Saturday, April 2, 2011

Do Deficits in Mindfulness Underlie Borderline Personality Features and Core Difficulties?


 
Review of Study Published in the Journal of Personality Disorders

          Previous research includes several different models to identify the core mechanisms responsible for the diverse features associated with Borderline Personality Disorder.  This disorder presents with a variety of features that include ineffective interpersonal skills and emotion-regulation dysfunction.  Individuals diagnosed with Borderline Personality Disorder typically have issues related to awareness, attention, and self-acceptance.   Most previous research regularly associates mindfulness with the presentation of many of these issues; but there is limited research exploring the correlation between mindfulness and Borderline Personality Disorder symptoms.   The purpose of this study was to observe whether, in fact, mindfulness deficits underlie the broad areas of dysfunction commonly associated with the clinical features of this disorder.  To do this, the authors examined the relationship between mindfulness deficits and a diverse non-clinical sample that was representative of a wide range of Borderline Personality features.
            The authors tested three main hypothesis based on the empirical evidence of previous research.  The first hypothesis was that there would be a negative association between mindfulness, and the core areas of dysfunction of Borderline Personality Disorder.  The second hypothesis predicted that the association between mindfulness and these clinical features would be statistically significant when controlling for neuroticism.  The final hypothesis was that mindfulness would be able to predict Borderline Personality Disorder features beyond its associations with the regular functioning of the features associated with this disorder.
          The sample used for this study consisted of 342 undergraduate students who were currently enrolled in an introductory psychology course at the University of North Texas.  Mindfulness was measured using a fifteen item, Likert-type scale known as the Mindfulness Attention Awareness Scale.  This scale assesses several different traits that are characteristic of mindfulness including aspects of both attention and awareness.  Borderline Personality Disorder features were assessed using both self-report scales and written response items.  Neuroticism was also assessed due to its high correlation with Borderline Personality Disorder.  This was accomplished using a six item, likert-type scale that assessed the tendency towards negative emotions.  
            The results of this study indicate that mindfulness is positively correlated with interpersonal and emotional functioning, and negatively related to the dysfunctional emotional and interpersonal features associated with Borderline Personality Disorder.  Although weaker; the negative correlation with Borderline Personality Disorder remained statistically significant when controlling for neuroticism.  Analysis of data suggests that mindfulness significantly predicts Borderline Personality Disorder beyond the effects of features common to the disorder. This research suggests that the dysfunctional features of Borderline Personality Disorder may be explained by problems related to mindfulness combined with features of neuroticism.  Mindfulness was indicated as a main construct for explaining the primary areas of dysfunction common to Borderline Personality Disorder.
             One limitation of this study was the use of undergraduate psychology students to comprise the sample.  This may indicate a limited ability to generalize results to clinical populations.  Another limitation is the inability to draw causal conclusions due to the correlational design of the study.  The relationship between mindfulness and neuroticism must be studied further in order to understand the direct effects of each variable on Borderline Personality Disorder features.
          This study was meticulously designed and analyzed using strict data analysis procedures.  The major problem with this study is the inability to isolate all independent variables.  This is not a reflection of faulty methodology, but an indication of the complex clinical presentation of features related to this disorder.  This problem is most likely characteristic of all clinical studies that attempt to broadly examine Borderline Personality Disorder. 
          This study has broad implications for future research and clinical work.  I am interested in understanding how mindfulness meditation can be positively utilized in clinical application.  The relationship between mindfulness and Borderline Personality Disorder suggests that future research involving mindfulness meditation may be warranted.  It would be interesting to see if the introduction of mindfulness meditation would increase the efficacy of current therapeutic models.