PhD Scientific Days 2023

Mental Health Sciences - Posters N

The role of MBCT in a fragmented world: coping with overwhelming negative emotions in borderline personality disorder

Text of the abstract

Introduction
Mindfulness-Based Cognitive Therapy (MBCT) is a time-limited group therapy that can be effective in coping with the cascade of negative cognitions and emotions. These are leading background factors in suicidal behaviour, non-suicidal self-injury (NSSI), and are also central issues in Borderline Personality Disorder (BPD).

Aims
Our aim was to establish the adaptation of MBCT for borderline outpatients with NSSI, and to investigate the relationship between mindfulness skills and emotion regulation processes. We expected that MBCT could show new directions in patients' attitudes and reactions to their emotions. Consequently, their maladaptive emotion regulation, impulsivity, self-harm and depressive symptoms will decrease.

Methods
A nonrandomized-controlled trial was conducted with mixed-methods evaluation on self-reported symptoms of NSSI, mindfulness skills, emotion dysregulation, depressive symptoms and self-compassion. N=104 patients were assessed for eligibility, and a total of 84 BPD patients fulfilled the inclusion criteria. After a two-stepped interview procedure, participants attended an 8-week MBCT group intervention. Participants were assessed 3 times: 1) 8 weeks before the intervention; 2) pre-intervention; and 3) post-intervention (N=49).

Results
Comparing pre- and post-intervention scores, we found significant reduction in the frequency of NSSI (ZWilcoxon(49)=6.441; p<.001), depression scores (t(48)=3.180, p=.003, d=.379) impulsivity (t(48)=4.780, p<.001, d=.492) and maladaptive emotion regulation strategies (t(48)=2.087; p=.042, d=.25). Significant improvement was shown in self-compassion (t(47)=-3.089; p=.003, d=.499) and mindfulness skills (t(48)=-5.844; p<.001, d=.906). There was no significant change in adaptive emotion regulation strategies t(48)=-1.164, p=.250), dissociation level(t(48)=1.470, p=.148) and anger expression total score (t(47)=1.691, p=.097).

Conclusion
Based on the results of the pilot study focused MBCT seems to be effective for BPD patients in reducing self-harm and emotion dysregulation. In order to patients truly receive an usable and lasting tool for adaptive coping, it is important to refine the sequence of exercises and the length of the MBCT group, with special attention to intrusive traumatic experiences, self-hatred and commitment difficulties.