搜索结果：Borderline personality disorder and emotion dysregulation

Mothers with borderline personality disorder face unique challenges in parenting, as borderline symptoms have been shown to negatively affect parent-child relationships. These challenges can lead to non-supportive reactions to children's negative emotions, a form of parent emotion socialization (PES) that has been linked to negative outcomes in children. Given the inherent emotional arousal evoked by parenting, emotion dysregulation likely influences the type of PES parents utilize. However, few studies have specifically examined how emotion dysregulation affects PES in mothers with borderline pathology. Against this background, this study aims to (1) investigate the link between maternal emotion dysregulation and PES strategies and (2) assess if emotion dysregulation moderates the relationship between presence of significant borderline pathology and PES. The study sample was comprised of 148 mothers (Mage = 34.92). Of these mothers, 53 had significant borderline features-that is, they either met full diagnostic criteria or exhibited marked subthreshold symptoms. Emotion regulation was evaluated using the Difficulties in Emotion Regulation Scale - Short Form, and PES was assessed using the Coping with Children's Negative Emotion Scale. Significant borderline features were determined using the Personality Assessment Inventory Borderline Scale. As a part of aim 1, bivariate correlations were conducted to examine relationships between emotion dysregulation and two PES strategies: supportive and non-supportive. The moderating role of emotion dysregulation on the relationships between borderline features and supportive and non-supportive PES was assessed using two moderation models. Results from the first aim revealed a small, negative correlation between emotion dysregulation and supportive PES and a medium, positive correlation between emotion dysregulation and non-supportive PES. Emotion dysregulation was found to be a significant moderator of the relationship between borderline pathology and non-supportive PES. The current study significantly contributes to the literature by further elucidating the relationship between maternal borderline pathology and PES and its underlying mechanisms.

The construct of borderline personality disorder (BPD) remains contentious, with some arguing that it embraces too much pathology to be of any real value as a clinical diagnosis. Examining BPD's comorbidity is key to understanding its heterogeneous vs. homogeneous nature. This study aimed to uncover differences in patterns of symptoms and their severity between 3 groups of patients a with a DSM-5 diagnosis of BPD: (i) those with a single borderline diagnosis; (ii) those with a dual diagnosis of BPD and antisocial personality disorder (ASPD); those with a dual diagnosis of BPD and narcissistic personality disorder (NPD). Groups were compared in terms of: (i) borderline symptom severity; (ii) self-report measures of emotional dysregulation, suicidality, and identity disturbance; (iii) DSM-defined borderline symptom profiles. Network analysis assessed whether a stable and reproducible structure of symptoms could be seen across all three groups and whether groups differed in symptom prevalence. Results of network analyses showed that the three groups shared the same symptom structure but differed systematically in which symptoms were most strongly endorsed: identity/interpersonal dysfunction in BPD, affective/behavioural dysregulation in BPD+ASPD, and a mixed/intermediate profile in BPD + NPD. BPD+ASPD showed the greatest severity of borderline symptoms, greatest emotional dysregulation, and highest impulsiveness and anger. The BPD group showed the highest identity disturbance and suicidality, BPD + NPD the lowest. In their symptom profiles, BPD were more likely to meet criteria for fear of abandonment, unstable relationships, identity disturbance and suicidality, while BPD+ASPD were more likely to meet criteria for impulsivity, affective instability, and anger control difficulty. The three groups differed on measures of identity and interpersonal relationships, supporting the idea that PD reflects disturbances of relationality. Results highlight that BPD can manifest in different ways that depend on its comorbidity. These differences require treatment to be tailored to the individual patient, with a focus on identity/interpersonal dysfunction when BPD presents alone, and on affective/behavioural dysregulation when BPD co-occurs with ASPD.

Borderline personality symptoms are often associated with social-cognitive impairments, but the impact of childhood trauma on emotional processing remains poorly understood. This study explored the moderating role of childhood abuse and neglect in the relationship between borderline traits and emotion recognition. A total of 216 non-clinical adults first completed self-report measures, including the Borderline Personality Disorder subscale of the Coolidge Axis-II Inventory and the Childhood Trauma Questionnaire. They then performed a facial emotion recognition task involving five expressions-neutral, anger, happiness, sadness, and fear-with all but neutral shown at low and moderate intensity levels. Emotion recognition was evaluated in terms of accuracy, response latency, and misattribution patterns. While no direct associations emerged between borderline traits and recognition accuracy for specific emotional expressions, higher trait levels were linked to increased misidentification of neutral faces and greater misattribution of anger. Additionally, childhood neglect and abuse moderated the effects of borderline traits on emotion recognition, with neglect altering responses to neutral and low-intensity happy cues, and abuse to subtle anger. A general pattern of emotional hypersensitivity was observed among participants who reported low levels of trauma, reflected in greater misinterpretation of neutral expressions and improved recognition of subtle emotional cues; as self-reported trauma levels increased, this pattern tended to diminish or even reverse. Considered alongside response time and misattribution patterns, the findings suggest avoidance and disengagement tendencies in emotional processing under severe trauma. In conclusion, when childhood abuse and neglect accompany BPD symptoms, emotion processing may demand nuanced clinical attention tailored to trauma-related dynamics.

Personality disorders (PDs) have long been studied in adulthood, with relatively limited attention to their developmental course during adolescence. Recent research, however, underscores the importance of early identification and intervention in youth, as personality pathology can be reliably detected in this period and is associated with significant functional impairments. Grounded in the DSM-5 Alternative Model for Personality Disorders (AMPD), the present study explores potential intrapsychic mechanisms linking maladaptive trait domains to global personality functioning in adolescents. Drawing on developmental theories that emphasize the role of self-regulatory and reflective capacities in personality development, we examined whether emotion dysregulation and metacognitive difficulties help explain the relationship between pathological traits and functioning. A sample of 470 Iranian adolescents aged 14-17 years completed validated measures of personality traits, emotion regulation, metacognition, and personality functioning. Data were analyzed using Pearson correlation coefficient and mediation analysis. All trait domains except antagonism were significantly associated with poorer functioning. Mediation analyses suggested that both emotion dysregulation and metacognition partially accounted for these associations, particularly for negative affectivity, detachment, disinhibition, and psychoticism. These findings support developmental models of personality by highlighting the interplay between emotion regulation and metacognition in shaping adolescent personality functioning. While the cross-sectional design and reliance on self-report measures limit causal interpretations, the study emphasizes the importance of incorporating emotion regulation and metacognitive processes into early assessments and interventions. Future research should employ longitudinal and multi-method approaches to further clarify the developmental pathways underlying personality pathology in adolescence.

BACKGROUND: Insecure attachment predicts borderline personality (BP), with emotion regulation widely recognized as a key mediator of this association. While interpersonal difficulties are central to BP, most studies have focused on intrapersonal emotion regulation, overlooking its interpersonal forms. Given the importance of understanding emotional and relational dysfunctions in BP, this study examined difficulties in Interpersonal Emotion Regulation (IER), investigating the role of maladaptive strategies—venting and excessive reassurance-seeking—as mediators in the relationship between attachment insecurity and BP. METHODS: A total of 420 adults completed self-report measures assessing BP features (PAI-BOR: affective instability, identity disturbances, negative relationships, and self-harm), attachment orientations (ECR-12: attachment anxiety and attachment avoidance), and IER difficulties (DIRE: venting and reassurance-seeking). Pearson’s correlations tested associations among variables, and a path analysis was conducted, using attachment anxiety and avoidance as exogenous variables, IER difficulties as mediators, and BP features as outcome variables. RESULTS: Attachment anxiety was positively associated with all BP features and greater difficulties in IER (venting and reassurance-seeking). IER mediated the relationship between attachment anxiety and BP features, with venting significantly mediating all BP dimensions. CONCLUSIONS: Findings highlight a self-perpetuating cycle of relational difficulties and emotional dysregulation in BP, with IER playing a crucial role. Excessive reliance on others for emotional regulation, likely stemming from mentalization impairments, may lead individuals with BP and anxious attachment to externalize distress, reinforcing negative moods and straining relationships. Psychological interventions should focus on breaking this cycle by enhancing emotion regulation abilities, fostering autonomy, and reducing maladaptive dependence on others for emotional relief.

Comorbid borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) predict poorer treatment outcomes. Available treatments for BPD and psychological trauma are often phase-based, first ensuring stabilization of dysregulated behaviors and emotions and later focusing on treating trauma. This study investigates the feasibility, acceptability, and preliminary efficacy of combining dialectical behavioral therapy group skills training (DBT-ST), consisting of mindfulness, emotion regulation, distress tolerance, and interpersonal-effectiveness skills, with eye movement desensitization and reprocessing (EMDR) individual therapy for patients with BPD and psychological trauma. Forty-two participants with BPD and psychological trauma (40 females, mean age = 28.5, SD = 9.2) participated in the study. All participants underwent an initial 6-month DBT-ST group (phase 1), then those randomized to the experimental group received EMDR, and those in the control condition continued DBT-ST (phase 2). Feasibility and acceptability were assessed through qualitative interviews. Additionally, borderline personality disorder symptoms and trauma-related symptoms were measured as secondary clinical outcomes. Assessments were conducted at baseline, post phase 1, and post phase 2. Overall retention from baseline to post phase 2 was 62%. Descriptively, retention was 81.2% in the DBT-ST continuation group and 72.2% in the DBT-ST+EMDR group, though this difference was not statistically significant. Qualitative interviews suggested that the sequential design was acceptable, and that DBT-ST helped some participants feel more prepared for subsequent trauma-focused work, although these findings are based on a small qualitative subsample. Both conditions reduced BPD symptoms, while only the DBT-ST+EMDR condition significantly reduced dissociative symptoms from baseline to post phase 2. A definitive, fully powered randomized clinical trial is warranted to confirm these findings and optimize the integration of DBT-ST and EMDR. Clinical Trials, NCT04856449. Registered on 08-04-2021.

BACKGROUND: Accurately perceiving and learning about others’ personalities is crucial for successful social relationships. Borderline Personality Disorder (BPD) is marked by unstable interpersonal dynamics, an unstable and negative self-concept, and a tendency to evaluate others unfavorably. Individuals with BPD are also more likely to be viewed negatively by others and experience social stigmatization. This study investigated whether women with BPD exhibit negativity biases when evaluating their own and others’ personality traits, and how these biases influence learning about others. METHODS: Thirty women with BPD and thirty-one age- and intelligence-matched controls estimated and learned the personality of six individuals (learning profiles) by predicting their self-ratings on 40 personality traits, balanced across the Big Five personality dimensions. After each prediction, participants received feedback with the target’s actual rating, allowing participants to gradually learn each profile’s personality. Three profiles reflected BPD group personality patterns and three profiles reflected control group patterns. Crucially, participants were told that these profiles were from real individuals but were unaware of their clinical status. RESULTS: As hypothesized, the BPD group rated themselves more negatively than controls, both at the trait level and on standardized personality measures (NEO-FFI, PID-5-BF). When evaluating others, both groups rated BPD profiles similarly, but the control group rated control profiles more favorably. For both groups, accuracy improved slightly over time for control profiles but not BPD profiles, suggesting that BPD trait patterns are inherently harder to learn. Computational modeling indicated that both groups used fine-grained learning strategies—regardless of profile type—with no credible group differences in learning mechanisms. CONCLUSION: These findings demonstrate that individuals with BPD exhibit pervasive negativity biases in self- and other-evaluations, yet retain intact social learning capacities. This suggests that interpersonal difficulties in BPD may stem more from negatively biased expectations than from deficits in learning. Moreover, the inherent difficulty in learning about BPD-like personality profiles—observed in both groups—may hinder mutual understanding and contribute to persistent social challenges. Importantly, the intact learning capacity points to a valuable therapeutic resource: targeting negative social expectations may help to reduce bias and improve social functioning in BPD.

While the effects of psychotherapy methods are being intensively researched, little is known about the clinical and neurobiological effects of specific psychotherapeutic interventions. This study examines the effects of experiential emotion-focused and cognitive interventions in schema therapy on emotion regulation in borderline personality disorder. In a randomized, single-blinded, parallel group design, clinical effects and effects on resting-state functional connectivity in neural emotion regulation networks and neurotransmitter metabolism (Glx/GABA) in key regions of these networks are compared. The 9-week treatment protocol includes emotion-focused interventions such as chair dialogues, imagery rescripting, or mode role-playing in the test condition; these interventions are omitted in the active control condition (dismantling design). Resting-state functional MR imaging (rsfMRI) and MEGA-sLASER 1 H MR spectroscopy in the pregenual cingulate cortex (pgACC), anteromedial cingulate cortex (aMCC), and dorsolateral prefrontal cortex (DLPFC) are performed before and after the therapy interval and 6 months after the end of therapy and compared with the neurobiological parameters of healthy control subjects. The clinical effects are recorded using a comprehensive test battery and specified using the Reliable Change Index (RCI). Clinical and biological data are examined using mixed model analysis both longitudinally and in terms of their interactions. The aim is to show that different psychotherapeutic interventions have different effects on deficits in emotion regulation associated with specific effects on neural emotion regulation networks. This would contribute to a better understanding of the neurobiological effects and mechanisms underlying psychotherapeutic core interventions and to their more targeted use in BPD and other related disorders in the future. ClinicalTrials.gov Identifier: NCT06367907, Retrospectively registered, April 2024.

Borderline Personality Disorder (BPD) is a complex mental health condition characterized by pervasive instability in mood, interpersonal relationships, self-concepts, and behavior. A reliable assessment of BPD symptom severity is essential for effective treatment planning and evaluation. This study introduces and evaluates the Borderline Symptom List Interview (BSL-I), a semi-structured interview designed to assess the severity of BPD symptoms comprehensively. The BSL-I is a freely accessible 31-item interview designed to assess BPD symptom severity. It evaluates (a) the frequency and subjective distress associated with BPD-specific and typical psychopathological symptoms, (b) the behavioral consequences of these symptoms, (c) functional impairment, and (d) facets of positive mental health. The items were developed through an iterative process, incorporating feedback from international experts and individuals with lived experience of BPD. Psychometric properties of the BSL-I were examined cross-sectionally in different samples of clients meeting DSM-5 criteria for BPD (n&#x2009;=&#x2009;171), clinical controls (n&#x2009;=&#x2009;89), and healthy controls (n&#x2009;=&#x2009;43). The BSL-I demonstrates good internal consistency within the BPD sample (Cronbach's &#x3b1;&#x2009;=&#x2009;0.82) and good interrater reliability (ICC&#x2009;=&#x2009;0.768). It significantly discriminates between BPD clients and clinical controls (Cohen's d&#x2009;=&#x2009;2.02) and healthy controls (Cohen's d&#x2009;=&#x2009;3.88). High correlations were observed with other established BPD symptom measures, including the number of IPDE criteria (r&#x2009;=&#x2009;0.70, p&#x2009;<&#x2009;0.001) and the BSL-23 (r&#x2009;=&#x2009;0.83, p&#x2009;<&#x2009;0.001). Our findings indicate that the BSL-I is a reliable and valid multidimensional instrument for assessing the severity of BPD. Both clinical experts and clients found the application of the BSL-I acceptable and feasible. Future research might explore its sensitivity to change resulting from psychosocial treatments and assess its utility for treatment planning and outcome measurement. The BSL-I is a practical and psychometrically sound instrument for assessing the severity of BPD symptoms in clinical and research contexts.

The tendency to forgive is associated with traits such as agreeableness and neuroticism, mental well-being, and interpersonal functioning. Given documented associations with interpersonal conflict and aggression in borderline personality disorder (BPD), forgiveness (or, lack thereof) may be particularly relevant for BPD symptomatology but remains understudied. This study examines forgiveness in BPD compared to a heterogeneous clinical control group without personality disorder (CC), exploring its associations with aggression and interpersonal dysfunction using both direct (self-reported) and indirect (implicit) measures. Fifty-one female BPD patients and fifty-one CC participants completed self-report measures of forgiveness (Transgression-Related Interpersonal Motivations Inventory, Tendency to Forgive Scale) and a Forgiveness Implicit Association Test (F-IAT), alongside assessments of borderline symptoms, aggression, and interpersonal problems. Independent-samples t-tests compared the two samples, while Pearson correlations explored associations between clinical characteristics within the BPD sample. Both groups revealed largely comparable scores in both explicit and implicit forgiveness, with no significant differences across measures. Within the BPD group, higher TRIM-Revenge scores were associated with greater aggression, particularly anger, while TTF scores showed negative associations with overall aggression, physical aggression, and hostility. Circumplex analysis indicated that the F-IAT aligned with nonassertive, TRIM-Revenge with cold and competitive, and TTF with warm and non-dominant interpersonal styles, whereas TRIM-Avoidance and TRIM-Benevolence exhibited limited interpersonal relevance. Despite limited prior research suggesting reduced forgiveness in BPD, the present findings indicate that women with BPD exhibit forgiveness tendencies comparable to those of the CC. Notably, explicit forgiveness was systematically associated with aggression and interpersonal difficulties, whereas implicit and explicit measures showed limited convergence. These findings underscore the utility of a multidimensional approach to assessing forgiveness in BPD, revealing distinct clinical and interpersonal correlates across forgiveness dimensions.

Problematic emotion management is a core symptom of personality disorders and does not tend to improve spontaneously with age. Systems Training for Emotional Predictability and Problem Solving (STEPPS), a treatment program targeting emotional intensity difficulties, has been found to be effective for younger adults with borderline personality disorder. After a pilot study and a Delphi study, STEPPS was adjusted for older adults to better suit this population. The aim of present study was to evaluate first outcomes (e.g., level of improvement) of the adjusted STEPPS Older Adults (STEPPS-OA). A total of 52 patients, with a mean age of 67 years (range: 60-80), participated in this proof-of-concept study with pre-, mid-, and post-treatment measurement points. A total number of 38 patients completed the treatment; 14 patients (27%) dropped out. A majority of the patients (58%) had borderline personality disorder. After treatment, patients reported significantly decreased borderline personality disorder severity and symptomatic distress. Furthermore, there was a significant improvement of adaptive emotion regulation strategies and all personality functioning factors. Finally, some maladaptive personality traits (i.e., Disinhibition and Negative Affectivity) decreased significantly. Results of this proof-of-concept study indicate STEPPS-OA is a promising treatment option for managing emotional intensity difficulties for older adults with personality disorders.

BACKGROUND: To explore how emotional-modulated inhibitory control, as assessed by the emotional Go/No-Go task and EEG, correlates with the multidimensional profile of borderline personality disorder (BPD). METHODS: Eighty-two participants completed the Personality Assessment Inventory-Borderline Features (PAI-BOR), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) scale. EEG was recorded during an emotional Go/No-Go task and event-related potential (ERP) components were analyzed for correlations with BPD features. Participants were then divided into groups with or without BPD features, and comparisons of ERP components were then made within groups. RESULTS: ERP analysis revealed BPD features correlations with brain activity. Affective instability was positively correlated with left frontal N2 during positive-neutral No-Go trials. Self-harm was associated with left frontal late positive potential(LPP) during negative-neutral Go trials. Left frontal and central LPP slightly related to identity problems. 32 participants grouped into participants with BPD features(the BPF group) showed more depression, anxiety, emotional instability, identity issues, self-harm, and interpersonal problems. The BPF group had impaired performance on No-Go trials, smaller N2 amplitudes at left frontal channels during negative emotional cues, and delayed N2 peak latency. A group-trial type interaction was observed, with higher LPP amplitudes in Go trials for the control group but not in the BPF group, indicating distinct emotion processing between the BPF and control groups. CONCLUSION: The findings of this study propose that there are neural associations among affective instability, self-harm, and identity problems in BPD, which are consistent with the neural foundation of emotion-modulated inhibitory control observed in the emotional Go/No-Go task. The lack of association between negative sociality and ERP components highlights the complex nature of social information processing in BPD. Moreover, significant emotional, cognitive, and neural differences are also observed between the BPF and control groups. These results enhance understanding of how emotional valence modulates inhibitory control processes in individuals with varying levels of BPF.

Numerous studies have demonstrated that the Alternative Model for Personality Disorders (AMPD) outperforms traditional categorical nosology (i.e., Section II) in predicting an array of salient clinical outcomes. However, despite the centrality of social-cognitive impairments in personality disorder, few studies have examined the superiority of the AMPD over Section II in predicting social-cognitive deficits. The current study addresses this gap by evaluating the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features in predicting mentalizing - a social-cognitive construct proposed to underlie the development of personality disorder. Participants included 267 university students (Mage = 20.49, SD&#x2009;=&#x2009;1.74) who completed self-report measures of LPF, borderline personality features, and two measures of mentalizing: the Reflective Functioning Questionnaire (RFQ) and the Mentalization Scale (MentS). Hierarchical regressions revealed that LPF explained additional variance in the RFQ beyond borderline features and internalizing psychopathology. Although borderline features also incremented LPF in predicting the RFQ, additional variance explained was less than half that contributed by the LPF over borderline features. LPF also incremented the variance explained in the MentS total score and subscales over and above borderline features and internalizing symptoms, whereas borderline features did not increment LPF in predicting any of the MentS variables. These results strengthen the evidence base for the superiority of the AMPD over Section II and suggest that mentalizing deficits are better captured by LPF than borderline personality disorder symptoms. Findings support the extension of mentalization-based treatment to AMPD-defined personality disorder, which should be explored in future research.

Intimacy, feeling close to others, and mutual trust and regard are important aspects of a secure attachment style that contributes to stable relationships. Difficulties experiencing intimacy have been linked to traumatic childhood experiences, such as abuse and neglect, rejection sensitivity (RS), and borderline personality disorder (BPD). In experimental studies, patients with BPD perceived unfamiliar faces as less trustworthy and detected less positive cues of happiness, social affirmation, and inclusion. However, it remains unclear whether social-cognitive judgments of unfamiliar faces predict attachment-related intimacy beyond BPD features, childhood trauma, and RS. This study aimed to simultaneously investigate the predictive effects of BPD features, childhood trauma, RS, and first-impression social-cognitive judgments of trustworthiness and happiness on intimacy in close relationships, beyond romantic relationships. Additionally, we investigated whether the association between BPD features and attachment-related intimacy is moderated by childhood trauma, RS, and first-impression social judgments. In an online study, 509 women completed questionnaires on intimacy in close relationships (subscales of the Adult Attachment Scale Revised), BPD features (Personality Assessment Inventory Borderline Features Scale), childhood trauma (Childhood Trauma Questionnaire Short Form), and RS (Adult Rejection Sensitivity Questionnaire). Additionally, they evaluated happiness and trustworthiness in unfamiliar female faces. Hierarchical linear regression analysis with intimacy as outcome tested the predictive strengths of all variables including interactions with BPD features. Higher BPD features, childhood trauma, particularly emotional neglect, and RS, as well as lower trustworthiness impressions predicted less intimacy in close relationships. Despite their interrelations, all predictors except happiness ratings showed unique predictive effects on intimacy. Interaction effects were not significant. Findings support the importance of BPD features, childhood trauma, and RS for experiences of closeness and connection in adult attachment relationships. Additionally, findings provide first evidence for a small direct link between trustworthiness evaluations of unfamiliar faces and lower experiences of intimacy. Future research should investigate these associations in clinical samples including both women and men to further understand whether trustworthiness impressions could be an important socio-cognitive mechanism and potential treatment target.

Disruptions in epistemic trust have been recognised as key sequelae of trauma and as markers of vulnerability to borderline personality pathology. However, prior research has relied primarily on self-reports and lacks behavioural measures of epistemic stance. The present pre-registered studies introduce a novel behavioural task-the Balloon Analogue Risk Task for Epistemic Trust (BART-ET)-and examine its associations with borderline personality features, trauma history, and psychological distress. Two cross-sectional studies were conducted with a combined sample of 273 young adults aged 18-25 (Study 1: N&#x2009;=&#x2009;120; Study 2: N&#x2009;=&#x2009;153). Participants completed self-report measures of borderline personality features (PAI-BOR) and epistemic trust, mistrust, and credulity (ETMCQ). Study 2 additionally included the Childhood Trauma Questionnaire (CTQ) and the Brief Symptom Inventory (BSI-GSI). All participants completed the BART-ET in a laboratory setting, which operationalised epistemic mistrust as the degree of deviation from a confederate experimenter's advice during a risk-taking task. Analyses involved correlational tests and structural equation modelling (SEM) to evaluate hypothesised associations and mediation pathways. As expected, across both studies, higher levels of borderline personality traits were associated with greater epistemic mistrust-both behaviourally (on the BART-ET) and via self-report (ETMCQ)-and with greater epistemic credulity, but not with epistemic trust, as measured with the ETMCQ. Behavioural and self-report measures of mistrust were significantly correlated, suggesting convergent validity of the BART-ET as an index of epistemic mistrust. In Study 2, childhood trauma exposure was associated with borderline features and with epistemic mistrust assessed behaviourally and via self-report. Preregistered mediation models controlling for general distress (BSI-GSI) suggested that the association between childhood trauma and epistemic mistrust was not unique to BPD features. These findings suggest that epistemic mistrust-rather than a simple absence of trust-is a social-cognitive correlate of borderline personality vulnerability and trauma exposure in young adults. The results also indicate that the BART-ET may be a useful behavioural tool for studying epistemic mistrust in clinical contexts, though further validation is needed.

In a similar way to depression, the development of borderline personality traits seems closely linked to the experience of Stressful Life Events (SLEs). This study examined the extent to which emotion regulation and personality traits simultaneously mediate and significantly attenuate the direct path between SLEs and depressive symptoms. Parallel and serial multiple mediation models were employed to analyze a sample of 196 adolescents assessed twice over a 12-month period. A regression-based path analysis approach was employed to simultaneously estimate the specific indirect effects of emotion regulation and borderline traits on the direct relationship between SLEs and depression. In a parallel multiple mediation model, both borderline traits and emotion regulation fully mediated the direct relationship between SLEs and depressive symptoms. The serial multiple mediation model also showed complete mediation. In this model, the indirect pathway from SLEs to depressive symptoms, first through borderline traits and subsequently through emotion regulation, accounted for 70.8% of the total indirect effect. In contrast, the indirect effects via borderline traits and emotion regulation accounted for 24% and 5.3% of the total indirect effects, respectively. To strengthen clinical practice, early identification of borderline personality traits combined with targeted interventions to address specific symptoms may enhance emotional regulation and reduce the risk of depressive symptoms in vulnerable adolescents.

There is a need for a parenting intervention that specifically addresses the concerns for parents with borderline personality disorder (BPD) due to the challenges that these parents experience and the stigma that surrounds parenting with BPD. Such interventions may also prevent intergenerational transmission of psychopathology and support clinicians to provide care within a personality disorder framework. This study aims to evaluate the effectiveness of a brief parenting group intervention for parents with BPD. The design was a parallel randomized controlled trial (RCT) with two arms: the brief parenting intervention group and a treatment as usual (TAU) group. Participants were parents with a diagnosis of BPD who were parenting at least one child between birth and 5 years old. Participants were randomised to either the brief parenting group intervention (Coming up for AIR (CUFA)) through a public mental health service or to TAU. Participants, clinicians, and researchers were not blind to the allocation. It was hypothesised that the CUFA parenting intervention would reduce self-reported parenting stress (primary outcome) and improve parental mental health (secondary outcome) compared to TAU. Participants (N&#x2009;=&#x2009;93) were randomly allocated to the parenting intervention (n&#x2009;=&#x2009;45) and TAU (n&#x2009;=&#x2009;48). For the analyses of the per protocol sample 25 participants in the CUFA parenting intervention and 21 participants in the TAU condition were included. Multi-level analysis on the intention to treat sample indicated that the CUFA parenting intervention (dpre-post = 1.29) significantly reduced parenting stress compared to TAU (dpre-post = 0.01). This finding was replicated in the per protocol sample. A brief parenting intervention can have a positive effect on reducing parenting stress and improving parental mental health. Offering a parenting intervention needs a supportive and integrated approach to lower barriers for service attendance. Future research may investigate the effect on child wellbeing. It is important and in line with treatment guidelines to offer a parenting intervention to people with BPD. Trial registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12620001257954.