PhD Scientific Days 2024

Mental Health Sciences II.

From Self-Harm to Self-Calm: A Pilot Investigation of Mindfulness-Based Cognitive Therapy Group in a Clinical Sample of Borderline Personality Disorder Patients Engaged in Non-Suicidal Self-Injury

Text of the abstract

Introduction: Borderline personality disorder (BPD) patients encounter healthcare system challenges, including stigma and long waitlists. Given the personal and societal burdens there's a need for brief, tailored interventions for decreasing suicidal risk.
Aims: Our study explored the correlation between NSSI, mindfulness deficit, emotion dysregulation, and impulsivity in BPD patients. Additionally, we assessed changes in these factors after MBCT-NSSI intervention.
Methods: Using a non-randomized controlled time-series design, we assessed self-reported NSSI symptoms, mindfulness skills, emotion regulation, depressive symptoms, and self compassion in BPD outpatients at three points: 1) 8-12 weeks pre-intervention (N=120); 2) pre-intervention (N=72); and 3) post-intervention (N=50).
Results: Baseline characteristics showed low self-esteem, self-compassion, and mindfulness skills, along with elevated levels of depression, hopelessness, impulsivity and frequent self-harming behavior. Heightened impulsivity (95% CI: 1.019-1.214), lowered acceptance (95% CI: .787-.984) and self-compassion (95% CI: .945-.997) seems to be the key risk factors behind NSSI frequency. Mindfulness skills were not directly related to NSSI, but they were moderately correlated with above risk factors. After MBCT-NSSI training self-harm frequency (Z(49)= 6.482, p<.001) and impulsivity (η2=.394) significantly decreased, while mindfulness skills (η2=496) improved. Impulsivity (95% CI: .816-.967), and maladaptive emotion regulation (95% CI: .935-.997) heightened the risk of drop-out.
Conclusions: This study reveals some interconnections between NSSI and psychological factors among BPD patients, and the potential benefits of MBCT-NSSI training. While the training is not a replacement for comprehensive therapy, this focused intervention can have a great impact in reducing suicide risk and preventing deterioration.
Funding: The research was financed by the Higher Education Institutional Excellence Programme of the Ministry for Innovation and Technology in Hungary, within the framework of the Neurology thematic programme of the Semmelweis University, TKP/2021. The Regional and Institutional Committee of Science and Research Ethics of Semmelweis University approved the research procedure (Number: 240/2018).