Previous work by the group convinced the researchers to pursue development of focused cognitive reappraisal training as a novel approach to treatment of BPD, either as stand-alone treatment or in concert with evidence-based treatments of BPD. The present proposal aims to refine and test a proposed clinical intervention for BPD patients, training in reappraisal-by-distancing, in terms of its ability to influence hypothesized neural and behavioral targets and, once that is established, to demonstrate its ability improve clinically relevant outcome measures.
Medically healthy men and women with Borderline Personality Disorder who are mentally competent and give informed voluntary written consent.
Participants will be between the ages of 18 and 55.
Within these requirements, the inclusion and
Participants with comorbid avoidant personality disorder will be included.
Participants who meet criteria for PTSD will be included as long as they are not actively experiencing symptoms.
Participants will not meet criteria for Schizotypal Personality Disorder.
Participants currently meeting criteria for Major Depressive Disorder will be excluded.
Parallel
Cognitive Reappraisal by Distancing
BehavioralReappraisal-by-distancing treatment. Patients meet 2 times a week for 6 weeks to learn reappraisal by distancing through repeated practice with negative emotional pictures. The therapist will help model and shape the technique.
Downregulate condition
BehavioralPatients either meet 2x a week for 6- weeks to gain added practice, under the guidance of a therapist, using their customary emotion regulatory strategies to downregulate their negative reactions to aversive pictures.
Change in Picture Induced Negative Emotion Signature (PINES) Network Activity
Change in Picture Induced Negative Emotion Signature (PINES) network activity. by measuring neural activation using fMRI.
Change in Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) Score
A validated 9-item self-report scale that assesses the severity of borderline personality disorder symptoms across four sectors: affective, cognitive, impulsive, and interpersonal. Total scores range from 0-36, with higher scores indicating greater symptom severity. Each item is rated on a 5-point scale (0-4), where 0 indicates no symptoms and 4 indicates severe symptoms.
Change in Active Lability Scale (ALS) Score
A 54-item self-report measure that assesses rapid changes in emotional states. Items are rated on a 4-point scale ranging from 0 ("very uncharacteristic of me") to 3 ("very characteristic of me"). Total scores range from 0-162, with higher scores indicating greater emotional instability.
Change in Perceived Stress Scale (PSS)
A 10-item self-report measure that assesses the degree to which situations in one's life are appraised as stressful. Items are rated on a 5-point scale from 0 ("never") to 4 ("very often"). Total scores range from 0-40, with higher scores indicating greater perceived stress.
Change in Difficulties in Emotion Regulation Scale (DERS) Scores
A 36-item self-report measure that assesses six dimensions of emotion regulation difficulties. Items are rated on a 5-point scale from 1 ("almost never") to 5 ("almost always"). Total scores range from 36-180, with higher scores indicating greater difficulties with emotion regulation.
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Icahn School of Medicine at Mount Sinai
Lead sponsor
William Marsh Rice University
Collaborator
National Institute of Mental Health (NIMH)
Collaborator
