Tag: BPD

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Implementing DBT in Short-Term SUD-treatment

Conditions: Substance Abuse Disorder; Dialectical Behavior Therapy; Emotion Management Skills

Interventions: Behavioral: DBT-informed milieu therapy; Behavioral: Treatment as usual

Sponsors: Helse Møre og Romsdal HF

Not yet recruiting
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Self-esteem and inner strengths: a network study in Thai university students with borderline personality disorder symptoms

IntroductionSelf-esteem is widely regarded as an important construct in the psychological functioning of individuals with borderline personality disorder (BPD) symptoms. During emerging adulthood, fluctuations in self-esteem are often linked to emotional dysregulation and maladaptive adjustment; however, self-esteem has rarely been examined within a broader system of culturally relevant psychological resources. Drawing on the Theravāda Buddhist framework of the Ten Pāramīs, inner strengths may represent protective resources that can be examined alongside self-esteem to clarify how these strengths co-occur among students experiencing BPD symptoms.MethodsThe present study employed a regularized psychological network approach to investigate partial associations between self-esteem and Ten Pāramī–based inner strengths among Thai university students screening positive for BPD symptoms. Participants were 346 Thai university students (25.4% male, 74.6% female; mean age = 21.60 ± 2.24 years) identified using a standardized BPD screening instrument. Inner strengths included Truthfulness, Perseverance, Wisdom, Generosity, adherence to the Five Precepts, Meditation, Tolerance, Equanimity, Determination, and Loving-kindness.ResultThe estimated network showed a predominantly positive pattern of partial associations among strengths. The strongest edge was observed between Generosity and Loving-kindness, and links between self-esteem and Determination (and Equanimity) were among the most consistently estimated associations (based on bootstrap confidence intervals). Centrality indices were examined descriptively; however, case-dropping bootstrap results indicated very limited stability of centrality estimates (CS(cor = 0.7) = 0.13 for strength and expected influence), and centrality rankings were therefore treated as strictly exploratory. Discussion: Although some negative partial associations were estimated (e.g., involving Truthfulness, Perseverance, and Equanimity), their precision was limited and such patterns should be treated as exploratory. Exploratory gender-stratified analyses suggested that the strongest edges were similar in the female subsample, whereas the male subsample yielded a sparse/near-empty regularized network, limiting inference regarding gender differences. Given the cross-sectional design, all associations are interpreted as conditional co-occurrence rather than directional or causal effects.ConclusionOverall, these findings highlight a small set of robust co-occurring inner strengths linked to self-esteem in Thai university students with BPD symptoms and provide a culturally informed basis for hypothesis generation regarding strengths-based skills cultivation and supportive interventions in university settings.
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Enhancing psychiatry education: effectiveness of a psychodynamic psychotherapy module for borderline personality disorder for psychiatry residents

BackgroundPsychodynamic psychotherapy is the treatment of choice for borderline personality disorder (BPD); however, psychiatric residents frequently report difficulty in applying it, partly due to the lack of structured training models. This study developed and evaluated the effectiveness of psychodynamic psychotherapy learning modules for BPD among Indonesian psychiatry residents.MethodsA quasi-experimental pre-/post-test control group study using mixed methods was conducted across nine psychiatric residency programs in Indonesia. Thirty-four residents were recruited, of whom 33 completed the study. Learning outcomes were assessed using multiple-choice questions and the Psychodynamic Formulation Competency Assessment Scale (PF-CAS) and Practical Competency Assessment Scale (PC-CAS). The module program was evaluated by the participants using the Indonesian version of the Kirkpatrick Level 1 questionnaire.ResultsThe intervention group showed significantly greater improvement in psychodynamic formulation skills (PF-CAS) than the control group (p < 0.001). The multiple-choice scores improved in both groups, with no significant between-group differences. The intervention group showed a numerically greater improvement in Practical Skills (PC-CAS) than the control group, although the difference was not statistically significant. Participants’ feedback was highly positive, emphasizing the usefulness of psychodynamic formulation training, psychotherapy protocols, and supervision.ConclusionImplementation of the psychodynamic psychotherapy for BPD Learning Module enhanced competencies in the cognitive and affective domains and showed promising trends in practical skills. This positive reception highlights its feasibility and potential benefits as part of the residency training curriculum.
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Global research landscape, knowledge structure, and emerging trends in adverse childhood experiences and personality disorders: a bibliometric analysis

BackgroundThe relationship between adverse childhood experiences (ACEs) and personality disorders (PDs) has attracted sustained attention in psychiatry, psychology, and public health. Existing studies have mainly examined epidemiological associations, specific PDs diagnoses, or mechanisms, whereas bibliometric evidence mapping the field’s knowledge structure and thematic evolution remains limited. This study aimed to characterize trends, contributors, collaboration networks, core themes, and frontiers in ACEs–PDs research.MethodsEnglish-language publications on ACEs and PDs were retrieved from Web of Science Core Collection, Scopus, and PubMed from inception to December 31, 2025. After year screening, document-type filtering, and deduplication, 5,084 records were included. Bibliometric analyses were performed using R, VOSviewer, and CiteSpace. The merged dataset was used to examine annual trends, countries/regions, institutions, authors, journals, and keyword co-occurrence, while WoSCC records were used for co-citation analysis, keyword clustering, and burst detection.ResultsACEs–PDs research showed sustained growth, with a marked increase after 2000. The United States occupied a central position in publication output, citation impact, and international collaboration, while the United Kingdom, Germany, Canada, the Netherlands, and Australia also showed strong influence. Harvard University, the University of London, and Ruprecht Karls University Heidelberg were leading institutions; Zanarini M, Fonagy P, Schmahl C, Paris J, and Kleindienst N were key contributors. Influential journals mainly covered psychiatry, personality disorders, child maltreatment, trauma, and developmental psychopathology. Keyword analyses identified childhood adversity, personality disorder, borderline personality disorder, depression, childhood sexual abuse, and post-traumatic stress disorder as core themes. VOSviewer and CiteSpace analyses indicated that hotspots have expanded from childhood abuse, PDs diagnosis, and psychiatric comorbidity to emotion dysregulation, non-suicidal self-injury, social support, functional connectivity, early intervention, and mechanism validation. Highly cited publications revealed a knowledge base centered on childhood abuse/trauma, borderline personality disorder, psychiatric comorbidity, emotion regulation, and neurobiological mechanisms.ConclusionThis study maps development and knowledge structure of ACEs–PDs research. Findings suggest a shift from exposure–outcome association studies toward comorbidity, intermediate phenotypes, neurobiological mechanisms, and clinical translation. Future research should strengthen longitudinal and cross-cultural designs, consider ACE type, timing, duration, and severity, and integrate neuroimaging, inflammatory, epigenetic, and clinical-course phenotypes.
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Overlaps and differences in the core symptoms of patients with attention-deficit/hyperactivity disorder and patients with borderline personality disorder

BackgroundIndividuals with attention-deficit/hyperactivity disorder (ADHD) and individuals with borderline personality disorder (BPD) show symptomatic overlaps. They both suffer from deficits in emotional regulation, are impulsive and have problems with their self-concept. Therefore, a precise diagnostic differentiation is of great importance. The aim of this study was to find symptom overlaps and differences in patients with ADHD and BPD.Methods80 patients with ADHD, 55 patients with BPD and 55 healthy controls were examined regarding their ADHD and BPD symptoms and their degree of emotional dysregulation using self-report instruments.ResultsPatients with ADHD and patients with BPD did not differ significantly in their expression of emotional dysregulation. However, the ADHD patients showed higher scores in impulsivity, inattention, and hyperactivity, whereas the group with BPD showed higher scores in self-concept problems and suicidal behaviour. The two clinical groups showed significantly higher scores in emotional dysregulation and all other symptom domains compared to the control group.ConclusionThe symptom overlap in emotional dysregulation yields implications for both further research and diagnosis of ADHD. Further studies should define emotional dysregulation consistently to examine the same construct. Key Practitioner Message: This article yields implications that individuals with ADHD and BPD have several symptom overlaps and in fact have no difference in their emotional dysregulation. This has a vast importance for differential diagnosis and treatment of ADHD.
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Personality functioning in adolescents with depression: links with childhood maltreatment, psychopathology, self-harm and suicidal ideation

BackgroundAdolescence represents a critical developmental period marked by significant vulnerability to depression, a condition with heterogeneous presentations that complicate clinical management. The co-occurrence of personality dysfunction with depression is known to indicate greater severity and poorer prognosis, yet specific features of this comorbidity in adolescent clinical samples require further delineation. This study aimed to compare clinical and psychosocial correlates in depressed adolescents with and without impaired personality functioning.MethodsThe clinical sample comprised 73 adolescents (aged 12–17; 83.6% female) diagnosed with depression or reporting clinically significant depressive symptoms. Participants completed self-report measures assessing personality functioning (LoPF-Q 12–18), childhood maltreatment (CEQ), psychopathology (YSR 11-18), mentalizing capacity (RFQY-8), borderline traits (BPFS-C), and self-harm behavior. Based on LoPF-Q 12-18 T-scores, participants were categorized into two subgroups: depression without personality dysfunction (T ≤ 64; n=20) and depression with personality dysfunction (T ≥ 65; n=53).ResultsResults indicated that adolescents with co-occurring depression and personality dysfunction exhibited significantly lower functioning across all personality domains compared to those with depression alone. This subgroup also reported an earlier onset and higher frequency of self-harm, more severe suicidal ideation, elevated borderline traits, and greater impairments in mentalizing. Furthermore, they demonstrated higher levels of internalizing, affective, conduct, and PTSD symptoms, alongside greater exposure to emotional neglect.ConclusionImpaired personality functioning in depressed adolescents is associated with elevated and multifaceted patterns of symptoms, including subjective distress and risky behaviors. These findings underscore the necessity of routinely assessing personality functioning in adolescents with clinically significant depressive symptoms to enable early identification and the development of tailored, integrated interventions for this high-risk subgroup.
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Additive impulsivity and emotion dysregulation in adolescents with comorbid bipolar and substance use disorder: a cross-sectional factorial study

IntroductionComorbid bipolar disorder (BD) and substance use disorder (SUD) in adolescence is associated with poor clinical outcomes, yet the independent and interactive contributions of impulsivity and emotion dysregulation remain poorly understood.MethodsThis cross-sectional study employed a 2 × 2 factorial design to examine impulsivity, measured with the Barratt Impulsiveness Scale-11, and emotion regulation difficulties, measured with the Difficulties in Emotion Regulation Scale, across four groups of adolescents (N = 128; aged 12–18 years): BD+SUD (n = 32), BD-only (n = 32), SUD-only (n = 32), and healthy controls (n = 32). All clinical participants were assessed during euthymia. Factorial analyses of covariance controlled for age, sex, residence, family structure, and income.ResultsSignificant BD × SUD interactions were found for emotion regulation, F(1,120) = 35.89, p < .001, ηp2 = .230, and impulsivity, F(1,120) = 9.51, p = .002, ηp2 = .073. The BD+SUD group showed the highest scores on both measures, exceeding the SUD-only group by 38.90 points on emotion dysregulation and 26.72 points on impulsivity. In the substance-using subsample (n = 64), impulsivity was the strongest predictor of substance use severity (B = 0.61, p < .001; R2 = .48). The BD+SUD group also displayed earlier illness onset, mixed-feature predominance, greater polydrug use, and exclusive high-lethality suicide attempts. Low income was the strongest exploratory predictor of clinical group membership.DiscussionThese findings support an additive comorbidity model in which BD and SUD jointly amplify impulsivity and emotion dysregulation, and they highlight the need for integrated, impulsivity-focused interventions in adolescents with dual diagnoses.