Abstract
Emotional dysregulation is one of the core features of Borderline Personality Disorder (BPD). Early experiences in the family as well as mindfulness skills seems to be involved in both emotion dysregulation and the development of the disorder but it is not clear their precise contribution during adolescence. The aim of the study was to investigate if levels of mindfulness skills, emotion regulation and rearing styles in adolescents with BPD features were different compared to a control group. Then, we examined how these variables would predict BPD features vs. control group assignment. We carried out a cross-sectional study using a survey methodology to compare rearing styles, emotion regulation and mindfulness skills between a BPD features sample (n = 48) and a healthy control sample (n = 48). Then, a direct logistic regression analysis was performed on clinical status as outcome using the whole sample. As predicted, the BPD features group had lower levels in affect and mindfulness skills and higher scores in criticism and emotion dysregulation compared to the control group. Nonjudging and emotional overproduction showed the largest effect sizes. Mindfulness skills, and particularly nonjudging, predicted BPD features group assignment. This work highlights the role of nonjudging skills in BPD features and the potential relevance of BPD prevention programs targeting mindfulness skills.
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References
Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the aseba school-age forms & profiles: An integrated system of multi-informant assessment (Research C). University of Vermont: Research Center for Children, Youth & Families.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. https://doi.org/10.1177/1073191107313003.
Bersabé Morán, R., Fuentes, M. J., & Motrico, E. (2001). Análisis psicométrico De Dos escalas para evaluar estilos educativos parentales [Psychometric analysis of two scales to evaluate parents’ educational styles]. Psicothema, 13(4), 678–684.
Carmody, J., Baer, R. A., Lykins, L. B., E., & Olendzki, N. (2009). An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program. Journal of Clinical Psychology, 65(6), 613–626. https://doi.org/10.1002/jclp.20579.
Cebolla, A., García-Palacios, A., Soler, J., Guillen, V., Baños, R., & Botella, C. (2012). Psychometric properties of the Spanish validation of the five facets of Mindfulness Questionnaire (FFMQ). European Journal of Psychiatry, 26(2), 118–126. https://doi.org/10.4321/S0213-61632012000200005.
Cebolla, A., Galiana, L., Campos, D., Oliver, A., Soler, J., Demarzo, M., Baños, R. M., Felu-Soler, A., & García-Campayo, J. (2017). How does Mindfulness work? Exploring a theoretical model using samples of meditators and non-meditators. Mindfulness, 9, 860–870. https://doi.org/10.1007/s12671-017-0826-7.
Chanen, A. M., Jackson, H. J., McCutcheon, L. K., Jovev, M., Dudgeon, P., Yuen, H. P., Germano, D., Nistico, H., McDougall, E., Weinstein, C., Clarkson, V., & McGorry, P. D. (2008). Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: Randomised controlled trial. The British Journal of Psychiatry: The Journal of Mental Science, 193(6), 477–484. https://doi.org/10.1192/bjp.bp.107.048934.
Cheavens, J. S., Zachary Rosenthal, M., Daughters, S. B., Nowak, J., Kosson, D., Lynch, T. R., & Lejuez, C. W. (2005). An analogue investigation of the relationships among perceived parental criticism, negative affect, and borderline personality disorder features: The role of thought suppression. Behaviour Research and Therapy, 43(2), 257–268. https://doi.org/10.1016/j.brat.2004.01.006.
Coffey, K. A., & Hartman, M. (2008). Mechanisms of action in the inverse relationship between mindfulness and psychological distress. Complementary Health Practice Review, 13(2), 79–91. https://doi.org/10.1177/1533210108316307.
Coffey, K. A., Hartman, M., & Fredrickson, B. L. (2010). Deconstructing mindfulness and constructing Mental Health: Understanding mindfulness and its mechanisms of action. Mindfulness, 1, 235–253. https://doi.org/10.1007/s12671-010-0033-2.
Eisenlohr-Moul, T., Peters, J. R., Chamberlain, K. D., & Rodriguez, M. (2016). Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women. Journal of Psychopathology and Behavioral Assessment, 38(1), 149–157. https://doi.org/10.1007/s10862-015-9505-y.
Elices, M., Pascual, J. C., Ruiz, E., Feliú, A., Hervás, G., & Soler, J. (2014, April). Sobreproducción emocional en pacientes con trastorno límite de la personalidad. Poster presented at X Personality Disorders National Congress.
First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Entrevista Clínica Estructurada para Los Trastornos De Personalidad Del Eje II Del DSM-IV. Masson.
Fitzpatrick, S., Ip, J., Krantz, L., Zeifman, R., & Kuo, J. R. (2019). Use your words: The role of emotion labeling in regulating emotion in borderline personality disorder. Behaviour Research and Therapy, 120, 103447. https://doi.org/10.1016/j.brat.2019.103447.
Fonagy, P., Speranza, M., Luyten, P., Kaess, M., Hessels, C., & Bohus, M. (2015). ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice. European Child and Adolescent Psychiatry, 24(11), 1307–1320. https://doi.org/10.1007/s00787-015-0751-z.
Fuentes, M. J., Motrico, E., & Bersabé, R. M. (1999). Escala De Afecto (EA) y Escala De Normas Y Exigencias (ENE): versión hijos y versión padres. Universidad de Málaga.
Glenn, C. R., & Klonsky, E. D. (2009). Emotion dysregulation as a core feature of borderline personality disorder. Journal of Personality Disorders, 23(1), 20–28. https://doi.org/10.1521/pedi.2009.23.1.20.
Gómez-Simón, I., Penelo, E., & de la Osa, N. (2014). Factor structure and measurement invariance of the difficulties emotion regulation scale (DERS) in Spanish adolescents. Psicothema, 26(3), 401–408. https://doi.org/10.7334/psicothema2013.324.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94.
Hervas, G., & Vazquez, C. (2011). What else do you feel when you feel sad? Emotional overproduction, neuroticism and rumination. Emotion (Washington D C), 11(4), 881–895. https://doi.org/10.1037/a0021770.
Hervás, G., & Jódar, R. (2008). Adaptación Al Castellano de la escala de dificultades en la Regulación Emocional. Clínica Y Salud, 19(2), 139–156.
Hervás, G., Cebolla, A., & Soler, J. (2016). Intervenciones psicológicas basadas en mindfulness y sus beneficios: Estado actual de la cuestión. Clínica Y Salud, 27, 115–124. https://doi.org/10.1016/j.clysa.2016.09.002.
Johnson, J. G., Cohen, P., Chen, H., Kasen, S., & Brook, J. S. (2006). Parenting behaviors associated with risk for offspring personality disorder during adulthood. Archives of General Psychiatry, 63(5), 579–587. https://doi.org/10.1001/archpsyc.63.5.579.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., Ryan, N., & Version, L. (1997). (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980–988. https://doi.org/10.1097/00004583-199707000-00021.
Lemos, S., Vallejo, G., & Sandoval, M. (2002). Estructura Factorial Del Youth Self-report (YSR). Psicothema, 14, 816–822.
Linehan, M. M. (1993a). Cognitive-behavioral treatment of Borderline personality disorder (1.ª Ed). The Guilford Press.
Ma, Y., & Fang, S. (2019). Adolescents’ mindfulness and psychological distress: The mediating role of emotion regulation. Frontiers in Psychology, 1, 1358. https://doi.org/10.3389/fpsyg.2019.01358.
Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28(6), 969–981. https://doi.org/10.1016/j.cpr.2008.02.004.
Mitchell, R., Roberts, R., Bartsch, D., & Sullivan, T. (2019). Changes in mindfulness facets in a dialectical behaviour therapy skills training group program for borderline personality disorder. Journal of Clinical Psychology, 75(6), 958–969. https://doi.org/10.1002/jclp.22744.
Perroud, N., Nicastro, R., Jermann, F., & Huguelet, P. (2012). Mindfulness skills in borderline personality disorder patients during dialectical behavior therapy: Preliminary results. International Journal of Psychiatry in Clinical Practice, 16(3), 189–196. https://doi.org/10.3109/13651501.2012.674531.
Salbach-Andrae, H., Bürger, A., Klinkowski, N., Lenz, K., Pfeiffer, E., Fydrich, T., & Lehmkuhl, U. (2008). Diagnostik Von Persönlichkeitsstörungen Im Jugendalter Nach SKID-II [Diagnostic of personality disorders in adolescence according to SCID-II]. Zeitschrift fur Kinder- und Jugendpsychiatrie Und Psychotherapie, 36(2), 117–125. https://doi.org/10.1024/1422-4917.36.2.117.
Sansone, R. A., Farukhi, S., & Wiederman, M. W. (2013). Perceptions of childhood caretakers and borderline personality symptomatology. Child Abuse & Neglect, 37, 1030–1033. https://doi.org/10.1016/j.chiabu.2013.06.008.
Santamarina-Perez, P., Mendez, I., Singh, M. K., Berk, M., Picado, M., et al. (2020). Adapted Dialectical Behavior Therapy for adolescents with a high risk of Suicide in a community clinic, a pragmatic randomized controlled trial. Suicide & Life-threatening Behavior, 50(3), 652–667. https://doi.org/10.1111/sltb.12612.
Schuppert, H. M., Albers, C. J., Minderaa, R. B., Emmelkamp, P., P. M. G., & Nauta, M. H. (2012). Parental rearing and psychopathology in mothers of adolescents with and without borderline personality symptoms. Psychiatry and Mental Health, 6(1), 29. https://doi.org/10.1186/1753-2000-6-29.
Selby, E. A., Fehling, K. B., Panza, E. A., & Kranzler, A. (2016). Rumination, mindfulness, and borderline personality disorder symptoms. Mindfulness, 7(1), 228–235. https://doi.org/10.1007/s12671-015-0432-5.
Stepp, S. D. (2012). Development of Borderline Personality Disorder in Adolescence and Young Adulthood: Introduction to the Special section. Journal of Abnormal Child Psychology, 40(1), 1–5. https://doi.org/10.1007/s10802-011-9594-3.
Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of rearing and borderline personality disorder symptoms in adolescent girls. Development and Psychopathology, 26, 361–378. https://doi.org/10.1017/S0954579413001041.
Tyrer, P., Crawford, M., & Mulder, R. (2011). Reclassifying personality disorders. The Lancet, 377(9780), 1814–1815. https://doi.org/10.1016/S0140-6736(10)61926-5.
Ulloa, R. E., Ortiz, S., Higuera, F., Nogales, I., Fresán, A., Apiquian, R., Cortés, J., Arechavaleta, B., Foulliux, C., Martínez, P., Hernández, L., Domínguez, E., & de la Peña, F. (2006). Estudio de fiabilidad interevaluador de la versión en español de la entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime version (K-SADS-PL). [Interrater reliability of the Spanish version of Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime version (K-SADS-PL)]. Actas espanolas de psiquiatria, 34(1), 36–40.
Winograd, G., Cohen, P., & Chen, H. (2008). Adolescent borderline symptoms in the community: Prognosis for functioning over 20 years. Journal of Child Psychology and Psychiatry, 49(9), 933–941. https://doi.org/10.1111/j.1469-7610.2008.01930.x.
Winsper, C., Zanarini, M., & Wolke, D. (2012). Prospective study of family adversity and maladaptive rearing in childhood and borderline personality disorder symptoms in a nonclinical population at 11 years. Psychological Medicine, 5, 1–16. https://doi.org/10.1017/S0033291712000542.
Winsper, C., Lereya, S. T., Marwaha, S., Thompson, A., Eyden, J., & Singh, S. P. (2016). The aetiological and psychopathological validity of borderline personality disorder in youth: A systematic review and meta-analysis. Clinical Psychology Review, 44, 13–24. https://doi.org/10.1016/j.cpr.2015.12.001.
Wupperman, P., Neumann, C. S., & Axelrod, S. R. (2008). Do deficits in mindfulness underlie borderline personality features and core difficulties? Journal of Personality Disorders, 22(5), 466–482. https://doi.org/10.1521/pedi.2008.22.5.466.
Wupperman, P., Neumann, C. S., Whitman, J. B., & Axelrod, S. R. (2009). The role of mindfulness in borderline personality disorder features. The Journal of Nervous and Mental Disease, 197, 766–771. https://doi.org/10.1097/NMD.0b013e3181b97343.
Acknowledgements
This study was also supported by a grant of the Spanish Ministry of Science, Innovation and Universities (RTI2018-100689-B-I00).
Funding
This study was supported by the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (PI17/00997), co-financed by ERDF Funds from the European Commission, “A way of making Europe”, CIBERSAM, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program, Fundación Familia Alonso and Fundación Alicia Koplowitz.
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Sara Marco: Conceptualization, Data collection, Original draft preparation, Statistical analyses and data management. María Mayoral: Writing- Reviewing and Editing. Gonzalo Hervas: Conceptualization, Writing-Reviewing and Editing, Supervision.
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The study has been approved by Gregorio Maranon Hospital and Sant Joan de Déu Terres de Lleida Hospital Ethical Comitees. We carried out the investigation in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC (General Data Protection Regulation). Written informed consent of the participants and their parents was obtained before questionnaire completion and information of the purpose and methodology of the intervention was explained. This research involved human participants under 18 years and informed consent was collected from parents and adolescents.
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Marco, S., Mayoral, M. & Hervás, G. Differences in mindfulness, rearing styles and emotion dysregulation between adolescents with borderline personality disorder features and a control group. Curr Psychol 43, 16228–16236 (2024). https://doi.org/10.1007/s12144-023-05565-2
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DOI: https://doi.org/10.1007/s12144-023-05565-2