Cognitive Reappraisal Training for Borderline Personality

NCT04967222 | Completed Results DMC

• 2 other identifiers: GCO 20-0432-01001R61MH125130
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Previous work by the study group convinced the study team to pursue development of focused cognitive reappraisal training as a novel approach to treatment of BPD, either as stand-alone treatment or in concert with evidence-based treatments of BPD. The present proposal aims to refine and test a proposed clinical intervention for BPD patients, training in reappraisal-by-distancing, in terms of its ability to influence hypothesized neural and behavioral targets and, once that is established, to demonstrate its ability improve clinically relevant outcome measures.

Conditions

Borderline Personality Disorder

Keywords

BPD; Treatment; fMRI; cognitive reappraisal; Borderline Personality Disorder

Outcome Measures

Primary Outcomes (2)

• Change in PINES Network Activity

  BOLD signal change in Picture Induced Negative Emotion Signature (PINES) network activity that includes the amygdala, insula, and other regions by measuring neural activation using fMRI.

  Baseline and up to 6 weeks of treatment

• Change in Zanarini Rating Scale for Borderline Personality (ZAN-BPD)

  Zanarini Rating Scale for Borderline Personality, self-report. Full scale from 0-36. Higher score indicates poorer health outcomes.

  Baseline and up to 6 weeks of treatment

Secondary Outcomes (6)

• Change in ZAN-BPD Sector Scores

  Baseline and at 2-,4-, and 6-weeks

• Change in Affective Lability Scale Total (ALS)

  Baseline and at 2-,4-, and 6-weeks

• Change in Perceived Stress Scale (PSS)

  Baseline and at 2-,4-, and 6-weeks

• Change in Difficulty in Emotion Regulation Scale Scores (DERS)

  Baseline and at 2-,4-, and 6-weeks

• Change in Beck Depression Scale Score (BDI)

  Baseline and at 2-,4-, and 6-weeks

Study Arms (2)

Cognitive Reappraisal-by-Distancing (CRD)

EXPERIMENTAL

Subjects will be coached to use cognitive reappraisal-by-distancing to downregulate their negative reactions to aversive emotional pictures usng practice pictures.

Behavioral: Cognitive Reappraisal by Distancing

Control Downregulate Condition (CD)

ACTIVE COMPARATOR

Subjects will be coached to practice their customary emotion regulatory techniques in a treatment occurring twice a week for 6 weeks.

Behavioral: Control Downregulate Condition

Interventions

Cognitive Reappraisal by Distancing BEHAVIORAL

Reappraisal-by-distancing treatment. Participants meet 2 times a week for 6 weeks to learn reappraisal by distancing through repeated practice with negative emotional pictures. The therapist will help model and shape the technique. .

Also known as: CRD

Cognitive Reappraisal-by-Distancing (CRD)

Control Downregulate Condition BEHAVIORAL

Participants either meet 2x a week for 6- weeks to gain added practice, under the guidance of a therapist, using their customary emotion regulatory strategies to downregulate their negative reactions to aversive pictures.

Also known as: CD

Control Downregulate Condition (CD)

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Medically healthy men and women with Borderline Personality Disorder who are mentally competent and give informed voluntary written consent.
• Subjects who are being treated with psychotherapy or psychopharmacotherapy will be included so long as there has been no change in that treatment over the preceding 2 months.

You may not qualify if:

• Age \> 55
• Criteria for Schizotypal Personality Disorder or Avoidant Personality Disorder. SPD is excluded to avoid possible confound from the restricted affect that characterizes SPD and co-morbid AvPD subjects will be excluded because the researchers have shown that their patterns of neural activity in emotion processing are distinct from BPD subjects.

Sponsors & Collaborators

• Icahn School of Medicine at Mount Sinai: lead
• William Marsh Rice University: collaborator
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

Icahn School of Medicine at Mount Sinai

New York, New York, 10024, United States

Location

MeSH Terms

Conditions

Borderline Personality Disorder

Condition Hierarchy (Ancestors)

Personality Disorders; Mental Disorders

Results Point of Contact

• Title: Dr. Harold W Koenigsberg
• Organization: Icahn School of Medicine at Mount Sinai

harold.koenigsberg@mssm.edu

(718) 584-9000

Study Officials

• Harold Koenigsberg, MD

  Icahn School of Medicine at Mount Sinai

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Psychiatry

Study Record Dates

• First Submitted: July 8, 2021
• First Posted: July 19, 2021
• Study Start: December 1, 2021
• Primary Completion: June 3, 2024
• Study Completion: June 3, 2024
• Last Updated: August 5, 2025
• Results First Posted: August 5, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will share
• Time Frame: Beginning 9 months and ending 36 months following article publication.
• Access Criteria: Investigators whose proposed use of the data has been approved by an independent review committee identified for this purpose. For individual participant data meta-analysis.

Locations

US (1)