Impact of Mindfulness Training on Borderline Personality Disorder: A Randomized Trial
- 1.3k Downloads
Recent research suggests that deficits in the ability to be mindful may be related to core aspects of borderline personality disorder (BPD). Mindfulness plays a central role in BPD treatment, and evidence also indicates that mindfulness is the most commonly practiced of the skills taught in dialectical behavior therapy (DBT). The present study investigated whether a 10-week mindfulness training program would improve BPD symptoms and mindfulness-related capacities in a sample of individuals diagnosed with BPD. A total of 64 participants (mean age = 31.64, SD = 6.9; 86 % female) were randomized to 10 weeks of mindfulness (n = 32) or interpersonal effectiveness skills training (control group; n = 32). BPD symptoms and mindfulness capacities were measured at pre- and post-intervention. Compared to the control group, participants assigned to mindfulness experienced a significantly greater reduction and increase, respectively, in BPD symptoms and decentering capacity. Treatment response rates (in reference to BPD symptoms) were higher for the mindfulness group (40 vs. 13 %). Interpersonal effectiveness alone did not result in improvements on any outcome measures. These findings suggest that mindfulness training may be a useful approach to decreasing BPD symptoms while simultaneously improving mindfulness capacities.
KeywordsBorderline personality disorder Mindfulness Meditation Decentering
We would like to thank all participants of the study. This study was supported by the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) and by a grant from Facultad de Psicología (UdelaR) to the first author. This study was also funded by a grant from the ISCIII (PI13/00134) and co-financed with European Union ERDF funds. JS was supported by PROMOSAM: Investigación en procesos, mecanismos y tratamientos psicológicos para la promoción de la salud mental (Red de Excelencia PSI2014-56303-REDT) founded by Ministerio de Economía y Competitividad (2014). MJP is funded by the Ministerio de Ciencia e Innovación of the Spanish Government and by the Instituto de Salud Carlos III through a “Miguel Servet” research contract (CP10-00393), within the “Plan Estatal de I+D+I” 2013–2016, co-financed by the European Regional Development Fund (ERDF).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing.Google Scholar
- Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R.-D., Domsalla, M., Chapman, A. L., & Wolf, M. (2008). The short version of the Borderline Symptom List (BSL-23): development and initial data on psychometric properties. Psychopathology, 42(1), 32–39. doi: 10.1159/000173701.CrossRefPubMedGoogle Scholar
- Cebolla, A., Garcia Palacios, A., Soler, J., Guillén, V., Baños, R., & Botella, C. (2012). Psychometric properties of the Spanish validation of the Five Facets of Mindfulness Questionnaire ( FFMQ ). The European Journal of Psychiatry, 26(2), 118–126. doi: 10.4321/S0213-61632012000200005.CrossRefGoogle Scholar
- Feliu-Soler, A., Pascual, J. C., Borràs, X., Portella, M. J., Martín-Blanco, A., Armario, A., & Soler, J. (2014). Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results. Clinical Psychology & Psychotherapy, 21(4), 363–370. doi: 10.1002/cpp.1837.CrossRefGoogle Scholar
- Fresco, D. M., Moore, M. T., van Dulmen, M. H. M., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–46. doi: 10.1016/j.beth.2006.08.003.CrossRefPubMedGoogle Scholar
- Gibbon, M., & Spitzer, R. L. (1997). User’s guide for the structured clinical interview for DSM-IV axis II personality disorders: SCID-II. Washington, DC: American Psychiatric Publishing.Google Scholar
- Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Delacorte.Google Scholar
- Linehan, M. M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.Google Scholar
- Linehan, M. M. (1993b). Skills training manual for treating borderline personality disorder. Guilford Press.Google Scholar
- Linehan, M. M. (2003). From chaos to freedom set. Seattle, WA: Behavioral Technology Transfer Group.Google Scholar
- Linehan, M. M. (2004). Wise mind: being able to drop in. Seattle, WA: Behavioral Technology Transfer Group.Google Scholar
- Linehan, M. M. (2014). DBT skills training manual (2nd ed.). New York, NY: Guilford Press.Google Scholar
- Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder a randomized clinical trial and component analysis. JAMA, 98195, 1–8. doi: 10.1001/jamapsychiatry.2014.3039.Google Scholar
- Little, R., & Rubin, D. (1987). Statistical analysis with missing data. New York, NY: Wiley.Google Scholar
- Martín-Blanco, A., Soler, J., Villalta, L., Feliu-Soler, A., Elices, M., Pérez, V., & Pascual, J. C. (2014). Exploring the interaction between childhood maltreatment and temperamental traits on the severity of borderline personality disorder. Comprehensive Psychiatry, 55(2), 311–8. doi: 10.1016/j.comppsych.2013.08.026.CrossRefPubMedGoogle Scholar
- Mott, J., Koucky, E., & Teng, E. (2015). The impact of patient preference on mental health treatment: a methodological critique and suggestions for future research. European Journal for Person Centered Healthcare, 3(1), 26–36.Google Scholar
- Peters, J. R., Eisenlohr-Moul, T. A., Upton, B. T., & Baer, R. A. (2013). Nonjudgment as a moderator of the relationship between present-centered awareness and borderline features: synergistic interactions in mindfulness assessment. Personality and Individual Differences, 55(1), 24–28. doi: 10.1016/j.paid.2013.01.021.CrossRefGoogle Scholar
- Soler, J., Pascual, J. C., Tiana, T., Cebrià, A., Barrachina, J., Campins, M. J., & Pérez, V. (2009). Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behaviour Research and Therapy, 47(5), 353–8. doi: 10.1016/j.brat.2009.01.013.CrossRefPubMedGoogle Scholar
- Soler, J., Valdepérez, A., Feliu-Soler, A., Pascual, J. C., Portella, M. J., Martín-Blanco, A., & Pérez, V. (2012). Effects of the dialectical behavioral therapy-mindfulness module on attention in patients with borderline personality disorder. Behaviour Research and Therapy, 50(2), 150–7. doi: 10.1016/j.brat.2011.12.002.CrossRefPubMedGoogle Scholar
- Soler, J., Franquesa, A., Feliu-Soler, A., Cebolla, A., Garcia-Campayo, J., Tejedor, R., & Portella, M. J. (2014). Assessing decentering: validation, psychometric properties and clinical usefulness of the Experiences Questionnaire in a Spanish sample. Behavior Therapy, 45(6), 863–871. doi: 10.1016/j.beth.2014.05.004.CrossRefPubMedGoogle Scholar
- Stoffers, J., Völlm, B. A., Rücker, G., Timmer, A., Huband, N., & Lieb, K. (2012). Psychological therapies for people with borderline personality disorder (Review). In Cochrane Database of Systematic Reviews (Cochrane D.). Wiley. doi: 10.1002/14651858.CD005652
- Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1–20. doi: 10.1002/jclp.22114.CrossRefPubMedGoogle Scholar