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BACKGROUND Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present... more
BACKGROUND Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present study is to examine which factors are associated with early dropout from DBT-ST in a sample of subjects with BPD. METHOD 118 subjects with BPD diagnosis were included in the study. Apart from socio-demographic and clinical variables, childhood trauma history, personality dimensions, and comorbidities with other psychiatric disorders were collected. Differences in regards to the aforementioned variables were compared between individuals who dropped out prematurely from therapy and those who finalized it. RESULTS Significant differences between groups regarding socio-demographic and clinical variables, including childhood trauma history and comorbid personality disorders, were not found. Both groups differed significantly in regards to trait impulsiveness...
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Research Interests: Psychology, Clinical Psychology, Psychiatry, Mindfulness, Borderline Personality Disorder, and 11 morePsychopathology, Medicine, Mood, Major Depressive Disorder, Awareness, Acceptance, Eating Disorder, Depressive Symptoms, Psychology and Cognitive Sciences, Cocaine dependence, and Medical and Health Sciences
Ayahuasca is a psychedelic decoction originating from Amazonia. The ayahuasca-induced introspective experience has been shown to have potential benefits in the treatment of several pathologies, to protect mental health and to improve... more
Ayahuasca is a psychedelic decoction originating from Amazonia. The ayahuasca-induced introspective experience has been shown to have potential benefits in the treatment of several pathologies, to protect mental health and to improve neuropsychological functions and creativity, and boost mindfulness. The underlying psychological processes related to the use of ayahuasca in a psychotherapeutic context are not yet well described in the scientific literature, but there is some evidence to suggest that psychological variables described in psychotherapies could be useful in explaining the therapeutic effects of the brew. In this study we explore the link between ayahuasca use and Decentering, Values and Self, comparing subjects without experience of ayahuasca (n = 41) with subjects with experience (n = 81). Results confirm that ayahuasca users scored higher than non-users in Decentering and Positive self, but not in Valued living, Life fulfillment, Self in social relations, Self in close...
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Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight... more
Individuals with eating disorders might be characterized by lower levels of direct engagement with the eating experience. This study aims to explore similarities and differences in direct experience while eating in four different weight conditions and healthy controls (HCs): anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and obesity (OB). : A total sample of 143 women were recruited. Participants were asked to eat an orange slice and write down 10 things about the experience of eating, classifying the focus of these thoughts as either experiential ("direct experience") or analytical ("thinking about"). A direct experience index (DEI) was calculated by dividing the number of times a participant classified an experience as a "direct experience" (the numerator) by the total number of observations. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) and rated their level of anxiety after the...
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The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the... more
The therapeutic effects of the Amazonian plant tea ayahuasca may relate to its ability to enhance mindfulness capacities. Ayahuasca induces a modified state of awareness through the combined action of its active principles: the psychedelic dimethyltryptamine (DMT) and a series of centrally acting β-carbolines, mainly harmine and tetrahydroharmine. To better understand the therapeutic potential of ayahuasca, here we compared the impact on mindfulness capacities induced by two independent interventions: (a) participation in four ayahuasca sessions without any specific purpose related to improving mindfulness capacities; and (b) participation in a standard mindfulness training course: 8 weeks mindfulness-based stress reduction (MBSR), with the specific goal of improving these skills. Participants of two independent groups completed two self-report instruments: The Five Facet Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). The MINDSENS Composite Index was also c...
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Structural imaging studies of borderline personality disorder (BPD) have found regions of reduced cortical volume, but these have varied considerably across studies. Reduced hippocampus and amygdala volume have also been a regular finding... more
Structural imaging studies of borderline personality disorder (BPD) have found regions of reduced cortical volume, but these have varied considerably across studies. Reduced hippocampus and amygdala volume have also been a regular finding in studies using conventional volumetric measurement. How far comorbid major depression, which is common in BPD and can also affect in brain structure, influences the findings is not clear. Seventy-six women with BPD and 76 matched controls were examined using whole-brain voxel-based morphometry (VBM). The hippocampus and amygdala were also measured, using both conventional volume measurement and VBM within a mask restricted to these two subcortical structures. Lifetime history of major depression was assessed using structured psychiatric interview. At a threshold of p = 0.05 corrected, the BPD patients showed clusters of volume reduction in the dorsolateral prefrontal cortex bilaterally and in the pregenual/subgenual medial frontal cortex. There w...
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Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The aim of the study was to investigate the efficacy of an intervention that... more
Dialectical behavioral therapy (DBT) skills have become increasingly used to treat several psychiatric conditions, including major depressive disorder (MDD). The aim of the study was to investigate the efficacy of an intervention that combines emotion regulation and mindfulness skills of DBT to prevent depression relapse/recurrence. A total of 75 individuals (79% females; mean age, 52 years) with a diagnosis of MDD in complete or partial remission were recruited. Participants were randomly allocated either to an intervention combining emotion regulation and mindfulness skills (ER + M group, n = 37) or to a psychoeducative program (n = 38). After the 10-week treatment period, participants were followed for 1 year. Analyses were run in per-protocol (PP) and intention-to-treat (ITT) samples. The primary outcome measure was time to depression relapse/recurrence. ER + M training was not more effective than the control intervention in preventing depression relapse. However, PP and ITT ana...
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Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode... more
Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network (DMN), purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers, and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here we investigated in an open-label uncontrolled study in sixteen healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications, and their association with mindfulness measures. Using 1H-magnetic resonance spectroscopy (MRS) and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior (PCC) and anterior (ACC) cingulate cortex after a sing...
Research Interests: Mindfulness, Magnetic Resonance Imaging, Neuropsychopharmacology, Magnetic Resonance Spectroscopy, Medicine, and 15 moreHuman, Brain Mapping, Humans, Cerebral Cortex, Default Mode Network, Female, Ayahuasca, Male, Hallucinogens, Middle Aged, Adult, Hallucinogen, Glutamic Acid, Anterior cingulate cortex, and Medical and Health Sciences
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Research Interests: Psychology, Clinical Psychology, Cognitive Science, Psychotherapy, Mindfulness, and 15 moreBorderline Personality Disorder, Medicine, Empathy, Meditation, Humans, Major Depressive Disorder, Female, Clinical Psychology and Psychotherapy, Male, Middle Aged, Psychotherapist, Adult, Kindness, Pilot Projects, and Combined Modality Therapy
Research Interests: Psychology, Clinical Psychology, Depression, Personality Disorders, Borderline Personality Disorder, and 15 moreMedicine, Executive Function, Memory, Cognitive Rehabilitation, Humans, Female, Cognitive Therapy, Psychoeducation, Male, Psychological Intervention, Psychosocial, Interpersonal Relations, Clinical Sciences, Adult, and Ambulatory Care
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Research Interests: Clinical Psychology, Mindfulness, Borderline Personality Disorder, Language, Adolescent, and 15 moreMedicine, Anxiety, Humans, Behavior Therapy, Female, Confirmatory factor analysis, Male, Mental Disorders, METACOGNITIVE AWARENESS, Aged, Middle Aged, Convergent Validity, Adult, ANXIETY, and decentering
To assess the psychometric properties and the factor structure of the Spanish version of the Scale of Body Connection (SBC) in a community population of meditators and non-meditators and to investigate the relationships among mindfulness,... more
To assess the psychometric properties and the factor structure of the Spanish version of the Scale of Body Connection (SBC) in a community population of meditators and non-meditators and to investigate the relationships among mindfulness, body awareness and body dissociation. Design. Validation study. Sampling. An internet-based commercial system was used to recruit the sample. Instruments. In addition to the SBC, the Five Facet Mindfulness Questionnaire (FFMQ) and the Depression, Anxiety, and Stress Scale (DASS-21) were administered. A sample of 578 subjects responded to all of the items in the protocol. A total of 55.2% of respondents had some previous experience with meditation. A Scree plot showed a two-factor solution involving the Body Awareness (BA) and Body Dissociation (BD) subscales. This study differed from the original validation study in the lack of independence of the subscales; they were correlated in the present study (r=-.11). Internal consistency for BA was α: .86,...
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Research Interests: Psychology, Clinical Psychology, Psychometrics, Personality, Personality Disorders, and 15 moreBorderline Personality Disorder, Medicine, Humans, Linear Discriminant Analysis, Female, Personality Disorder, Predictive Validity, Construct Validity, Male, Mental Disorder, Adult, American Psychiatric Association, Discriminant Validity, Personality Inventory, and Diagnostic and Statistical Manual
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Research Interests: Psychology, Clinical Psychology, Cognitive Science, Mindfulness, Borderline Personality Disorder, and 15 moreTreatment Outcome, Dialectic, Group Psychotherapy, Medicine, Emotions, Humans, Behavior Therapy, Female, Clinical Psychology and Psychotherapy, Male, Psychotherapist, Adult, Dialectical Behavior Therapy, Analysis of Variance, and Guidance and Counseling Intervention Programs
BackgroundSeveral studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations.AimsTo compare the likelihood that... more
BackgroundSeveral studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations.AimsTo compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin.MethodA total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM–IV criteria. Immigrants were divided into five groups according to reg...
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Research Interests: Psychology, Clinical Psychology, Mindfulness, Borderline Personality Disorder, Attention, and 14 moreAdolescent, Medicine, Impulsivity, Meditation, Humans, Business and Management, Behavior Therapy, Female, Male, Middle Aged, Adult, Dialectical Behavior Therapy, Behaviour Therapy, and Psychomotor Performance
Impulsivity is considered a core characteristic of borderline personality disorder (BPD). Previous research on the effects of mindfulness training (MT) has shown that it might modify impulsivity-related aspects of BPD. Therefore, the aim... more
Impulsivity is considered a core characteristic of borderline personality disorder (BPD). Previous research on the effects of mindfulness training (MT) has shown that it might modify impulsivity-related aspects of BPD. Therefore, the aim of this study was to investigate the impact of MT on various facets of impulsivity in BPD patients. Subjects with BPD diagnosis (n = 64) were randomly assigned to 10 weeks of MT (n = 32) or interpersonal effectiveness skills training (IE; n = 32). All participants were assessed pre- and post-intervention with a self-reported measure of impulsivity and five behavioral neuropsychological tasks to evaluate response inhibition, tolerance for delay rewards, and time perception. An interaction effect of time × group was only observed for some of the behavioral paradigms used. Participants in the MT group improved their ability to delay gratification and showed changes in time perception, consistent with a decrease in impulsivity. No differences were obser...
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Non-suicidal self-injury (NSSI) is highly prevalent during late adolescence and young adulthood. There is some evidence of a link between NSSI and Borderline Personality Disorder (BPD), but little is known about the association between... more
Non-suicidal self-injury (NSSI) is highly prevalent during late adolescence and young adulthood. There is some evidence of a link between NSSI and Borderline Personality Disorder (BPD), but little is known about the association between BPD traits and the various functions that maintain NSSI. The main purpose of this study was to explore the association between borderline personality traits and NSSI functions in a sample of college students. We also compared NSSI functions in college students who engaged in NSSI to those in an age-matched sample of BPD patients. This study included a total of 238 college students and 36 BPD patients. Participants were asked to complete a number of clinical measures. In the non-clinical sample, BPD features were more pronounced in the presence of NSSI, and we observed a differential relationship between NSSI functions and psychopathological BPD-traits. The NSSI clinical variables most strongly associated with BPD were frequency, variety of methods and...
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The aim of this prospective study was to expand previously reported evidence on the 10-year clinical and functional course of borderline personality disorder (BPD) in a Spanish sample. Participants diagnosed with BPD were assessed at... more
The aim of this prospective study was to expand previously reported evidence on the 10-year clinical and functional course of borderline personality disorder (BPD) in a Spanish sample. Participants diagnosed with BPD were assessed at baseline and at 10-year follow-up to evaluate BPD symptomatology and other relevant clinical measures, suicidal behavior, dimensional personality traits, Axis I and II comorbidity, use of mental health resources, and psychosocial functioning. At the 10-year follow up, significant improvements were observed on BPD domains, suicidal behavior, and other clinical measures. Neuroticism, impulsiveness, and aggression-hostility features trended toward normalization, whereas activity and sociability were impaired over time. Comorbidity with Axis I and personality disorders remained high. Social functioning and occupational functioning were largely unchanged. These findings confirm the tendency toward a symptomatic remission of BPD over the long term with regard to symptom criteria and characteristic dimensional traits. However, psychosocial functioning remains impaired.
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Research Interests: Psychology, Clinical Psychology, Mindfulness, Borderline Personality Disorder, Adolescent, and 15 moreMedicine, Humans, Personality Assessment Inventory, Neuroticism, Child Abuse, Female, Male, Big Five Personality Traits, Clinical Sciences, Moderation, Adult, Childhood maltreatment, Psychological Abuse, Cross Sectional Studies, and Personality Inventory
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The Mindful Attention Awareness Scale (MAAS) is a brief and easy to administer scale that mainly assesses the individual’s dispositional capacity to be aware and conscious in day-to-day life experiences. This is a 15-item self-reported... more
The Mindful Attention Awareness Scale (MAAS) is a brief and easy to administer scale that mainly assesses the individual’s dispositional capacity to be aware and conscious in day-to-day life experiences. This is a 15-item self-reported single-factor scale that is exclusively focused on attention/awareness component of mindfulness construct. The instrument can be independently used to assess individuals either with or without meditation experience and has been widely used in mindfulness research. In order to establish the psychometric proprieties of the MAAS a total of 385 individuals were assessed. 201 individuals came from a clinical sample and 184 control individuals were university students. The MAAS showed good psychometric proprieties in terms of validity and reliability. The scale obtained an adequate convergent validity with the Five Facets Mindfulness Questionnaire (FFMQ) and good discriminating validity with relation to depressive symptoms. Additionally, the MAAS obtained g...
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Research Interests: Neuroscience, Magnetic Resonance Imaging, Borderline Personality Disorder, Medicine, Anisotropy, and 15 moreDiffusion MRI, Biological Sciences, Biological Psychiatry, Brain, Humans, Default Mode Network, Female, Amygdala, Middle Aged, Adult, Fractional Anisotropy, Case Control Studies, Impulsive behavior, Diffusion magnetic resonance imaging, and Medical and Health Sciences
Research Interests: Psychology, Borderline Personality Disorder, Medicine, Humans, Child, and 13 moreMethylation, Child Abuse, Hospitalization, Female, Male, DNA methylation, Young Adult, Adult, Psychiatric, Glucocorticoid Receptors, Severity of Illness Index, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Borderline Personality Disorder, Attention, Facial expression, Face perception, Emotions, and 15 moreBrain Mapping, Impulsivity, Brain, Humans, Facial expressions, Functional Magnetic Resonance Imaging, Emotion Recognition, Female, Functional Imaging, Amygdala, Cognitive impairment, Adult, Analysis of Variance, Fusiform Gyrus, and Case Control Studies
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Many individuals with borderline personality disorder (BPD) receive medical treatment in clinical practice, although to date, there are no drugs specifically available for BPD. The recent Cochrane guideline suggests a benefit from using... more
Many individuals with borderline personality disorder (BPD) receive medical treatment in clinical practice, although to date, there are no drugs specifically available for BPD. The recent Cochrane guideline suggests a benefit from using second-generation antipsychotics such as olanzapine or aripiprazole; nevertheless, side effects limit their use. Asenapine is a novel FDA-approved atypical antipsychotic for schizophrenia and bipolar disorder. However, it has not yet been tested for BPD. The goal of this observational open-label study was to assess the safety, tolerability and efficacy of asenapine in a series of cases of patients with BPD. Twelve individuals with BPD were recruited and treated with asenapine during an 8-week period. Eight individuals completed the study; a significant improvement was observed in the CGI-BPD (P<0.001) and BSL-23 (P<0.048) scales for BPD symptomatology. Besides, there was a significant improvement in the general psychopathology domains (BPRS, P<0.004), whereas no significant differences were observed in depressive symptoms. No serious adverse effects were reported and a significant weight reduction was observed (P=0.002). Asenapine appears to be a safe and effective agent in the treatment of patients with BPD, especially when other alternatives are not tolerated. These preliminary findings should be replicated in a controlled clinical trial.
Research Interests: Psychology, Psychiatry, Borderline Personality Disorder, Treatment Outcome, Medicine, and 14 moreHumans, Female, Male, Young Adult, Middle Aged, Olanzapine, Adult, Analysis of Variance, Aripiprazole, Clinical Psychopharmacology, Psychiatric Status Rating Scales, Tolerability, Antipsychotic agents, and Pharmacology and pharmaceutical sciences
Research Interests: Psychology, Psychiatry, Borderline Personality Disorder, Treatment, Medicine, and 15 moreSpain, Humans, Female, Clinical, Male, Middle Aged, Adult, Retrospective Studies, Polypharmacy, Clinical Psychopharmacology, Antipsychotic agents, Pharmacology and pharmaceutical sciences, Antidepressive agents, Drug prescriptions, and Medical prescription
Borderline personality disorder (BPD) is a severe psychiatric disorder that has a high clinical heterogeneity and frequent co-occurrence with other personality disorders (PDs). Although several studies have been performed to assess axis... more
Borderline personality disorder (BPD) is a severe psychiatric disorder that has a high clinical heterogeneity and frequent co-occurrence with other personality disorders (PDs). Although several studies have been performed to assess axis II comorbidity in BPD, more research is needed to clarify associated factors. The aim of this study was to determine the prevalence of co-occurrent axis II disorders in a large sample of patients with BPD and to investigate the influence of sex, age, and severity on this comorbidity. Data were collected from 484 patients with BPD through 2 semistructured interviews. We analyzed the frequency of axis II comorbidity and assessed differences regarding sex, age, and severity of BPD. About 74% of patients with BPD had at least 1 co-occurrent axis II disorder. The most common were paranoid, passive-aggressive, avoidant, and dependent PDs. Significant sex differences were found. Women presented more comorbidity with dependent PD, whereas men showed higher rates of comorbidity with antisocial PD. We also observed a significant positive correlation between age and the number of co-occurrent axis II disorders in women with BPD. Another finding was the positive correlation between BPD severity and the number of co-occurrent axis II disorders. These findings suggest that comorbidity with other axis II disorders and sex, age, and severity should be taken into account when developing treatment strategies and determining the prognosis of BPD.