Borderline Personality Disorder
Conditions
Keywords
Dialectical behavior therapy, Borderline personality disorder, Therapy effectiveness
Brief summary
This research examines the behavioral and neural mechanisms of dialectical behavior therapy (DBT) effect in patients with borderline personality disorder (BPD).
Detailed description
This project aims to evaluate the behavioral and neural mechanisms of dialectical behavior therapy (DBT) effect in patients with borderline personality disorder (BPD). The project includes three subject groups: patients with BPD undergoing the DBT program (BPD-DBT), control patients with BPD on the waiting list for the program (BPD-control), and healthy controls (HC). Patients in the BPD-DBT group undergo a 24-week DBT program in an outpatient setting. All participants undergo a test battery comprising of self-report measures, clinical evaluation and fMRI and EEG measurement in the week before the DBT program beginning (T1), after 24 weeks (follow-up, T3), and at 24 weeks after T3 (follow-up, T4). The BPD-DBT group undergoes another assessment at T2 (after 12 weeks) to monitor selected symptoms during the DBT program by a short set of questionnaires.
Interventions
BEHAVIORALDialectical behavior therapy
A complex psychotherapy program for patients with borderline personality disorder.
Sponsors
Brno University Hospital
Masaryk University
Masarykova Univerzita
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
BPD-DBT group: Inclusion Criteria: * diagnosis of borderline personality disorder according to Diagnostic and Statistical Manual 5th Edition (DSM-5) criteria (rated by Structured Clinical Interview for DSM-5 for Personality Disorders, BPD section) * minimum age 16, informed consent of the patient * informed consent of patient's legal representative in case of patients under age 18 * more than one self-injury incident and/or suicidal attempt in the past six months
Exclusion criteria
* neurological disorder * comorbid affective disorder or schizophrenia-related disorder * intelligence quotient\<70 * contraindications for MRI measurement * pregnancy * body mass index under 15 BPD-C group: Inclusion Criteria: * diagnosis of borderline personality disorder according to Diagnostic and Statistical Manual 5th Edition (DSM-5) criteria (rated by Structured Clinical Interview for DSM-5 for Personality Disorders, BPD section) * minimum age 16, informed consent of the patient * informed consent of patient's legal representative in case of patients under age 18 * more than one self-injury incident and/or suicidal attempt in the past six months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Decrease of borderline symptoms | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of symptoms measured by Borderline Symptoms List-23 |
| Decrease of self-injury incidents and suicidal attempts | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | significant decrease of self-injury incidents and suicidal attempts assessed by semi-structured interview Lifetime - Suicide Attempt Self-Injury Count |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Increase in reasons for living | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant increase in reasons for living measured by Brief Reasons for Living Inventory 10 |
| Decrease of impulsivity | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of impulsivity measured by UPPS-P questionnaire |
| Increase of mindfulness | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | sifnigicant increase of mindfulness measured by Five Facet Mindfulness Questionnaire |
| Decrease of rejection sensitivity | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of rejection sensitivity measured by Rejection Sensitivity RS-Adult questionnaire |
| Decrease of dissociation symptoms | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of dissociation symptoms measured by Multiscale Dissociation Inventory |
| Decrease of anxiety | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of anxiety symptoms measured by Beck Anxiety Inventory |
| Decrease of depression ranking | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant decrease of depression symptoms measured by Beck Depression Inventory II, and MADRS clinical rating |
| Decrease in the number of days spent in the hospital | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | significant decrease of days spent in the hospital assessed by semi-structured interview -Treatment History Interview |
| Changes in fMRI neural activity during Faces task | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | Significant changes in fMRI neural activity during the Faces task. During the task, participants view images of faces expressing negative emotions or scrambled versions of the same images as a neutral control. The task is presented in pseudorandomized blocks, with each face displayed for a fixed duration. To maintain attention, participants respond based on the basis of face gender or frame color. |
| Changes in fMRI neural activity during fMRI neurofeedback | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | fMRI neurofeedback is used to measure changes in fMRI neural activity. During fMRI neurofeedback, patients try to regulate their emotions according to the direction of the arrows (up or down). They receive feedback on how well they are regulating their emotions through a colour scale. |
| Changes in fMRI neural activity during Cyberball task | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | The Cyberball task is used to measure changes in fMRI neural activity. Participants play a virtual ball-tossing game, believing they are interacting with two other players, though the game is pre-programmed. They control a hand on the screen to pass the ball, while the co-players are represented by animated figures with names and photographs to enhance ecological validity. There are three conditions: inclusion, exclusion, and overinclusion. |
| Changes in frontal asymmetry during social exclusion measured by EEG | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | EEG is used to assess changes in frontal asymmetry during Cyberball task in fMRI. Frontal asymmetry: EEG alpha power localized in frontal scalp electrodes and differences between left and right hemisphere. |
| Changes in ECG during fMRI | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | The Brain Products EEG/ExG system is used to assess heart rate variability. Heart rate variability: Mean R-R interval and standard deviation of R-R intervals evaluated in whole fMRI measurement in standard heart beats removing abnormal beats. R peaks detection performed in one channel recording localized on the chest. |
| Changes in skin conductance during fMRI | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | The Brain Products EEG/ExG system is used to assess changes in skin conductance and monitor the participant's emotional state during the experimental measurement. |
| Increase of emotion regulation | From baseline (T1), a second assessment takes place after 12 weeks (T2), the third assessment takes place 12 weeks after T2 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). | significant increase of emotion regulation measured by Difficulties in emotion regulation scale, and ecological momentary assessment |
| Ecological momentary assessment of emotional variability | From baseline (T1), the third assessment takes place 24 weeks after T1 (T3), and the fourth assessment takes place 24 weeks after T3 (T4). The second assessment (T2) is not included in this outcome measure. | EMA assesses respondents' emotions in their natural environment. They complete short questionnaires every hour from 9 AM to 9 PM for two days. First, they rate their ability to identify their current emotion (0-100). Then, they choose an emotion or select An emotion I cannot name / No emotion. Next, they rate its intensity (0-100). Finally, they rate their control over the emotion and how overwhelming it feels (both 0-100). |
Countries
Czechia
Outcome results
None listed