The effectiveness of a day hospital mentalization-based therapy programme for adolescents with borderline personality traits: Findings from Touchstone-Child and Adolescent Mental Health Service

BACKGROUND

Individuals with borderline personality disorder (BPD) are at a substantial risk of harm to themselves and others, experience high levels of functional impairment and typically are high users of tertiary healthcare to address their mental health concerns. As indicators for BPD typically emerge in adolescence, a day therapy service in Bentley, Western Australia, Touchstone Child and Adolescent Mental Health Service (CAMHS), was developed as an intensive intervention for adolescents with indicators for BPD and its associated symptomology. Touchstone utilizes mentalization-based therapy (MBT) in a therapeutic community setting, where the current study sought to document the anecdotal outcomes using the data provided at Touchstone, to enable a greater understanding of this treatment approach for adolescents with indicators for BPD.

METHOD

Forty-six participants attended the Touchstone programme between 2015 and 2020. The programme involved 6 months of MBT (group and individual), occupational therapy, education and creative therapies. Measures of self-injury, mood and emergency department presentations were collected pre- and post-programme.

RESULTS

Results indicate that participants show a reduction in non-suicidal acts and thoughts, as well as a reduction in negative moods and feelings from pre-Touchstone to post-Touchstone. There is also a decrease in participant presentation to tertiary emergency departments for mental health concerns.

CONCLUSIONS

The current study shows evidence for the efficacy of Touchstone as an MBT therapeutic community intervention to reduce symptoms of emerging BPD and effectively reduce presentations to emergency departments for mental health presentations, alleviating pressure on tertiary hospitals and reducing economic impact of adolescents within this demographic.

Childhood emotional abuse and alcohol use disorders in a national Nepali women sample: The mediating role of borderline personality traits

While many studies have found an association between childhood emotional abuse and alcohol use disorders (AUD) during adulthood, underlying psychological mechanisms linking the two remain inadequately understood. Drawing on the developmental psychopathology perspective, this study examined the relationship between childhood emotional abuse and AUD during adulthood with a national sample of women in Nepal (N = 1,100, M age = 37.73), focusing on the mediating role of borderline personality traits. Mediation analyses were performed using the Karlson-Holm-Breen (KHB) method and bootstrapping confidence intervals. Results indicated that Nepali women's borderline personality traits significantly mediated the relationship between childhood emotional abuse and AUD. Hence, emotional abuse in childhood increases the risk for AUD during adulthood for Nepali women by increasing the risk of borderline personality traits. Findings underscore the necessity of continued emphasis on developing and implementing early interventions for childhood emotional abuse and therapeutic interventions for borderline personality traits in reducing AUD among vulnerable women in Nepal.

The Sense of Commitment in Individuals With Borderline Personality Traits in a Non-clinical Population

This is the first study to test the hypothesis that individuals' sense of commitment in joint activities and relationships may be influenced by personality traits characteristic of borderline personality disorder (BPD). This study consisted of 3 online experiments implemented via Amazon Mechanical Turk. Participants were presented with videos (Experiment 1) or vignettes (Experiments 2, 3) describing situations in which everyday commitments were violated. Participants then reported their perceptions, interpretations, and affective and behavioral responses to those situations. Participants' BPD traits (BPDt) were assessed using the short form of the Five-Factor Borderline Inventory on the basis of which they were divided into two groups: High and Low BPDt. The results revealed that participants with High BPD traits were less optimistic about others acting in accordance with an implicit sense of commitment (Experiment 1), although there was no difference between groups when the commitment was explicitly stated (Experiment 3). Participants in the High BPDt group also reported heightened emotional responses (Experiments 1-3) and less adaptive behavioral responses (Experiments 1, 3) to perceived or anticipated violations of commitment. Our findings suggest that high levels of BPD traits may give rise to a difficulty in adapting one's social expectations and behavior in light of interpersonal commitments and in a manner that is calibrated to the social norms in the community. Future research should investigate to what extent a disturbed sense of commitment may contribute to the difficulties in interpersonal functioning experienced by many individuals with a clinical diagnosis of BPD.