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.

 Link to Study 

Meditation Appears to Cause Changes in Brain's Gray Matter

MRI scans show increased volume in parts of brain linked to empathy, awareness

"A mindfulness meditation training program can trigger measurable changes in brain areas associated with awareness, empathy and sense of self within eight weeks, a new study has found."

"The meditation group participants spent an average of 27 minutes a day doing mindfulness meditation exercises. The MRI scans taken after the eight-week program revealed increased gray matter density in the hippocampus (important for learning and memory) and in structures associated with compassion and self-awareness."

"The investigators also found that participant-reported reductions in stress were associated with decreased gray matter density in the amygdala, which plays a role in anxiety and stress."

Link to Full Article

The positive effects of meditation have been known in the East for thousands of years, but the practice only started gaining popularity in Western society in the mid-20th century.  It wasn't until the 1960's that researchers began studying the effects of mediation and learning of its many benefits.  In the last 50 years scientific research has consistently indicated that the daily practice of meditation provides both mental and physical health benefits.  Until recently, researchers have had a very limited understanding of how meditation causes these positive changes.

This article, posted on January 25, 2011 in the health section of U.S. News and World Report, discusses the most recent research findings regarding this age-old practice.  The results of this study(as well as several others) indicate that the regular practice of meditation causes structural changes in the brain.  Increased density in the gray matter of the hippocampus and amygdala were observed after only two months of daily practice.  Neuroscience continues to provide proof of the brain's amazing plasticity.  Practicing meditation capitalizes on the brain's capacity for change, and translates to signifcant imporvements in daily life.  It is never too late to start!

Link To The National Center for Complementary and Alternative Medicine

Talk therapy may help tough-to-treat depression

People with long-lasting depression may benefit from talk therapy when other treatment methods such as antidepressant drugs alone aren't working, suggests a new study. But the topic needs more research, the authors say - and they also point out that talk therapy isn't accessible or affordable for everyone.

"About 15 million adults in America suffer from major depressive disorder - serious cases of depression that last more than two weeks - in any given year, according to the National Institute of Mental Health. Most people who are diagnosed with major depressive disorder get prescribed an antidepressant rather than going straight into talk therapy, explained Dr. Ranak Trivedi, the lead author on the current study from the University of Washington School of Public Health.  But up to half of those people might not feel any better after they start taking the medication, she said."

"Talk therapy costs more than medication, at least in the short term. And insurance companies often put limits on reimbursements (although new rules issued by the Obama administration are intended to improve coverage of mental health care for people whose insurance comes through their employers)."

"But Trivedi said that in the long run, talk therapy may well be worth it. "People who take antidepressants often end up taking them for life," she said. With talk therapy, patients often go for a few months, or sometimes a few years, and then stop when their symptoms have gone away."

Link To Full Article

An interesting article written by Genevra Pittman for Reuters Health on January 13, 2011 that examines the the use of medication and talk therapy in the treatment of depression.  I find it a little frightening that most patients diagnosed with major depressive disorder in this country are prescribed anti-depressants(sometimes several different medications when patients don't respond to their first anti-depressant drug) before they are referred to some form of talk therapy.

The article explains that Dr. Trivedi's research "suggests that talk therapy may be promising for people who don't get better on medication - but they also reflect the fact that many more studies are needed."  While psychotropic medications can be important tools for treating several forms of mental illness, they aren't the only answer.  These widely prescribed drugs are strong medications that produce lasting changes in brain chemistry and cause serious side effects(many of which end up being treated with even more medication).  It's baffling to me how readily these psychotropic medications are dispensed to patients before considering a more benign treatment option such as talk therapy.  Unforunately, it is unlikely that any research showing the effectiveness of non-pharmacological interventions will be widely reported while the pharmaceutical companies continue to provide millions of dollars of "support" to mainstream media, government agencies, and major organizations like the American Psychiatry Association.

Cognitive and Behavioral Nutrition: Reading the Labels

Just because a person who plays a doctor on TV says something is good for you, should you listen?

"...before most of us put anything into our bodies, we look at what is in it -- calories, salt, fat grams, etc -- and decide whether we will incorporate it (literally, put it into our bodies). I then ask this question: Do you use that same level of care and consideration of evidence when deciding whether to incorporate ideas and information into your mind or behaviors into your way of living?"

"Well, here's some good news. You can find "cognitive nutrition" and "behavioral nutrition" labels out there. You just need to know what they look like. They're not presented in clean small squares like the nutrition facts on the Krispy Kreme Doughnuts' box, but they do exist in the form of good scientific evidence. And how do we find this information and how do we know what is good scientific evidence? This is where we all need to ratchet up our levels of skepticism and thoughtfulness and decide what we are going to allow into our minds. While not a perfect rule of thumb (witness the autism-measles vaccine fraud), publication of a research finding in a peer-reviewed journal (articles are read and judged by experts in the field before being accepted for publication) is a good indicator of good cognitive and behavioral nutrition. We also need to attend carefully to people who we have good reason to believe are well-trained in making judgments about the goodness or badness of scientific data and their implications."

Link To Full Aricle

Interesting piece published on January 12, 2011 by research psychologist Marshall P. Duke.  With such an extraordinary amount of good and bad information available to us everyday through the internet, mainstream media and social interaction, it is important that we become informed consumers of knowledge.  "If we are going to do something that will affect the physical and/or emotional health and well being of ourselves and our families, we should base what we do on sound, reliable, scientific data -- on good evidence derived from good science."  Dr Duke provides several suggestions to help discern fact from fiction in order to make informed decisions.

Can you control your dreams?

"A lucid dreamer is a person who is aware that he or she is dreaming and is able to manipulate the plot and outcome of the dream, like a video game. It is not uncommon, and in children it can happen frequently, even as an expression of creativity, said Gary Schwartz, professor of psychology and neurology at the University of Arizona."

"Research suggests that various techniques can increase the frequency of lucid dreams. For instance, you can remind yourself before you go to sleep that you want to be aware that you're dreaming when dreams happen, said Deirdre Barrett, psychologist at Harvard University and the Cambridge Health Alliance and editor of Dreaming: The Journal of the International Association for the Study of Dreams."

Link To Full Article

This article, published on January 12, 2011 by CNN gives a brief overview of lucid dreaming and offers several methods that can be used to facilitate the process.  The subject was unfortunately reported on because of a connection to the Arizona shooter Jared Loughner, who apparently took an interest in the phenomenon.  The article then discusses how the inability to distinguish dreams from reality is considered a "red flag" for mental illness.  It is important to note that the author is not suggesting a link between the practice of lucid dreaming and mental illness.

There are several organizations dedicated to the study of dreams and the practice of lucid dreaming, as well as countless books/online sources related to the subject.

The Lucidity Institute Inc. (an online collection of materials on lucid dreaming)

International Association for the Study of Dreams (multidisciplinary organization dedicated to the pure and applied investigation of dreams and dreaming)

Mindfulness Therapy is No Fad, Experts Say

 Jaunuary 8, 2011 | By Chris Woolston, Special to the Los Angeles Times

There is solid evidence that mindfulness therapy, which combines elements of Buddhism and yoga, can relieve anxiety and improve mood

"Mindfulness therapy encourages patients to focus on their breathing and their body, to notice but not judge their thoughts and to generally live in the moment. It may sound a bit squishy and New Agey to some, but Hofmann and other experts say mindfulness has something that discredited theories of the past never had: solid evidence that it can help."

"The treatment seemed to help ease the mental stress of people recovering from cancer and other serious illnesses, but it had the strongest benefits for people diagnosed with mood disorders, including generalized anxiety disorder and recurring depression."

Link to Full Article 

One of many articles exemplifying the numerous applications and proven benefits of mindfulness meditation.  While it's probably more informative to read about this research in scientific journals, it's nice to see this information becoming available through mainstream media.

Rudeness Is a Neurotoxin

"Studies have shown that children exposed to serious psychological trauma during childhood are at risk of suffering increased psychiatric disorders, including depression, anger, hostility, drug abuse, suicidal ideation, loneliness and even psychosis as adults. Using modern brain imaging, the physical damage to these children's brain development can be seen as clearly as a bone fracture on an X-ray. Early-childhood sexual abuse, physical abuse and witnessing domestic violence undermine the normal wiring of brain circuits, especially those circuits connecting the left and right sides of the brain through a massive bundle of connections called the corpus callosum. Impairment in integrating information between right and left hemispheres is associated with increased risk of craving, drug abuse and dependence, and a weakened ability to make moral judgments." 

This article is written by Douglas Fields Ph.D., Chief of the Nervous System Development and Plasticity Section, National Institute of Child Health and Human Development and adjunct professor in the Neuroscience and Cognitive Science Program at the University of Maryland.  Published in the Huffington Post on January 5, 2011, the article explores "rudeness" as it relates to Dr. Fields' scientific research on the biological basis human development.

Link to Full Article 

I first became familiar with Dr Fields' work after reading his most current book, The Other Brain.  This book is an excellent source of information for anyone interested in psychology, neurobiology, and brain science.  It explores the subject of glia and recent scientific research that has established important links between glial cells and brain function.  This research has played a large role in the new understanding of psychiatric illnesses such as schizophrenia and depression, and in neurodegenerative diseases such as Alzheimer's and Parkinson's.  The author also explains how glia are implicated in the newest biological models of addiction.  Dr. Fields offers the reader an extraordinarily informative overview of glia research from it's origins to the newest discoveries in the field.  I highly recommend this book for anyone interested in behavioral neuroscience.