Background: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While...Show moreBackground: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While previous studies have shown a link between dissociation and WM deficits, the influence of (mal)adaptive skills on this relationship remains unexplored. A core component of BPD treatment is practicing emotional regulation, which has been found to be associated with dissociation and WM capacity. Exploring these associations may be of clinical importance since practicing emotional regulation during treatment may additionally improve WM capacity in people with dissociation. This cross-sectional study examined how adaptive coping skills and maladaptive coping (self-harm) impact the relationship between dissociation and WM in 57 female BPD patients. Methods: An emotional working memory task (EWMT, adapted Sternberg recognition task), assessed WM in terms of accuracy and reaction time (RT) during distraction. Participants self-reported dissociation (Dissociation Stress Scale acute), self-harming behavior (Borderline Symptom List Supplement) and the use of (mal)adaptive skills (Dialectical Behavior Therapy-Revised Ways of Coping Checklist). Baseline characteristics were compared to a healthy control group (HC, n = 28) using a one-way Multivariate Analysis of Variance (MANOVA). Within the BPD group, simple and hierarchical linear regression analyses and correlation analyses were conducted to assess associations between clinical variables and WM. Results: BPD patients reported increased dissociation and self-harm, and less adaptive coping skills compared to HC, while they did not differ regarding WM. Within the BPD group, both pre-task dissociation and adaptive skills significantly predicted accuracy but not RT on the EWMT. Self-harm and adaptive skills were found to influence the association between dissociation and WM performance. These findings emphasize the importance of assessing dissociative symptoms prior to and during treatment. Strengthening adaptive skills and reducing self-harm remains an important treatment avenue that may enhance WM through better emotional regulation capacities.Show less
Emotion regulation (ER) often happens in social contexts but research on interpersonal ER is still scare. This study aimed to investigate the impact of interpersonal ER strategies on emotional...Show moreEmotion regulation (ER) often happens in social contexts but research on interpersonal ER is still scare. This study aimed to investigate the impact of interpersonal ER strategies on emotional working memory (eWM) performance, particularly focusing on individuals with borderline personality disorder (BPD). The study hypothesized that ER domains, specifically those addressing negative affect, adversely affect eWM performance and that the presence of BPD would moderate this relationship. This within-subject, experimental study involved 164 participants, with complete data from 89 individuals (68 females, mean age 25.30 ± 4.16 years). BPD was assessed by trained clinicians using the International Personality Disorder Examination. Participants completed the Interpersonal Emotion Regulation Questionnaire and an Emotional Working Memory Task (EWMT) featuring emotionally arousing stimuli as distractors. Linear regression analyses were conducted to examine the predictive and moderating effects of interpersonal ER strategies and BPD on eWM performance. The study found opposite effects of what was originally hypothesized: the Perspective Taking domain of ER significantly predicted eWM performance. This relationship was moderated by BPD: individuals with BPD and higher scores on the Perspective Taking scale experienced less distraction during the EWMT in the presence of emotional facial stimuli, while there was no significant difference for controls. Additionally, Enhancing Positive Affect negatively influenced eWM performance, suggesting that higher scores in this domain were associated with increased distraction by emotional stimuli. However, no significant effects were found for the Soothing and Social Modeling domains. The findings highlight the importance of not only considering intrapersonal but also interpersonal ER strategies in understanding and treating emotional dysregulation in BPD. Integrating computer-based eWM training programs and interpersonal ER strategies into therapeutic approaches may enhance cognitive control and emotional regulation in individuals with BPD.Show less
Background: Childhood trauma (CT) has been associated with eating disorder symptoms (EDs) and borderline personality disorder (BPD) symptoms. Particularly, specific BPD features such as affective...Show moreBackground: Childhood trauma (CT) has been associated with eating disorder symptoms (EDs) and borderline personality disorder (BPD) symptoms. Particularly, specific BPD features such as affective instability, impulsivity, dissociation, self-harm, are a frequent consequence of childhood trauma and co-occur with eating disorders. Previous findings suggested that symptoms of BPD could mediate the relationship between CT and EDs. The aim of this self-report study was to investigate whether there is a relationship between childhood trauma and eating disorder symptoms and whether this relationship is partly explained by borderline personality features. Methods: Four hundred and fourteen individuals completed the self-report scales on CT, BPD symptoms and EDs. Using the PROCESS macro tool, it was investigated whether there was a direct effect of CT severity on overall scores of ED symptoms as well as an indirect effect via BPD symptoms. The role of specific features of BPD were analysed in an exploratory manner. Results: Severity of CT significantly predicted EDs symptoms, also after accounting for overall borderline personality symptoms. In addition, there was a significant indirect effect of CT via overall BPD symptoms on EDs. Except for affective instability, indirect effects were found for all BPD features. Conclusion: In the context of previous findings, our results suggested that symptoms of BPD might mediate the relationship between CT and EDs. Given the correlational design of this study that cannot allow causal conclusions, experimental, longitudinal designs should be used in future research to further and deeply understand these associations.Show less
Background: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any...Show moreBackground: A large number of studies have been conducted on the topic of comorbid posttraumatic stress disorder (PTSD) in borderline personality disorder (BPD), however, there is hardly any research that examines the comorbidity rate of PTSD in non-BPD personality disorders (PDs). Knowledge about all clusters of PDs in terms of comorbid PTSD is needed in order to generate a more detailed clinical picture of PDs. Aims: This study is primarily designed to investigate the point-prevalence of comorbid PTSD in clinical practice and, in addition, to explore to what extent the point-prevalence of comorbid PTSD differs between BPD and non-BPD PD patients and gender. Secondly, this study also investigates whether the amount of comorbid disorders is predicted by BPD (versus non-BPD PDs), PTSD and/or gender. Methods: For this retrospective study, data of 183 PD patients was used. During the intake process, the PD diagnosis and comorbid psychiatric disorders were examined using The Structured Clinical Interview for DSM-V and The Mini International Neuropsychiatric Interview Plus. Results: The point-prevalence rates of comorbid PTSD in this non-BPD PD sample is 12.7% and in this BPD sample is 23.1%. Additionally, there was no difference in likelihood of comorbid PTSD in BPD and non-BPD PD patients and between gender. Furthermore, BPD (versus non-BPD PDs), PTSD and gender did not predict the amount of comorbid disorders. Conclusions and implications: The results indicate that in clinical practice, comorbid PTSD and other comorbid disorders might not be recognized so often and thus might be underdiagnosed in PD patients. Hence, there must be more sensitivity in clinical practice for the recognition of comorbid PTSD and other comorbid disorders in PD patients.Show less
Background: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In...Show moreBackground: Verbal auditory hallucinations (VAH) are experienced by 46% of the patients with a borderline personality disorder (BPD). They may constitute a persistent source of distress. In patients with a schizophrenia spectrum disorder, the first choice of treatment for such hallucinations is antipsychotics. Since the effectiveness of these compounds in BPD is largely unknown, the current study focuses on the effectiveness of antipsychotics on VAH in patients with BPD. Method: Patients with BPD who experienced VAH were interviewed with the aid of the Psychotic Symptom Rating Scales – Auditory Hallucinations Rating Scale (PSYRATS - AHRS). To assess improvement over time a pre- and post-test was carried out. A logistic regression analysis was used to investigate the likelihood that receiving antipsychotics was predicted by the degree of suffering from VAH in patients with BPD at pre-test. A Wilcoxon signed rank test was used to investigate improvement over time in degree of suffering and general functioning. A Man-Whitney U test was used to investigate the expectation that patients with BPD and VAH who use antipsychotics experience a larger decrease in the degree of suffering from VAH than patients with BPD and VAH who do not use antipsychotics. Results: Among the 23 patients thus assessed, no improvement over time was found in the degree of suffering or in general functioning when using antipsychotics. Conclusion: Antipsychotics may not be effective in treating VAH in patients with BPD. Future research among a larger patient group may need to take into account the types of antipsychotic prescribed, dosages, and duration of treatment.Show less
