Skip to main content
Log in

Impact of Mindfulness Training on Borderline Personality Disorder: A Randomized Trial

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. doi:10.1177/1073191105283504.

    Article  PubMed  Google Scholar 

  • Barrachina, J., Soler, J., Campins, M. J., Tejero, A., Pascual, J. C., Alvarez, E., & Pérez Sola, V. (2004). Validation of a Spanish version of the Diagnostic Interview for Bordelines-Revised (DIB-R). Actas Españolas de Psiquiatría, 32(5), 293–8.

    PubMed  Google Scholar 

  • Bender, D. S., Dolan, R., Skodol, A. E., Sanislow, C. A., Dyck, I. R., McGlashan, T. H., & Gunderson, J. G. (2001). Treatment utilization by patients with personality disorders. American Journal of Psychiatry, 158(2), 295–302. doi:10.1176/appi.ajp.158.2.295.

    Article  PubMed  Google Scholar 

  • Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & Devins, G. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241. doi:10.1093/clipsy/bph077.

    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.

    Article  PubMed  Google 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.

    Article  Google Scholar 

  • Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosomatic Medicine, 69(6), 560–5. doi:10.1097/PSY.0b013e3180f6171f.

    Article  PubMed  Google Scholar 

  • Dimidjian, S., & Linehan, M. M. (2003). Defining an agenda for future research on the clinical application of mindfulness practice. Clinical Psychology: Science and Practice, 10, 166–171. doi:10.1093/clipsy/bpg019.

    Google 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.

    Article  Google 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.

    Article  PubMed  Google 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 

  • Gómez-Beneyto, M., Villar, M., Renovell, M., Pérez, M., Herández, M., & Leal, C. (1994). The diagnosis of personality disorder with a modified version of the SCID-II in a Spanish clinical sample. Journal of Personality Disorders, 8, 104–10. doi:10.1521/pedi.1994.8.2.104.

    Article  Google Scholar 

  • Hayes-skelton, S. A., Calloway, A., Roemer, L., & Orsillo, S. M. (2015). Decentering as a potential common mechanism across two therapies for generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 83(2), 395–404. doi:10.1037/a0038305.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19. doi:10.1037//0022-006X.59.1.12.

    Article  PubMed  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 

  • Kröger, C., Harbeck, S., Armbrust, M., & Kliem, S. (2013). Effectiveness, response, and dropout of dialectical behavior therapy for borderline personality disorder in an inpatient setting. Behaviour Research and Therapy, 51(8), 411–6. doi:10.1016/j.brat.2013.04.008.

    Article  PubMed  Google Scholar 

  • Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74–84. doi:10.1016/S0140-6736(10)61422-5.

    Article  Google Scholar 

  • Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. Lancet, 364(9432), 453–61. doi:10.1016/S0140-6736(04)16770-6.

    Article  PubMed  Google Scholar 

  • Lindenboim, N., Comtois, K. A., & Linehan, M. M. (2007). Skills practice in dialectical behavior therapy for suicidal women meeting criteria for borderline personality disorder. Cognitive and Behavioral Practice, 14(2), 147–156. doi:10.1016/j.cbpra.2006.10.004.

    Article  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.

  • 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.

    Article  PubMed  Google 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 

  • Pérez Gálvez, B., García Fernández, L., de Vicente Manzaro, M., & Olivera Valenzuela, M. (2010). Validation of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) in a Spanish sample of alcoholic patients. Adicciones, 22, 199–206.

    Article  PubMed  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.

    Article  Google Scholar 

  • Sachse, S., Keville, S., & Feigenbaum, J. (2011). A feasibility study of mindfulness-based cognitive therapy for individuals with borderline personality disorder. Psychology and Psychotherapy, 84(2), 184–200. doi:10.1348/147608310X516387.

    Article  PubMed  Google 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.

    Article  PubMed  Google 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.

    Article  PubMed  Google Scholar 

  • Soler, J., Vega, D., Feliu-Soler, A., Trujols, J., Soto, A., Elices, M., & Pascual, J. C. (2013). Validation of the Spanish version of the Borderline Symptom List, short form (BSL-23). BMC Psychiatry, 13, 139. doi:10.1186/1471-244X-13-139.

    Article  PubMed  PubMed Central  Google 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.

    Article  PubMed  Google Scholar 

  • Stepp, S. D., Epler, A. J., Jahng, S., & Trull, T. J. (2008). The effect of dialectical behavior therapy skills use on borderline personality disorder features. Journal of Personality Disorders, 22(6), 549–63. doi:10.1521/pedi.2008.22.6.549.

    Article  PubMed  PubMed Central  Google 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.

    Article  PubMed  Google Scholar 

  • 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), 466–82. doi:10.1521/pedi.2008.22.5.466.

    Article  PubMed  Google Scholar 

  • 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(10), 766–71. doi:10.1097/NMD.0b013e3181b97343.

    Article  PubMed  Google Scholar 

  • Wupperman, P., Fickling, M., Klemanski, D. H., Berking, M., & Whitman, J. B. (2013). Borderline personality features and harmful dysregulated behavior: the mediational effect of mindfulness. Journal of Clinical Psychology, 69(9), 903–11. doi:10.1002/jclp.21969.

    Article  PubMed  Google Scholar 

  • Zanarini, M., Gunderson, J. G., Frankenburg, F. R., & Chauncey, D. L. (1989). The revised diagnostic interview for borderlines: discriminating BPD from other axis II disorders. Journal of Personality Disorders, 3(1), 10–18. doi:10.1521/pedi.1989.3.1.10.

    Article  Google Scholar 

  • Zimmerman, M., & Mattia, J. I. (2001). The psychiatric diagnostic screening questionnaire: development, reliability and validity. Comprehensive Psychiatry, 42(3), 175–89. doi:10.1053/comp.2001.23126.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

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).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joaquim Soler.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Additional information

Trial Registration: ClinicalTrials.gov Identifier: NCT02397031.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elices, M., Pascual, J.C., Portella, M.J. et al. Impact of Mindfulness Training on Borderline Personality Disorder: A Randomized Trial. Mindfulness 7, 584–595 (2016). https://doi.org/10.1007/s12671-016-0492-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-016-0492-1

Keywords

Navigation