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Brain Sciences
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Advances in Borderline Personality Disorder: From Early Detection to Treatment
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Advances in Borderline Personality Disorder: From Early Detection to Treatment

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Psychiatric Diseases".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 12385

Special Issue Editor

Dr. Irene Messina

E-Mail Website
Guest Editor
Centro Psicologia Dinamica, Universitas Mercatorum, 00186 Rome, Italy
Interests: affective neuroscience; emotion regulation; psychotherapy; psychopathology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Borderline personality disorder (BPD) is a complex disorder with large inter-individual variability in symptom profiles, which may include impaired relatedness (unstable relationships with others, identity disturbance, and chronic emptiness), affective dysregulation (affective liability, excessive anger, and efforts to avoid abandonment), and behavior dysregulation (impulsivity, suicidality, and self-injurious behavior). The problematic nature of BPD is characterized by self-mutilation, suicide attempts, addictions, and episodes of depression, anxiety, and aggression, which produce substantial healthcare-related and social-related costs. Psychotherapy is considered the primary treatment for BPD, and this is effective in reducing overall borderline personality disorder severity. Affective neurosciences have shown functional impairment associated with BPD in the default mode network (DMN), the salience network (SN), and the central executive network (CEN), accounting for disturbances in emotion regulation, social cognition, and all emotion-related functions. Consistently, early evidence has reported effects of treatments in these neural systems. The scope of this Special Issue is to provide a venue for the dissemination of research findings from the study of brain mechanisms in BPD and its treatment, including studies focused on concepts that may have clinical implications for the treatment of BPD (for example, emotion regulation/dysregulation, self-harm, social cognition, and others). We encourage the submission of original articles based on experimental research and neuroimaging studies applying novel techniques, as well as review articles and meta-analyses, which may enhance the understanding of processes and mechanisms underlying and maintaining BPD.

Dr. Irene Messina
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • borderline
  • psychotherapy
  • neuroimaging
  • treatment
  • early detection

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Published Papers (5 papers)

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Research

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12 pages, 472 KiB  
Article
Breakdown or Personality Disorder? Psychiatric Characterization and Developmental Pathways Towards Young Adulthood in Adolescents with Pathological Personality Structure
by Chiara Rogantini, Marika Orlandi, Arianna Vecchio, Diletta Cristina Pratile, Raffaella Fiamma Cabini, Elena Ballante, Valentina De Giorgis, Renato Borgatti and Martina Maria Mensi
Brain Sci. 2024, 14(11), 1115; https://doi.org/10.3390/brainsci14111115 - 1 Nov 2024
Viewed by 786
Abstract
Background/Objectives: Research is lacking about the development of personality disorders (PDs) from adolescence to early adulthood. This study aimed to characterize the profile of high-risk adolescents compared to adolescents with full-blown PDs and adolescents with other psychiatric disorders and to identify clinical [...] Read more.
Background/Objectives: Research is lacking about the development of personality disorders (PDs) from adolescence to early adulthood. This study aimed to characterize the profile of high-risk adolescents compared to adolescents with full-blown PDs and adolescents with other psychiatric disorders and to identify clinical markers that constitute a risk profile. Methods: We evaluated 99 adolescents (12–17 years old) through DSM-5-based semi-structured interviews, questionnaires, cognitive tasks, and scales regarding functioning and disorder severity. We divided patients into three groups: 22 adolescents with full-blown personality disorder (FBPD), 57 adolescents at high risk for personality disorders (HPD), and 20 adolescents with other DSM-5 psychiatric disorders (OTH). At follow-up, 56 patients completed the assessment. Possible developmental trajectories of FBPD and HPD patients were remission (total or partial) of PD-related symptoms, stability of symptoms, or transition from HPD to FBPD. Results: FBPD adolescents had more impaired family backgrounds. At baseline, the HPD group was mainly composed of female patients, younger than the FBPD ones. Externalizing symptoms may represent prodromal symptoms of FBPD. High-risk patients who made the transition were younger than those who did not, and their mothers reported higher internalizing symptoms at baseline. None of the FBPD patients remitted. Conclusions: These findings support the hypothesis of a PD “at-risk mental state” and the importance of the implementation of PD early detection and treatment in adolescents, regardless of patient age. Full article
(This article belongs to the Special Issue Advances in Borderline Personality Disorder: From Early Detection to Treatment)
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20 pages, 2748 KiB  
Article
Short- and Long-Term Outcomes of an Adventure Therapy Programme on Borderline Personality Disorder: A Pragmatic Controlled Clinical Trial
by Alba Gabarda-Blasco, Aina Elias, Mariona Mendo-Cullell, Laura Arenas-Pijoan, Carles Forné, David Fernandez-Oñate, Laura Bossa, Aurora Torrent, Xavier Gallart-Palau and Iolanda Batalla
Brain Sci. 2024, 14(3), 236; https://doi.org/10.3390/brainsci14030236 - 29 Feb 2024
Viewed by 2039
Abstract
Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response [...] Read more.
Adventure Therapy (AT) is a therapeutic intervention utilizing the natural environment and adventure activities as tools for psychotherapeutic interventions. It has been demonstrated to be appropriate for the intervention of patients with borderline personality disorder (BPD). This study aims to evaluate the response to AT treatment compared with the response to treatment as usual (TAU), based on cognitive behavioural therapy, in the short and long term, assessing clinical, psychosocial, and functional outcomes; quality of life; and physical health levels. This study extends the sample of and is a follow-up to a pilot study published in 2021, with a sample of 30 patients in the AT group and 10 in the control group. It does not allow us to affirm that AT provides better outcomes than TAU, as the positive effects observed immediately after therapy seem to be attenuated in the long term. Therefore, the effectiveness of long-term psychotherapy did not show differences between AT and TAU therapies in the treatment of BPD patients. However, the effects of intangibles observed during therapy by professionals and patients were not reflected in the measurements collected. Therefore, we believe it is necessary to increase the programme duration, complement treatment with a specific physical health programme, assess results with more specific instruments, and/or move towards a qualitative methodology to measure perceived changes in clinical improvement. New studies are needed to evaluate the results of the proposed changes. Full article
(This article belongs to the Special Issue Advances in Borderline Personality Disorder: From Early Detection to Treatment)
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17 pages, 685 KiB  
Article
“Holding in Anger” as a Mediator in the Relationship between Attachment Orientations and Borderline Personality Features
by Irene Messina, Pietro Spataro, Sara Sorella and Alessandro Grecucci
Brain Sci. 2023, 13(6), 878; https://doi.org/10.3390/brainsci13060878 - 29 May 2023
Cited by 1 | Viewed by 1664
Abstract
Insecure attachment and difficulties in regulating anger have both been put forward as possible explanations for emotional dysfunction in borderline personality (BP). This study aimed to test a model according to which the influence of attachment on BP features in a subclinical population [...] Read more.
Insecure attachment and difficulties in regulating anger have both been put forward as possible explanations for emotional dysfunction in borderline personality (BP). This study aimed to test a model according to which the influence of attachment on BP features in a subclinical population is mediated by anger regulation. In a sample of 302 participants, BP features were assessed with the Borderline features scale of the Personality Assessment Inventory (PAI-BOR), attachment was measured with the Experiences in Close Relationships-12 (ECR-12), and trait anger and anger regulation were assessed with the State and Trait Anger Expression Inventory-2 (STAXI-2). The results indicated that anger suppression emerged as a significant mediator of the associations between both anxious and avoidant attachment and BP traits, while anger control resulted as a marginal mediator in the association between attachment avoidance and BP. Suppressing anger may reflect different forms of cognitive or behavioural avoidance of anger, which may differ on the basis of attachment orientations. We argue that these results may have important clinical implications: the promotion of anger regulation in BP should be considered a critical treatment goal. Full article
(This article belongs to the Special Issue Advances in Borderline Personality Disorder: From Early Detection to Treatment)
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Review

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17 pages, 350 KiB  
Review
Mentalizing in Adolescents with Borderline Personality Disorder
by Magdalena Uzar, Monika Dmitrzak-Węglarz and Agnieszka Słopień
Brain Sci. 2023, 13(10), 1473; https://doi.org/10.3390/brainsci13101473 - 18 Oct 2023
Cited by 1 | Viewed by 3386
Abstract
Mentalizing, recognized as the capacity to understand behaviors in the context of our own mental states and those of other people, is being researched more and more commonly in regard to various mental disorders. The research on mentalization focuses on, among other things, [...] Read more.
Mentalizing, recognized as the capacity to understand behaviors in the context of our own mental states and those of other people, is being researched more and more commonly in regard to various mental disorders. The research on mentalization focuses on, among other things, borderline personality disorder, which is at present perceived as an emerging problem in the population of adolescents. In order to summarize the currently accessible knowledge of mentalizing in adolescents with borderline personality disorder, we thoroughly analyzed relevant publications. Based on the available literature, it can be concluded that the mentalizing ability of adolescents with borderline personality disorder can be impaired. The evidence demonstrates that they are prone to hypermentalizing, defined as an overattribution of mental states to other people. However, this tendency has not been proven to be specific to teenagers with this disorder. Moreover, the existing data suggest that young people with borderline personality exhibit a reduced capacity to mentalize their own inner states. Full article
(This article belongs to the Special Issue Advances in Borderline Personality Disorder: From Early Detection to Treatment)

Other

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15 pages, 299 KiB  
Case Report
May Female Autism Spectrum Be Masked by Eating Disorders, Borderline Personality Disorder, or Complex PTSD Symptoms? A Case Series
by Barbara Carpita, Benedetta Nardi, Cristiana Pronestì, Francesca Parri, Federico Giovannoni, Ivan Mirko Cremone, Stefano Pini and Liliana Dell’Osso
Brain Sci. 2024, 14(1), 37; https://doi.org/10.3390/brainsci14010037 - 30 Dec 2023
Cited by 5 | Viewed by 3531
Abstract
Introduction: The prevalence of Autism Spectrum Disorder (ASD) is four times higher in males than females; however, females are significantly more likely to go undiagnosed due to the existence of a “female autistic phenotype”, a manifestation unique to females that conflicts with conventional, [...] Read more.
Introduction: The prevalence of Autism Spectrum Disorder (ASD) is four times higher in males than females; however, females are significantly more likely to go undiagnosed due to the existence of a “female autistic phenotype”, a manifestation unique to females that conflicts with conventional, masculine conceptualizations of ASD. Furthermore, subthreshold autistic traits, which exert a significantly negative impact on quality of life and represent a vulnerability factor for the development of other psychopathological conditions, may remain even more under-recognized. Subsequently, many women with ASD may never receive a diagnosis or any resulting care, with serious consequences for their health. Aims: We aimed to describe two brief cases in order to confirm the diagnostic difficulties that ASD female undergo during their clinical evaluation and the possible alternative phenotype that they can manifest. Methods: We reported the cases of two young women on the autism spectrum that came to clinical attention only after the development of severe symptomatology attributed to other mental disorders, overlooking the presence of underlying autism spectrum features and a brief résumé of the literature on this topic. Results: These cases confirm the need for a timely and proper identification of females on the autism spectrum in order to prevent complications and improve the outcome. Conclusions: Research on gender differences could lead to a reexamination of the sex ratio in the prevalence of ASD and provide a better understanding of several psychiatric conditions that are frequently diagnosed in women, supporting the neurodevelopmental approach to psychopathology. Full article
(This article belongs to the Special Issue Advances in Borderline Personality Disorder: From Early Detection to Treatment)
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