borderline personality disorder (BPD) still face multiple challenges regarding treatment accessibility, adherence, duration, and economic costs. Over the last decade, technology has addressed these concerns from different disciplines. The current scoping review aimed to delineate novel and ongoing clinical research on technology-based psychosocial interventions for patients with BPD. Online databases (PubMed, Cochrane Library, EMBASE, Web of Science, PsycInfo, and Google Scholar) were searched up to June 2020. Technology-based psychosocial treatments included innovative communication (eHealth) and computational (e.g., artificial intelligence), computing (e.g., computer-based), or medical (e.g., functional magnetic resonance imaging [fMRI]) software. Clinical research encompassed any testing stage (e.g., feasibility, efficacy). Fifteen studies met the inclusion criteria. The main findings were the following: almost two-thirds of the studies (9/15) tested software explicitly conceived as adjunctive interventions to conventional therapy; nearly half of the studies (7/15) were referred to as dialectical behavior therapy-based software; most studies (13/15) were focused on the initial stage of the clinical research cycle (feasibility/acceptance/usability testing), reporting good results at this point; more than one-third of the studies (6/15) tested mobile apps; there is emerging evidence for Internet-based interventions and real-time fMRI biofeedback but only little evidence for mHealth interventions, virtual and augmented reality, and computer-based interventions; there was no computational technology-based clinical research; and there was no satisfaction/preference, security/safety, or efficiency testing for any software. Taken together, the results suggest that there is a growing but still incipient amount of technology-based psychosocial interventions for BPD supported by some kind of clinical evidence. The limitations and directions for future research are discussed.

Effectiveness of Delivering Dialectical Behavioral Therapy Techniques by Email in Patients With Borderline Personality Disorder: Nonrandomized Controlled Trial

“…This study provides evidence that DBT delivered via email can be effective in reducing the severity of symptoms associated with borderline personality disorder. These findings concurrently add to literature on the efficacy of internet-based interventions for DBT, with more work needing to be done [ 23 ]. This innovative modality has the potential to increase the accessibility of mental health services for a large group of individuals who could benefit from these resources.…”

The Use of Computer-Driven Technologies in the Treatment of Borderline Personality Disorder: A Systematic Review

“…Mobile solutions are also available for anxiety and depressive disorders [23]. A scoping review of technology-based psychosocial interventions for patients with BDP was undertaken in 2020 and identified potential software packages in terms of their research development level, with limited evidence provided about the effectiveness of these interventions [24]. Computer-driven technologies are evolving fast and there is a need to explore the effectiveness of these interventions.…”

A systematic quality rating of available mobile health apps for borderline personality disorder

“…Several meta-analyses showed the efficacy of IMIs for various mental disorders (e.g., [ 8 – 10 ]), as yet mostly based on Internet-based interventions, while evidence for MHAs is less established [ 11 ]. Correspondingly, a recent scoping review on technology-based interventions for BPD shows that while evidence for Internet-based interventions is emerging, there is only little evidence for MHAs for BPD [ 12 ]. However, results on all five included MHAs supported their acceptance and/or usability [ 12 ].…”

“…Correspondingly, a recent scoping review on technology-based interventions for BPD shows that while evidence for Internet-based interventions is emerging, there is only little evidence for MHAs for BPD [ 12 ]. However, results on all five included MHAs supported their acceptance and/or usability [ 12 ]. A recent systematic review and meta-analysis on seven randomized controlled trials (RCTs) of MHAs for adults with common BPD symptoms [ 13 ] showed no significant effects between conditions with and without (e.g., waitlist, treatment-as-usual) MHAs on BPD-related symptoms.…”