Top

Gepubliceerd in:

19-12-2018 | ORIGINAL PAPER

Effects of Mindfulness Training on Borderline Personality Disorder: Impulsivity Versus Emotional Dysregulation

Auteurs: Cristina Carmona i Farrés, Matilde Elices, Joaquim Soler, Elisabet Domínguez-Clavé, Edith Pomarol-Clotet, Raymond Salvador, Juan C. Pascual

Gepubliceerd in: Mindfulness | Uitgave 7/2019

Abstract

Emotion dysregulation (ED) and impulsivity are the two core characteristics of borderline personality disorder (BPD). Although the mindfulness module of dialectical behavior therapy (DBT) has proven effective to treat general BPD symptomatology, no studies have yet been conducted to determine whether mindfulness specifically targets impulsivity and/or ED in patients with BPD. Therefore, the aim of the current study was to examine the impact of mindfulness training on those two characteristics. A clinical sample (n = 70) of individuals with BPD were randomized to one of two interventions: DBT mindfulness skills training (DBT-M) or DBT interpersonal effectiveness skills training (DBT-IE). Participants were assessed prior to treatment and at the end of the 10-week training program. Assessment included measures of impulsivity, emotion dysregulation, BPD severity, and mindfulness facets. Our findings showed that impulsivity decreased in the DBT-M group but not in the DBT-IE group. BPD psychopathology and some aspects of ED (e.g., emotional clarity and emotional acceptance) improved in both groups. These results show that the mindfulness module of DBT improves both emotion regulation and impulsivity. Trial Registration: ClinicalTrials.gov: NCT03363230

vorige artikel Meditation on the Soles of the Feet Practice Provides Some Control of Aggression for Individuals with Alzheimer’s Disease

volgende artikel Feasibility Pilot of a Brief Mindfulness Intervention for College Students with Posttraumatic Stress Symptoms and Problem Drinking

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Philadelphia: American Psychiatric Publishing.CrossRef

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.PubMedCrossRef

Barrachina, J., Soler, J., Campins, M. J., Tejero, A., Pascual, J. C., Alvarez, E., et al. (2004). Validation of a Spanish version of the Diagnostic Interview for Bordelines-Revised (DIB-R). Actas Españolas de Psiquiatría, 32(5), 293–298.PubMed

Barratt, E. S., Patton, J., & Stanford, M. (1975). Barratt impulsiveness scale. University of Texas Texas: Barratt-Psychiatry Medical Branch.

Beauchaine, T. P., Klein, D. N., Crowell, S. E., Derbidge, C. M., & Gatzke-Kopp, L. (2009). Multifinality in the development of personality disorders: a biology × sex × environment interaction model of antisocial and borderline traits. Development and Psychopathology, 21, 735–770.PubMedPubMedCentralCrossRef

Becker, E. S., Rinck, M., Margraf, J., & Roth, W. T. (2001). The emotional Stroop effect in anxiety disorders: general emotionality or disorder specificity? Journal of Anxiety Disorders, 15, 147–159.PubMedCrossRef

Bertsch, K., Hillmann, K., & Herpertz, S. C. (2018). Behavioral and neurobiological correlates of disturbed emotion processing in borderline personality disorder. Psychopathology, 51, 76–82.PubMedCrossRef

Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.

Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R. D., Domsalla, M., Chapman, A. L., ... & Wolf, M. (2009). The short version of the Borderline Symptom List (BSL-23): development and initial data on psychometric properties. Psychopathology, 42(1), 32–39.

Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behavior Therapy, 43(2), 365–380.PubMedCrossRef

Cackowski, S., Reitz, A.-C., Ende, G., Kleindienst, N., Bohus, M., Schmahl, C., & Krause-Utz, A. (2014). Impact of stress on different components of impulsivity in borderline personality disorder. Psychological Medicine, 44(15), 3329–3340.

Cebolla, A., García-Palacios, A., Soler, J., Guillen, V., Baños, R., & Botella, C. (2012). Psychometric properties of the Spanish validation of the Five Facets of Mindfulness Questionnaire (FFMQ). The European Journal of Psychiatry, 26(2), 118–126.CrossRef

Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44(3), 371–394.PubMedCrossRef

Cohen, J. (1988). Statistical power analysis for the behavioural sciences. Hillsdale, NJ: Erlbaum.

Collie, A., Maruff, P., Darby, D. G., & McStephen, M. (2003). The effects of practice on the cognitive test performance of neurologically normal individuals assessed at brief test–retest intervals. Journal of the International Neuropsychological Society, 9(3), 419–428.PubMedCrossRef

Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135(3), 495–510.PubMedPubMedCentralCrossRef

van der Heiden, C., Muris, P., & van der Molen, H. T. (2012). Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder. Behaviour Research and Therapy, 50(2), 100–109.PubMedCrossRef

Domes, G., Winter, B., Schnell, K., Vohs, K., Fast, K., & Herpertz, S. C. (2006). The influence of emotions on inhibitory functioning in borderline personality disorder. Psychological Medicine, 36(8), 1163–1172.PubMedCrossRef

Eisenlohr-Moul, T., Peters, J. R., Chamberlain, K. D., & Rodriguez, M. (2016). Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women. Journal of Psychopathology and Behavioral Assessment, 38(1), 149–157.PubMedCrossRef

Elices, M., Pascual, J. C., Portella, M. J., Feliu-Soler, A., Martín-Blanco, A., Carmona, C., & Soler, J. (2016). Impact of mindfulness training on borderline personality disorder: a randomized trial. Mindfulness, 7(3), 584–595.CrossRef

Feliu-Soler, A., Pascual, J. C., Borràs, X., Portella, M. J., Martín-Blanco, A., Armario, A., et al. (2014). Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results. Clinical Psychology & Psychotherapy, 21(4), 363–370.CrossRef

Fidell, S., Pearsons, K., Tabachnick, B. G., & Howe, R. (2000). Effects on sleep disturbance of changes in aircraft noise near three airports. The Journal of the Acoustical Society of America, 107(5), 2535–2547.

First, M. B., Gibbon, M., Spitzer, R. L., & Benjamin, L. S. (1997). User’s guide for the structured clinical interview for DSM-IV axis II personality disorders: SCID-II. Washington: American Psychiatric Pub.

Franco, C., Amutio, A., López-González, L., Oriol, X., & Martínez-Taboada, C. (2016). Effect of a mindfulness training program on the impulsivity and aggression levels of adolescents with behavioral problems in the classroom. Frontiers in Psychology, 7, 1385.PubMedPubMedCentral

Fresco, D. M., Moore, M. T., van Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246.PubMedCrossRef

Gómez-Beneyto, M., Villar, M., Renovell, M., Pérez, M., Herández, M., & Leal, C. (1994). The diagnosis of personality disorder with a modified version of the SCID-II in a Spanish clinical sample. Journal of Personality Disorders, 8, 104–110.CrossRef

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54.CrossRef

Gratz, K. L., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 37(1), 14–25.PubMedCrossRef

Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2010). An experimental investigation of emotional reactivity and delayed emotional recovery in borderline personality disorder: the role of shame. Comprehensive Psychiatry, 51(3), 275–285.PubMedCrossRef

Harned, M. S., Korslund, K. E., & Linehan, M. M. (2014). A pilot randomized controlled trial of dialectical behavior therapy with and without the dialectical behavior therapy prolonged exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy, 55, 7–17.PubMedPubMedCentralCrossRef

Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: understanding and treating human suffering. New York: Guilford.

Herpertz, S. C., Schneider, I., Schmahl, C., & Bertsch, K. (2018). Neurobiological mechanisms mediating emotion dysregulation as targets of change in borderline personality disorder. Psychopathology, 51(2), 96–104.PubMedCrossRef

Hervás, G., & Jódar, R. (2008). Adaptación al castellano de la Escala de Dificultades en la Regulación Emocional. Clínica y Salud, 19(2), 139–156.

Holzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559.PubMedCrossRef

Jankowski, T., & Holas, P. (2014). Metacognitive model of mindfulness. Consciousness and Cognition, 28, 64–80.PubMedCrossRef

Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Delacorte.

Kaiser, D., Jacob, G. A., Domes, G., & Arntz, A. (2017). Attentional Bias for emotional stimuli in borderline personality disorder: a meta-analysis. Psychopathology, 49(6), 383–396.CrossRef

Keng, S. L., Robins, C. J., Smoski, M. J., Dagenbach, J., & Leary, M. R. (2013). Reappraisal and mindfulness: a comparison of subjective effects and cognitive costs. Behaviour Research and Therapy, 51(12), 899–904.PubMedPubMedCentralCrossRef

Keng, S., Yan Tan, E., Eisenlohr-Moul, T. A., & Smoski, M. (2017). Effects of mindfulness, reappraisal, and suppression on sad mood and cognitive resources. Behavior Research and Therapy, 91, 33–42.CrossRef

Klonsky, E. D. (2007). The functions of deliberate self-injury: a review of the evidence. Clinical Psychology Review, 27(2), 226–239.PubMedCrossRef

Kotsou, I., Leys, C., & Fossion, P. (2018). Acceptance alone is a better predictor of psychopathology and well-being than emotional competence, emotion regulation and mindfulness. Journal of Affective Disorders, 226, 142–145.PubMedCrossRef

Krishnakumar, S., & Robinson, M. D. (2015). Maintaining an even keel: an affect-mediated model of mindfulness and hostile work behavior. Emotion, 15(5), 579.PubMedCrossRef

Kross, E., Card, D., Deldin, P., Clifton, J., & Ayduk, O. (2012). “Asking why” from a distance: its cognitive and emotional consequences for people with major depressive disorder. Journal of Abnormal Psychology, 121, 559e569.CrossRef

Lee, J. K., & Orsillo, S. M. (2014). Investigating cognitive flexibility as a potential mechanism of mindfulness in generalized anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 208–216.PubMedCrossRef

Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84.CrossRef

Linehan, M. M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.

Linehan, M. M. (1993b). Skills training manual for treating borderline personality disorder. New York City: Guilford Press.

Linehan, M. M. (2014). DBT Skills Training Manual (2nd ed.). New York, NY: Guilford Press.

Linehan, M. M., Bohus, M., & Lynch, T. (2007). Dialectical behavior therapy for pervasive emotion dysregulation. Theoretical and practical underpinnings. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 581–605). New York, NY: The Guilford Press.

Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder a randomized clinical trial and component analysis. JAMA, 98195, 1–8.

Little, R., & Rubin, D. (1987). Statistical analysis with missing data. New York, NY: Wiley.

MacLeod, C. M. (1992). The Stroop task: the “gold standard” of attentional measures. Journal of Experimental Psychology: General, 121(1), 12.CrossRef

Peckham, A. D., McHugh, R. K., & Otto, M. W. (2010). A meta-analysis of the magnitude of biased attention in depression. Depression and Anxiety, 27(12), 1135–1142.

Peters, J. R., Erisman, S. M., Upton, B. T., Baer, R. A., & Roemer, L. (2011). A preliminary investigation of the relationships between dispositional mindfulness and impulsivity. Mindfulness, 2(4), 228–235.CrossRef

Peters, J. R., Eisenlohr-moul, T. A., Upton, B. T., & Baer, R. A. (2013). Nonjudgment as a moderator of the relationship between present-centered awareness and borderline features: synergistic interactions in mindfulness assessment. Personality and Individual Differences, 55(1), 24–28.CrossRef

Peters, J. R., Smart, L. M., Eisenlohr-Moul, T. A., Geiger, P. J., Smith, G. T., & Baer, R. A. (2015). Anger rumination as a mediator of the relationship between mindfulness and aggression: the utility of a multidimensional mindfulness model. Journal of Clinical Psychology, 71(9), 871–884.PubMedCrossRef

Portella, M. J., Soler, J., Tejero, A., Barrachina, J., Tiana, T., Pascual, J. C., et al. (2011). Slow processing in borderline personality disorder: the emotional Stroop paradigm. Actas Espanolas de Psiquiatria, 39(6), 356–362.PubMed

Sauer, S., Walach, H., Schmidt, S., Hinterberger, T., Horan, M., & Kohls, N. (2011). Implicit and explicit emotional behavior and mindfulness. Consciousness and Cognition, 20(4), 1558–1569.PubMedCrossRef

Sebastian, A., Jacob, G., Lieb, K., & Tüscher, O. (2013). Impulsivity in borderline personality disorder: a matter of disturbed impulse control or a facet of emotional dysregulation? Current Psychiatry Reports, 15(2), 339.PubMedCrossRef

Shapiro, S., Carlson, L. E., Astin, J., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.PubMedCrossRef

Siegrist, M. (1997). Test-retest reliability of different versions of the Stroop test. The Journal of Psychology, 131(3), 299–306.CrossRef

Sieswerda, S., Arntz, A., Mertens, I., & Vertommen, S. (2007). Hypervigilance in patients with borderline personality disorder: specificity, automaticity, and predictors. Behaviour Research and Therapy, 45(5), 1011–1024.PubMedCrossRef

Soler, J., Pascual, J. C., Tiana, T., Cebrià, A., Barrachina, J., Campins, M. J., et al. (2009). Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behaviour Research and Therapy, 47(5), 353–358.PubMedCrossRef

Soler, J., Valdepérez, A., Feliu-Soler, A., Pascual, J. C., Portella, M. J., Martín-Blanco, A., et al. (2012). Effects of the dialectical behavioral therapy-mindfulness module on attention in patients with borderline personality disorder. Behaviour Research and Therapy, 50(2), 150–157.PubMedCrossRef

Soler, J., Vega, D., Feliu-Soler, A., Trujols, J., Soto, A., Elices, M., et al. (2013). Validation of the Spanish version of the Borderline Symptom List, short form (BSL-23). BMC Psychiatry, 13, 139.PubMedPubMedCentralCrossRef

Soler, J., Franquesa, A., Feliu-Soler, A., Cebolla, A., García-Campayo, J., Tejedor, R., et al. (2014). Assessing decentering: validation, psychometric properties, and clinical usefulness of the experiences questionnaire in a Spanish sample. Behavior Therapy, 45(6), 863–871.PubMedCrossRef

Soler, J., Elices, M., Pascual, J. C., Martín-Blanco, A., Feliu-Soler, A., Carmona, C., & Portella, M. J. (2016). Effects of mindfulness training on different components of impulsivity in borderline personality disorder: results from a pilot randomized study. Borderline Personality Disorder and Emotion Dysregulation, 51(1), 411–416.

Stoffers, J., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2012). Psychological therapies for people with borderline personality disorder (Review). In Cochrane Database of Systematic Reviews (Cochrane D). John Wiley & Sons.

Strauss, G. P., Allen, D. N., Jorgensen, M. L., & Cramer, S. L. (2005). Test-retest reliability of standard and emotional stroop tasks: an investigation of color-word and picture-word versions. Assessment, 12(3), 330–337.PubMedCrossRef

Teasdale, J. D., Moore, R., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: empirical evidence. Journal of Consulting and Clinical Psychology, 70(2), 275–287.PubMedCrossRef

Travers-Hill, E., Dunn, B. D., Hoppitt, L., Hitchcock, C., & Dalgleish, T. (2017). Beneficial effects of training in self-distancing and perspective broadening for people with a history of recurrent depression. Behaviour Research and Therapy, 95, 19–28.PubMedPubMedCentralCrossRef

Van den Hurk, P. A. M., Giommi, F., Gielen, S. C., Speckens, A. E. M., & Barendregt, H. P. (2010). Greater efficiency in attentional processing related to mindfulness meditation. The Quarterly Journal of Experimental Psychology, 63(6), 1168e1180.

Williams, J. M. G., Mathews, A., & MacLeod, C. (1996). The emotional Stroop task and psychopathology. Psychological Bulletin, 120(1), 3–24.PubMedCrossRef

Wimmer, L., Bellingrath, S., & von Stockhausen, L. (2016). Cognitive effects of mindfulness training: results of a pilot study based on a theory driven approach. Frontiers in Psychology, 7, 1–14.

Wingenfeld, K., Rullkoetter, N., Mensebach, C., Beblo, T., Mertens, M., Kreisel, S., et al. (2009). Neural correlates of the individual emotional Stroop in borderline personality disorder. Psychoneuroendocrinology, 34(4), 571–586.PubMedCrossRef

Wupperman, P., Neumann, C. S., Whitman, J. B., & Axelrod, S. R. (2009). The role of mindfulness in borderline personality disorder features. The Journal of Nervous and Mental Disease, 197(10), 766–771.PubMedCrossRef

Zanarini, M., Gunderson, J. G., Frankenburg, F. R., & Chauncey, D. L. (1989). The revised diagnostic interview for borderlines: discriminating BPD from other axis II disorders. Journal of Personality Disorders, 3(1), 10–18.CrossRef

Titel: Effects of Mindfulness Training on Borderline Personality Disorder: Impulsivity Versus Emotional Dysregulation
Auteurs: Cristina Carmona i Farrés
Matilde Elices
Joaquim Soler
Elisabet Domínguez-Clavé
Edith Pomarol-Clotet
Raymond Salvador
Juan C. Pascual
Publicatiedatum: 19-12-2018
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 7/2019
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-018-1071-4

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen

Andere artikelen Uitgave 7/2019

Support for the Development and Use of the Child Observation of Mindfulness Measure (C-OMM)

The Experiences of People with an Intellectual Disability of a Mindfulness-Based Program

Is Self-Compassion Related to Behavioural, Clinical and Emotional Outcomes in Adults with Diabetes? Results from the Second Diabetes MILES—Australia (MILES-2) Study

Mindfulness Meditators Do Not Show Differences in Electrophysiological Measures of Error Processing

Specific Facets of Trait Mindfulness Reduce Risk for Alcohol and Drug Use Among First-Year Undergraduate Students

Cross-Lagged Analyses Between Life Meaning, Self-Compassion, and Subjective Well-being Among Gifted Adults