Recent developments in psychosocial interventions for borderline personality disorder

A Comprehensive Literature Review of Borderline Personality Disorder: Unraveling Complexity From Diagnosis to Treatment

Borderline personality disorder (BPD) is a severe mental illness marked by unpredictable feelings, behaviors, and relationships. Symptoms like emotional instability, impulsivity, and poor social connections are the basis for diagnostic criteria. A noteworthy discovery highlights the clinical overlap between BPD and several psychotic disorders by arguing that BPD and psychotic symptoms raise the risk of psychopathology. According to neuroimaging evidence, structural and functional brain changes, notably in regions controlling affective regulation and impulse control, are seen in BPD patients. Adolf Stern, a psychoanalyst, used the word "borderline" in 1938 to describe patients who exhibited increased symptoms during therapy and displayed masochistic tendencies. Modern BPD research has highlighted the complexity of symptoms like boredom, a former diagnostic criterion associated with feelings of emptiness. Though there are still unanswered problems regarding its precise, practical components, the treatment technique known as Schema therapy (ST) has shown promise in treating BPD. It's interesting to note that BPD displays complex relationships with other illnesses; for instance, some neurochemical pathways coincide with those in bulimia nervosa, pointing to a deeper level of interconnection. Concerning diagnosis, BPD's defining symptoms include, among others, the fear of abandonment, identity disruption, and recurrent suicidal conduct. The range of treatment options includes pharmacological interventions and psychotherapies like dialectical behavior therapy (DBT). Even though antidepressants like selective serotonin reuptake inhibitors (SSRIs) are routinely prescribed, research on their efficacy is ongoing, underlining the significance of thorough treatment planning. In conclusion, BPD continues to be a complex condition that calls for early detection, especially considering that it usually manifests in adolescence. While many patients report symptom relief, lingering problems still exist, emphasizing the value of comprehensive and personalized treatment strategies.

Symptomatic Disorders in Adults and Adolescents With Borderline Personality Disorder

Symptomatic disorders often co-occur with borderline personality disorder (BPD). This study's purpose was to compare the rates of comorbidity reported by adult and adolescent inpatients with BPD, including complex comorbidity (i.e., a combination of disorders of affect and impulsivity). One hundred four adolescents (aged 13-17) and 290 adults (aged 18-35) with BPD were interviewed using an age-appropriate semistructured interview for the assessment of symptomatic disorders. Lifetime rates of mood disorders and ADHD were quite similar for the two study groups. However, rates of anxiety disorders, including PTSD, substance use disorders, eating disorders, and complex comorbidity were significantly higher among adults than adolescents. Taken together, the results of this study suggest that broadly defined disorders of both affect and impulsivity are more common among adults than adolescents with BPD. They also suggest that a pattern of complex comorbidity is even more distinguishing for these two groups of borderline patients.

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

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.