A Developmental Psychopathology and Neurobiological Model of Borderline Personality Disorder in Adolescence

Ensink, Karin; Biberdzic, Marko; Normandin, Lina; Clarkin, John F.

doi:10.1080/15289168.2015.1007715

Cited by 21 publications

(19 citation statements)

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“…A review of the current literature was carried out by searching for articles in Pubmed/Medline, PsycINFO, and Google Scholar, along with articles obtained from the references of other articles. The reference sections of the review articles mentioned above [i.e., (2,(4)(5)(6)(7)] were also examined to determine if there were any other studies that examined the neural substrates of BPD after treatment. Keywords used for this review included "dialectical, " "borderline, " "brain, " and "neural.…”

Section: Methodsmentioning

confidence: 99%

“…Comprehensive reviews have consistently demonstrated the multifaceted neurobiology of BPD in adults (2,4,5) as well as adolescents (6), along with the neurobiology of non-suicidal self-injury, a prominent and pervasive symptom among individuals with BPD (7). For example, abnormalities in the amygdala and anterior cingulate cortex (ACC) have been consistently implicated in the neurobiology of both BPD as well as individuals who engage in non-suicidal self-injury (2,(5)(6)(7). More specifically, a meta-analysis of neuroimaging studies on emotion processing showed left amygdala hyperactivity and reduced dorsolateral prefrontal cortex (dlPFC) among individuals with BPD (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Neural Changes in Borderline Personality Disorder After Dialectical Behavior Therapy–A Review

Iskric

Barkley-Levenson

2021

Front. Psychiatry

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The biological component of the biosocial theory of emotion regulation stipulates that borderline personality disorder (BPD) arises from biological vulnerabilities to heightened emotional reactivity. Comprehensive reviews have consistently implicated abnormalities in the amygdala, anterior cingulate cortex, and hippocampus in the neurobiology of BPD. While Dialectical Behavior Therapy (DBT) is the leading evidence-based psychotherapy for the treatment of BPD, there remains a paucity of literature examining changes in the neurobiology of BPD following DBT treatment. Nine studies were identified that examined neurobiological changes in BPD after the completion of DBT. Results indicated that there was significant deactivation of amygdala activity as well as the anterior cingulate cortex in patients with BPD after DBT treatment. As well, several studies found after DBT treatment, BPD patients had a decreased activity in the inferior frontal gyrus in response to arousing stimuli and increased activity in response to inhibitory control. Future research on the neurobiological change after DBT treatment can help clarify biological mechanisms of change in BPD.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neural Changes in Borderline Personality Disorder After Dialectical Behavior Therapy–A Review

Iskric

Barkley-Levenson

2021

Front. Psychiatry

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“…Adolescence is a complex period in which the individual is subject to profound emotional, physical, and psychological changes ( Fonagy et al, 2004 ; Bucchianeri et al, 2013 ; Normandin et al, 2015 ; Powers and Casey, 2015 ). It is, therefore, a sensitive period in the development of mental disorders ( Ensink et al, 2015 ; Sharp and Wall, 2017 ). Healthy development during adolescence is therefore crucial not only in avoiding problems in the adolescent himself but also for his future development ( Huebner et al, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Emotional Intelligence, Empathy, Self-Esteem, and Life Satisfaction in Spanish Adolescents: Regression vs. QCA Models

et al. 2020

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Adolescence is a complex period, in which the individual is subject to profound emotional, physical, and psychological changes. Healthy development during adolescence is crucial for future positive development; self-esteem and life satisfaction are fundamental. The importance of sociodemographic variables (sex and age), empathy, and emotional intelligence (EI) on self-esteem and life satisfaction was studied, comparing complementary methodologies, regression models, and fuzzy-set qualitative comparative analysis (fsQCA) models. This is a cross-sectional design in a convenience sample of 991 adolescents (528 females, 53.3%; aged between 12 and 19 years; M = 14.01, SD = 1.40) from Spanish schools. Data were collected using the Rosenberg Self-Esteem Scale (RSES), the Satisfaction With Life Scale (SWLS), the Basic Empathy Scale (BES), and Trait Meta-Mood Scale (TMMS)24. The results of the regression models suggest that cognitive empathy, emotional clarity, and emotional repair are the main predictor variables for self-esteem. Meanwhile, the results of the fsQCA suggest that being older and low levels of cognitive empathy, emotional clarity, and emotional repair predict higher levels of self-esteem. On the other hand, life satisfaction in regression models is significantly predicted by the emotional clarity and emotional repair dimensions of the TMMS24 and self-esteem. Meanwhile, in the prediction of life satisfaction, the results of the fsQCA suggest that the most important interactions were high emotional clarity, emotional repair, and low self-esteem. As research has already shown, promoting empathy and EI leads to higher levels of self-esteem and life satisfaction.

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“…Only recently, experts in the field declared adolescents with BPD as a sensible clinical population highly in need of early prevention and specific interventions (Chanen et al, 2017 ). While there is still no generally accepted developmental psychopathological model of BPD, most etiological theories are in favor of a transactional diathesis-stress model (Sharp & Fonagy, 2015 ) that include interactions between genetic vulnerability and childhood adversities (Ensink, Biberdzic, Normandin, & Clarkin, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of alliance ruptures in the psychotherapy of adolescents with borderline personality pathology: timing, typology and significance

Schenk

Zimmermann

Fürer

et al. 2019

ResPsy

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Jeremy Safran and his research group suggest that rupture-repair processes are important for the therapeutic change in patients with personality disorders. In this exploratory study, we describe alliance ruptures and resolutions on a session-by-session basis in a clinical sample of adolescents with Borderline Personality Pathology (BPP). Three research questions are addressed: i) Is there a typical trajectory of alliance ruptures over treatment time? ii) Which rupture and resolution markers occur frequently? iii) Which rupture markers are most significant for the therapeutic alliance? Ten patients who presented with identity diffusion and at least three Borderline Personality Disorder criteria were studied and treated with Adolescent Identity Treatment. Alliance ruptures and resolutions were coded in 187 therapy sessions according to the Rupture Resolution Rating System. Mixed-effect models were used for statistical analyses. Findings supported an inverted U-shaped trajectory of alliance ruptures across treatment time. The inspection of individual trajectories displayed that alliance ruptures emerge non-linearly with particular significant alliance ruptures appearing in phases or single peak sessions. Withdrawal rupture markers emerged more often compared to confrontation markers. However, confrontation markers inflicted a higher impact or strain on the immediate collaboration between patient and therapist compared to withdrawal markers. Clinicians should expect alliance ruptures to occur frequently in the treatment of adolescents with BPP. The findings support the theory of a dynamic therapeutic alliance characterised by a continuous negotiation between patients and therapists.

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A Developmental Psychopathology and Neurobiological Model of Borderline Personality Disorder in Adolescence

Cited by 21 publications

References 168 publications

Neural Changes in Borderline Personality Disorder After Dialectical Behavior Therapy–A Review

Neural Changes in Borderline Personality Disorder After Dialectical Behavior Therapy–A Review

Emotional Intelligence, Empathy, Self-Esteem, and Life Satisfaction in Spanish Adolescents: Regression vs. QCA Models

Trajectories of alliance ruptures in the psychotherapy of adolescents with borderline personality pathology: timing, typology and significance

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