Search Results (102)

Background/Objectives: Borderline Personality Disorder (BPD) involves emotional dysregulation, interpersonal instability and impulsivity. Although treatments have advanced, evaluating the latest innovations remains essential. This rapid review aimed to (1) identify and classify recent therapeutic innovations for BPD, (2) assess their effects on clinical and functional outcomes, and (3) highlight research gaps to inform future priorities. Methods: Employing a rapid review design, we searched PubMed/MEDLINE, PsycINFO, and Embase for publications from 1 January 2019 to 28 March 2025. Eligible studies addressed adult or adolescent BPD populations and novel interventions—psychotherapies, pharmacological agents, digital tools, and neuromodulation. Two independent reviewers conducted screening, full-text review, and data extraction using a standardised form. Results: Sixty-nine studies—predominantly from Europe and North America—were included. Psychotherapeutic programmes dominated, ranging from entirely novel models to adaptations of established treatments (for example, extended or modified Dialectical Behavior Therapy). Pharmacological research offered fresh insights, particularly into ketamine, while holistic approaches such as adventure therapy and digital interventions also emerged. Most investigations centred on symptom reduction; far fewer examined psychosocial functioning, mortality, or social inclusion. Conclusions: Recent innovations show promise in BPD treatment but underserve the needs of mortality and societal-level outcomes. Future research should adopt inclusive, equity-focused agendas that align with patient-centred and recovery-oriented goals, supported by a coordinated, integrated research strategy. Full article

Background/Objectives: With the rapid progression of technology, applications have been proposed as a promising alternative to conventional psychotherapeutic treatment. Nonetheless, research on unguided self-help applications for binge eating remains scarce, with most existing studies utilizing cognitive behavioral therapy (CBT) principles. Therefore, this paper presents the protocol for a randomized controlled trial designed to evaluate the efficacy and acceptability of eMOTE, a standalone application designed specifically for women in Portugal who binge eat. eMOTE, adapted from dialectical behavior therapy (DBT), is unique in that it focuses on teaching emotion regulation skills while also integrating core CBT strategies. Methods: At least 68 females who self-report binge eating episodes will be randomized into an intervention group with access to eMOTE for eight weeks or a delayed waitlist, which will have access to eMOTE after the T1 assessment. Assessments will be conducted at baseline (T0), post-intervention (T1), and at 2-month follow-up (T2). The primary outcomes will include objective and subjective binge eating frequency and binge eating symptomatology, while secondary outcomes will assess global levels of ED psychopathology, shape concern, weight concern, eating concern, dietary restraint, compensatory behaviors, mindfulness, emotion regulation difficulties, intuitive eating, psychological distress, and body mass index. Conclusions: This study will contribute to the limited literature on the use of smartphone technology as an alternative to traditional psychotherapy. Furthermore, this standalone application will offer insights into the use of emotion regulation and food monitoring components designed for adult females experiencing binge eating episodes. Full article

Background: Borderline personality disorder (BPD) is a severe psychiatric condition characterised by emotional instability, impulsivity, interpersonal dysfunction, and self-injurious behaviours. Despite growing clinical interest, the neuropsychological mechanisms underlying these symptoms are still not fully understood. This review aims to summarise findings from neuroimaging, psychophysiological, and neurodevelopmental studies in order to clarify the neurobiological and physiological basis of BPD, with a particular focus on emotional dysregulation and implications for the treatment of adolescents. Methods: A narrative review was conducted, integrating results from longitudinal neurodevelopmental studies, functional and structural neuroimaging research (e.g. FMRI and PET), and psychophysiological assessments (e.g., heart rate variability and cortisol reactivity). Studies were selected based on their contribution to understanding the neural correlates of BPD symptom dimensions, particularly emotion dysregulation, impulsivity, interpersonal dysfunction, and self-harm. Results: Findings suggest that early reductions in amygdala volume, as early as age 13 predict later BPD symptoms. Hyperactivity of the amygdala, combined with hypoactivity in the prefrontal cortex, underlies deficits in emotion regulation. Orbitofrontal abnormalities correlate with impulsivity, while disruptions in the default mode network and oxytocin signaling are related to interpersonal dysfunction. Self-injurious behaviour appears to serve a neuropsychological function in regulating emotional pain and trauma-related arousal. This is linked to disruption of the hypothalamic-pituitary-adrenal (HPA) axis and structural brain alterations. The Unified Protocol for Adolescents (UP-A) was more effective to Mentalization-Based Therapy for Adolescents (MBT-A) at reducing emotional dysregulation compared, though challenges in treating identity disturbance and relational difficulties remain. Discussion: The reviewed evidence suggests that BPD has its in early neurodevelopmental vulnerability and is sustained by maladaptive neurophysiological processes. Emotional dysregulation emerges as a central transdiagnostic mechanism. Self-harm may serve as a strategy for regulating emotions in response to trauma-related neural dysregulation. These findings advocate for the integration of neuroscience into psychotherapeutic practice, including the application of neuromodulation techniques and psychophysiological monitoring. Conclusions: A comprehensive understanding of BPD requires a neuropsychologically informed framework. Personalised treatment approaches combining pharmacotherapy, brain-based interventions, and developmentally adapted psychotherapies—particularly DBT, psychodynamic therapy, and trauma-informed care—are essential. Future research should prioritise interdisciplinary, longitudinal studies to further bridge the gap between neurobiological findings and clinical innovation. Full article

Ketamine infusion therapy has gained recognition as an innovative treatment for treatment-resistant depression (TRD), demonstrating rapid and robust antidepressant effects. Its therapeutic promise is increasingly understood to involve molecular and neurobiological processes that promote neural plasticity and cognitive flexibility. These changes may create a unique window for psychotherapeutic interventions to take deeper effect. This retrospective chart review examined the clinical outcomes of individuals with TRD who received either single or repeated ketamine infusion(s), with or without weekly psychotherapy. Depression severity, measured by Beck Depression Inventory scores, was assessed pre-treatment and 30 days post-infusion(s). The results showed significant symptom reduction across all groups, with the most pronounced effects observed in those who received concurrent psychotherapy. While infusion number did not significantly alter outcomes, the integration of ketamine with psychotherapy appeared to enhance treatment response. Full article

Dance encompasses physical, emotional, and social elements, creating a dynamic platform for the exploration of well-being. As a therapeutic approach, dance movement further applies these dimensions to enhance emotional resilience, foster mindfulness, and improve overall mental health. This study examined the relationship between self-compassion and life satisfaction among 912 recreational dancers (80% female and 20% male) in Greece. Participants completed the Self-Compassion Scale and Satisfaction with Life Scale. Confirmatory Factor Analysis validated the five-factor self-compassion model, and regression analysis identified predictors of life satisfaction. Self-kindness emerged as a strong positive predictor (β = 0.258, p < 0.001), while isolation (β = −0.307, p < 0.001) and self-judgment (β = −0.083, p = 0.029) negatively predicted life satisfaction. Common humanity (β = 0.064, p = 0.066) and mindfulness (β = 0.004, p = 0.907) showed no significant predictive effect. The model explained 21.7% of the variance in life satisfaction (R² = 0.217). Small but statistically significant differences in self-compassion dimensions were observed across dance styles. Partner-oriented dancers such as those practicing tango reported slightly higher self-kindness and mindfulness, while ballet dancers showed a small increase in self-judgment and isolation. Life satisfaction remained consistent across styles, highlighting dance’s overall contribution to well-being. These findings suggest that integrating self-compassion training into dance education and psychotherapy, particularly within a Therapeutic-Based Art Pedagogy framework, may contribute to emotional resilience, foster social connection, and promote mental health, positioning dance as a potentially transformative tool for holistic development. Full article

Background: There is a certain degree of overlap between persistent postural-perceptual dizziness (PPPD) (ICD-11) and anxiety disorders (ANX) with regard to the phenomenological, pathological and neurobiological characteristics of both conditions. The implementation of an integrative psychotherapy programme may potentially result in the generation of synergistic effects across both patient groups. Objectives: This study assessed (1) whether psychological mechanisms similarly influence symptom severity in PPPD and ANX group, (2) the effectiveness of psychotherapy, and (3) potential neurofunctional biomarkers. Methods: Patients with PPPD (n = 14) and ANX (n = 20) underwent an integrative psychotherapy programme with balance training and mindfulness-based interventions. Emotional and neutral pictures were presented during MRI scans before and after therapy, with healthy controls (HC = 29) for comparison. Clinical and psychological questionnaires were administered, and brain activity was analysed in key regions. Results: The only diagnostic difference in the direct comparison between patients with PPPD and with ANX were the vertigo intensity values before and after therapy. PPPD with comorbid anxiety disorder had significantly more fear of physical symptoms than patients without comorbid anxiety disorder. PPPD showed no change regarding vertigo intensity (VSS), anxiety, or depression scores, but reported decreased impact of vertigo on social functioning (VHQ), and improved personal control after therapy (IPQ). By contrast, anxiety, dizziness, depression, alexithymia, and IPQ scores were significantly reduced after therapy in the ANX group. Neuroimaging revealed decreased activity in the hippocampus and superior temporal gyri (STG) in the PPPD group post-therapy as compared to the pre-therapy measurement, while the ANX group showed reduced activity in the insula, thalamus, hippocampus, and inferior frontal gyrus. Compared to the ANX and HC groups, patients with PPPD showed increased activity in the supramarginal gyrus and STG, both of which could serve as biomarkers for PPPD patients but need to be further validated. Conclusions: Anxiety and vertigo may reinforce each other in PPPD, as symptoms persisted post-therapy, whereas ANX patients improved significantly. Nevertheless, there is some evidence for a successful management of symptoms in the PPPD group. Findings are limited by small sample size and require further research. Full article

Background/Objectives: Borderline personality disorder (BPD) is a complex psychiatric condition marked by emotional dysregulation, interpersonal instability, and impulsivity. Despite the advances in psychotherapy and pharmacotherapy, many patients show a partial or unstable response. Recent research suggests that oxytocin, a neuropeptide involved in social cognition and emotional regulation, may offer novel therapeutic avenues. Methods: We systematically synthesize evidence from PubMed, PsycINFO, Web of Science, and Google Scholar on oxytocin’s role in BPD, prioritizing studies on neurobiology, emotion regulation, clinical interventions, and adjunctive therapy models. Thirty studies were included and critically appraised using PRISMA and Cochrane’s tools. Due to methodological heterogeneity, no meta-analysis was conducted; instead, the findings were integrated through a narrative synthesis approach. Results: Evidence supports oxytocin’s modulatory effects on amygdala reactivity, prefrontal–limbic connectivity, and hypothalamic–pituitary–adrenal axis function. Intranasal oxytocin appears beneficial for emotional regulation and interpersonal sensitivity, particularly in individuals with early trauma. The reported effect sizes ranged from small (Cohen’s d ≈ 0.40) to large (d ≈ 0.83), though some trials reported null or adverse effects, such as increased hypermentalization. Heterogeneous responses were influenced by factors such as sex, trauma history, and OXTR gene variants. Conclusions: Although intranasal oxytocin shows promise in modulating core neurobiological systems implicated in BPD and enhancing emotion regulation and social cognition, its clinical effects remain variable and context-dependent. The evidence supports cautious exploration of oxytocin as an adjunct to psychotherapeutic interventions rather than as a standalone treatment. Future research should focus on biomarker-informed, stratified trials that account for trauma history, genetic variation, and sex differences to clarify its therapeutic potential. Full article

Opioid use disorder (OUD) and posttraumatic stress disorder (PTSD) frequently co-occur. However, there are no psychotherapy treatments intentionally designed for this comorbidity, nor designed to be augmented with medications for OUD. In this open-label pilot trial, we tested Helping Opioid Use Disorder and PTSD with Exposure (HOPE), a novel integrated, trauma-focused treatment for individuals (N = 6) with OUD/PTSD who were stabilized on medications for OUD. HOPE was delivered weekly for 10–12 sessions, and one follow-up visit was conducted ~1-month post-treatment. Primary outcomes included urine drug screens, the Timeline Followback, Desire for Drugs Questionnaire, Clinician-Administered PTSD Scale-5 (CAPS-5), and PTSD Checklist-5 (PCL-5). Boot-strapped linear mixed effect models and generalized estimating equations showed that PTSD symptoms (CAPS-5: B = −7.16, SE = 1.24, p < 0.01; PCL-5: B = −2.04, SE = 0.26, p < 0.01), desire for opioids (B = −0.56, SE = 0.15, p < 0.01), depression symptoms (B = −0.43, SE = 0.09, p < 0.01), and anxiety symptoms (B = −0.50, SE = 0.08, p < 0.01) decreased significantly over time. Client satisfaction increased throughout the study (B = 0.18, SE = 0.08, p = 0.02), and 83.3% of participants completed the therapy and follow-up visit. There were no significant changes in opioid or other substance use from baseline to follow-up. Although preliminary, results show high acceptability and feasibility of the HOPE therapy and demonstrate significant improvements in PTSD and associated symptoms with an integrated, trauma-focused treatment. Full article

Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment. Full article

Neuroimaging has emerged as an innovative and essential tool for understanding the intricate relationship between brain development, emotions, and behavior. Investigating the neurobiological mechanisms underlying this interaction during the critical phase of brain maturation is crucial for promoting individual psychological well-being and mitigating the profound impact of mood disorders during childhood. This narrative scoping review synthesizes current pediatric neuroimaging evidence, filling a gap in the literature by integrating structural, functional, and emerging modalities, to provide clear translational pathways for clinical and behavioral observations. The contribution of major neuroimaging techniques, including fMRI, PET, DTI, and sMRI, is analyzed, emphasizing their ability to detect structural and functional alterations associated with mood disorders, enabling early diagnosis and personalized therapeutic strategies. Furthermore, the potential of these technologies to monitor the effects of psychotherapy is explored, demonstrating how such interventions can modulate neural circuits and enhance emotional processing. Despite significant advancements and growing interest, challenges remain, including the complexity of data interpretation, technological limitations, and ethical considerations related to the use of these interventions in pediatric populations. This review synthesizes the most recent scientific evidence, underscoring the potential of neuroimaging to improve diagnostic accuracy and therapeutic outcomes, while outlining future research directions aimed at enhancing interventions for children and adolescents with mood disorders. Full article

Spirituality has gained increasing legitimacy in psychotherapy; however, certain spiritual experiences, such as past life memories, remain marginalized in clinical settings. These experiences often arise outside therapy and may hold deep existential meaning for individuals, yet patients frequently hesitate to disclose them in conventional psychotherapy for fear of being pathologized. This qualitative study examines how individuals who experienced past life memories outside therapy decided whether to share them during psychotherapy, how therapists responded, and how these responses influenced the therapeutic process. Fifteen participants who had undergone conventional psychotherapy were interviewed using a hermeneutic phenomenological approach. The findings reveal that participants perceived their experiences as vivid and transformative, yet many refrained from sharing them due to concerns about stigma and clinical judgment. When disclosures occurred, therapist responses ranged from validating to dismissive, at times resulting in iatrogenic harm affecting the therapeutic alliance and patients’ willingness to continue. Participants expressed a desire for therapeutic spaces that could respectfully engage with spiritually meaningful experiences. The study introduces the concept of Spiritual-Psychoeducation as a potential framework for supporting the integration of such narratives in therapy. These findings suggest a need for expanded clinical sensitivity to anomalous spiritual experiences, divine gifts within the therapeutic process, as meaningful elements of psychological healing. Full article

Psychotherapy is an essential component of mental healthcare, yet its formal instruction within medical curricula remains underdeveloped. This scoping review aimed to map the best practices for teaching psychotherapy to medical students by examining the types of psychotherapy covered and the teaching strategies employed. A systematic search was conducted across the PubMed, Embase, PsycINFO and Google Scholar databases without time restrictions, and studies were selected if they focused on psychotherapy education for medical students. Fifteen studies met the inclusion criteria. The findings revealed that multimodal approaches, combining didactic sessions, experiential learning, clinical exposure and digital content, were the most commonly used and pedagogically effective strategies. Role play and clinical exposition were particularly valued for enhancing communication skills, empathy and therapeutic understanding, while e-learning emerged as a flexible but less frequently used tool. Motivational interviewing was the most frequently taught psychotherapeutic modality, followed by mindfulness, cognitive-behavioral therapy and psychodynamic approaches. Although the overall quality of studies was moderate to high, the heterogeneity in study design and outcome measures limited direct comparisons. These results highlight the need for standardized, experiential and integrated teaching strategies to better prepare future physicians for incorporating psychotherapy principles into clinical practice. Full article

Background/Objectives: Psychological vulnerability in individuals with obesity represents a significant concern in the context of bariatric surgery. This study aimed to assess psychosocial functioning and identify the psychological, clinical, and sociodemographic predictors of impairment among patients undergoing preoperative evaluation. Methods: A retrospective observational study was conducted on patients referred for bariatric surgery at a single academic medical center. Data were collected through clinical interviews and validated psychometric tools: the Clinical Impairment Assessment (CIA), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Robust multiple regression analysis determined associations between CIA scores and psychological and demographic factors. Results: A total of 688 patients were evaluated (median age: 46 years; 70.3% female). Most had a high school education (56.9%) and were employed (69%). Elevated scores on the Clinical Impairment Assessment (CIA) were significantly associated with female gender (β = 1.075, p = 0.029), moderate anxiety (GAD-7 ≥ 10; β = 3.85, p < 0.001), and severe depressive symptoms (PHQ-9 ≥ 15; β = 16.67, p < 0.001). Other significant predictors included prior psychotherapy (β = 1.18, p = 0.044), aesthetic motivation for surgery (β = 0.92, p = 0.120), and expectations that weight loss would improve self-esteem (β = 2.11, p = 0.001) or social relationships (β = 1.98, p = 0.002). Conversely, physical activity was associated with lower CIA scores (β = –1.23, p = 0.050). The regression model showed strong explanatory power (McFadden R² = 0.529). Conclusions: This study highlights key predictors of psychosocial distress in bariatric candidates, underscoring the importance of comprehensive psychological assessment before surgery. The CIA appears to be a valuable screening and monitoring tool. Future research should explore the longitudinal evolution of psychosocial functioning and support the integration of psychological care into multidisciplinary bariatric programs. Full article

Background/Objectives:Tinnitus, the perception of sound without an external source, is a prevalent and often distressing condition with complex neurobiological and psychological underpinnings. A growing body of literature suggests a frequent co-occurrence between tinnitus and psychiatric symptoms such as anxiety, depression, and sleep disturbances. However, the extent to which these conditions are associated, and whether treatments targeting one domain impact the other, remains unclear. This scoping review aimed to (1) identify associations between tinnitus and mental health comorbidities, (2) evaluate whether tinnitus treatments affect psychiatric outcomes, and (3) explore whether psychiatric treatments influence tinnitus symptoms. Methods: A comprehensive search of PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, and Google Scholar was conducted for articles published between January 2014 and May 2025. Eligible studies were written in English, French, or Spanish, focused primarily on tinnitus, included at least one co-occurring psychiatric condition, and described how tinnitus was evaluated. A total of 30 studies were included. Data were extracted and synthesized thematically. Study quality was assessed using the Mixed Methods Appraisal Tool and relevant Joanna Briggs Institute checklists. Results: Most studies reported significant associations between tinnitus and psychiatric symptoms, particularly anxiety, depression, stress, insomnia, and, in some cases, psychosis. Treatments aimed at tinnitus, such as eye movement desensitization and reprocessing and cognitive behavioral therapy, were sometimes associated with secondary improvements in mental health. Conversely, limited evidence suggested that psychiatric treatment, including antipsychotic medication and psychotherapy, may reduce tinnitus severity in selected cases. Conclusions: Tinnitus and psychiatric comorbidities frequently co-occur, and early evidence suggests that addressing one may benefit the other. Given the specific inclusion criteria, this review presents a selected subset of the broader literature, focusing only on studies that evaluated tinnitus alongside clinically measured psychiatric symptoms. Future research should prioritize integrated, longitudinal interventions to better understand these complex interactions. Full article

Background: Borderline Personality Disorder (BPD) is a severe psychiatric condition characterized by pervasive emotional dysregulation, impulsivity, and unstable interpersonal relationships. Affecting over 1% of the general population, BPD carries significant morbidity, frequent hospitalizations, and an increased risk of suicide. Although specialized psychotherapeutic approaches have shown efficacy, their impact is often constrained by availability, lengthy treatment durations, moderate effect sizes, and high dropout rates. Pharmacological treatments for BPD remain inadequate and are usually accompanied by adverse side effects. Objective: This narrative review seeks to explore the potential of transcranial direct current stimulation (tDCS) as a safe, cost-effective, and accessible neuromodulation intervention aimed at alleviating core BPD symptoms—namely, emotional dysregulation and impulsivity—while also addressing common comorbidities and opportunities for integration with existing therapeutic modalities. Methods: We conducted a narrative literature synthesis in accordance with the SANRA (Scale for the Assessment of Narrative Review Articles) guidelines. A PubMed/MEDLINE search was performed using keywords related to transcranial direct current stimulation (tDCS) and BPD, identifying five published randomized controlled trials on the topic. To provide a broader perspective, we also included studies from related fields examining mechanisms of action, safety and tolerability, cost-effectiveness, stimulation parameters, and clinical outcomes relevant to BPD. Results: Conventional tDCS protocols—typically involving 1–2 mA currents for 20–30 min—have demonstrated an excellent safety profile, resulting in only minimal and transient side effects without any risk of overdose or misuse, which is a key advantage for populations at high risk of suicidality. With moderately priced devices and the feasibility of home-based administration, tDCS provides a substantially more affordable alternative to both long-term pharmacotherapy and intensive psychotherapy. Neurobiologically, tDCS modulates the excitability of the dorsolateral and ventrolateral prefrontal cortex and enhances fronto-limbic connectivity, thereby strengthening top-down regulatory control over emotion and behavior. Pilot randomized controlled trials report moderate effect sizes for improvements in emotional regulation, inhibitory control, and rejection sensitivity, along with ancillary gains in executive functioning and reductions in depressive and substance-use symptoms when stimulating the left dorsolateral prefrontal cortex. Conclusions: tDCS stimulation emerges as a safe and scalable adjunctive treatment for BPD, leveraging targeted neuromodulation to address core features and common comorbidities like depression. However, variability in current protocols and the scarcity of well-powered randomized trials underscore the pressing need for standardized methodologies, longer-term follow-up, and individualized stimulation strategies to establish enduring clinical benefits. Full article