Cognitive Conflict in Borderline Personality Disorder

NCT04498104 | Completed

• 1 other identifier: UBipcsBPD1
• Study Type: observational
• Target: 156
• Locations: 1 country
• Sites: 3

Brief Summary

Background: Borderline personality disorder (BPD) is a severe psychological condition characterized by emotional, interpersonal and self-image instability in addition to impulsive behaviour. Although there have been several explanatory models and psychotherapy approaches that have been designed to comprehend and intervene on BPD, most seem not to recognize idiosyncratic cognitive conflict as an important feature on this disorder. Adding personal dilemmas, such as those conceptualized in personal construct theory, as a key element to BPD's explanatory model could provide a better picture to understand this disorder and possibly to enhance effectiveness of current psychotherapy approaches. Despite the fact that constructivist explanatory models have been used and tested in several clinical populations, there is little work done studying the relevance of inner conflicts in BPD. According to the prototypical symptomatology manifested by these patients, psychological instability can be assumed as a transversal feature present in this disorder; therefore, a larger amount of cognitive conflict can be expected in BPD patients. Method and Analysis: In order to test this assumption, this study aims to examine the characteristics of the interpersonal cognitive system of patients diagnosed with BPD and note their potential differences with the general population using the repertory grid technique, a complex assessment tool derived from personal construct theory. Statistical analyses will be performed to examine whether the clinical sample tends to present with more cases and with higher number of cognitive conflicts than the control group. Likewise, the association between cognitive conflict and symptom severity will be explored. Results will be a first step to determine if cognitive conflicts have an important role in the explanation of BPD. This will also help to value the convenience to further investigate the efficacy of conflict resolution psychotherapy interventions with these patients. This research work is undertaken in the context of a funded predoctoral research program.

Conditions

Borderline Personality Disorder

Keywords

Repertory grid technique; Predictors of outcome; Implicative dilemma; Dilemmatic construct; Personal Construct Theory

Outcome Measures

Primary Outcomes (2)

• Implicative dilemma

  The repertory grid technique (RGT) is a personalized assessment procedure using a structured interview designed to make explicit the personal constructs (bipolar dimensions of subjective meaning) used to interpret and organize reality. An implicative dilemma can be identified when an individual does not perform a desired change due to the negative implications involved for their desired identity. The RGT can detect personal constructs in which the current perception of the self is similar to the ideal self (congruent constructs) and the constructs in which the subject's self-perception is contrary to their ideal construction (discrepant construct). A statistical analysis of the RGT reveals when a potential pole shift of a discrepant construct involves the pole shift of a congruent construct due to an existing association between the two constructs. Implicative dilemmas may cause dissatisfaction and psychological discomfort.

  Through study completion, an average of 2 years.

• Dilemmatic construct

  Dilemmatic constructs can be identified when an individual is not sure how would they like to be in a certain identity aspect. This type of cognitive conflict can be assessed and analyzed with the RGT in order to identify self-construction domains in which the person may find it difficult to choose how to ideally be. Indecision in regard to identity can add psychological distress to those who experience it.

  Through study completion, an average of 2 years.

Secondary Outcomes (4)

• Diagnostic Interview for Borderlines - Revised (DIB-R)

  Through study completion, an average of 2 years.

• Structured Clinical Interview for DSM-IV-II (SCID-II)

  Through study completion, an average of 2 years.

• Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM)

  Through study completion, an average of 2 years.

• Depression Anxiety Stress Scales (DASS-21)

  Through study completion, an average of 2 years.

Study Arms (2)

Borderline Personality Disorder

Borderline personality disorder diagnosed participants

Other: Psychological assessment

Control

Healthy participants

Other: Psychological assessment

Interventions

Psychological assessment OTHER

Psychological assessment with the repertory grid technique (RGT) in order to quantify cognitive conflicts.

Borderline Personality Disorder; Control

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Study Population: The borderline personality group will be formed by participants diagnosed with BPD that receive treatment from outpatient or inpatient public and private mental health facilities in the local area of Barcelona, Spain (CSMA Benito Menni, ITA - especialistas en salud mental and ITLímit). The control group will be formed by healthy volunteers of a student sample from the University of Barcelona and a nonstudent community sample who were not receiving psychotherapy when evaluated. These participants will be matched by age, gender and educational level with the clinical sample.

You may qualify if:

• Aged between 18 and 60 years old.
• Having been diagnosed with BPD by a well-trained professional according to DSM-5 criteria.

You may not qualify if:

• Having been diagnosed with bipolar disorder, psychotic disorder, prevalent continued and active substance abuse, disabling physical illness, organic cerebral dysfunctions or mental developmental severe difficulties.
• Not able to communicate either in Spanish or Catalan.

Sponsors & Collaborators

• University of Barcelona: lead

Study Sites (3)

ITA - especialistas en salud mental

Barcelona, 08006, Spain

Location

CSMA Bennito Menni - (Germanes Hospitalaries)

Barcelona, 08035, Spain

Location

ITLimit

Sant Cugat del Vallès, 08195, Spain

Location

Related Publications (8)

• Feixas G, Saul LA, Avila-Espada A. Viewing Cognitive Conflicts as Dilemmas: Implications for Mental Health. J Constr Psychol. 2009 Apr;22(2):141-169. doi: 10.1080/10720530802675755. Epub 2009 Feb 18.

  PMID: 22629109 BACKGROUND

• Montesano A, Lopez-Gonzalez MA, Saul LA, Feixas G. A review of cognitive conflicts research: a meta-analytic study of prevalence and relation to symptoms. Neuropsychiatr Dis Treat. 2015 Dec 4;11:2997-3006. doi: 10.2147/NDT.S91861. eCollection 2015.

  PMID: 26675503 BACKGROUND

• Feixas G, Compan V. Dilemma-focused intervention for unipolar depression: a treatment manual. BMC Psychiatry. 2016 Jul 12;16:235. doi: 10.1186/s12888-016-0947-x.

  PMID: 27406383 BACKGROUND

• Feixas G, Bados A, Garcia-Grau E, Paz C, Montesano A, Compan V, Salla M, Aguilera M, Trujillo A, Canete J, Medeiros-Ferreira L, Soriano J, Ibarra M, Medina JC, Ortiz E, Lana F. A DILEMMA-FOCUSED INTERVENTION FOR DEPRESSION: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL WITH A 3-MONTH FOLLOW-UP. Depress Anxiety. 2016 Sep;33(9):862-9. doi: 10.1002/da.22510. Epub 2016 Apr 22.

  PMID: 27103215 BACKGROUND

• Feixas G, Paz C, Garcia-Grau E, Montesano A, Medina JC, Bados A, Trujillo A, Ortiz E, Compan V, Salla M, Aguilera M, Guasch V, Codina J, Winter DA. One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies. PLoS One. 2018 Dec 13;13(12):e0208245. doi: 10.1371/journal.pone.0208245. eCollection 2018.

  PMID: 30543642 BACKGROUND

• Paz C, Montesano A, Winter D, Feixas G. Cognitive conflict resolution during psychotherapy: Its impact on depressive symptoms and psychological distress. Psychother Res. 2019 Jan;29(1):45-57. doi: 10.1080/10503307.2017.1405172. Epub 2017 Nov 26.

  PMID: 29173128 BACKGROUND

• Feixas G, Saul LA. The Multi-Center Dilemma Project: an investigation on the role of cognitive conflicts in health. Span J Psychol. 2004 May;7(1):69-78. doi: 10.1017/s1138741600004765.

  PMID: 15139250 BACKGROUND

• Storebo OJ, Stoffers-Winterling JM, Vollm BA, Kongerslev MT, Mattivi JT, Jorgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955. doi: 10.1002/14651858.CD012955.pub2.

  PMID: 32368793 BACKGROUND

Related Links

• Link to our research group webpage "Intervention in Clinical and Health Psychology"

MeSH Terms

Conditions

Borderline Personality Disorder

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders

Study Officials

• Guillem Feixas, Professor

  University of Barcelona

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 30, 2020
• First Posted: August 4, 2020
• Study Start: April 2, 2019
• Primary Completion: March 1, 2021
• Study Completion: March 1, 2022
• Last Updated: May 18, 2022

Record last verified: 2022-05

Locations

ES (3)