Metacognitive improvement and symptom change in a 3-month treatment for borderline personality disorder.

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Serval ID
serval:BIB_09E4130C52EC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Metacognitive improvement and symptom change in a 3-month treatment for borderline personality disorder.
Journal
Psychology and psychotherapy
Author(s)
Maillard P., Dimaggio G., Berthoud L., de Roten Y., Despland J.N., Kramer U.
ISSN
2044-8341 (Electronic)
ISSN-L
1476-0835
Publication state
Published
Issued date
06/2020
Peer-reviewed
Oui
Volume
93
Number
2
Pages
309-325
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Recognizing and reflecting on one's own and other people's mental states represent a major difficulty for patients with borderline personality disorder (BPD). Only recently have studies begun exploring whether these capacities increase with successful therapies and if such an improvement is linked with outcome. The present study investigated whether metacognition would improve and if its improvement was related with symptom change in BPD patients.
The transcripts from the first and the penultimate session of a ten-session version of good psychiatric management were analysed with the MAS-R scale in a N = 37 BPD sample. Patients, selected from a previously published RCT (Kramer et al., 2014), were assigned either to the good psychiatric management treatment or to the same treatment with the addition of the Motive-Oriented Therapeutic Relationship (Caspar, 2007), a form of therapeutic relationship based on an individualized case formulation. Symptoms were assessed with the OQ-45.
Findings partially support the hypotheses. First, improvement in capacities to understand others' mind, to take a critical distance from one's own rigid and maladaptive beliefs, and to use behavioural and attentional strategies to face adversities is found in both treatment groups. Controlling for marital status, only the ability to differentiate between reality and representations remains significant. Second, no link between metacognitive change and symptom change during treatment is found. However, a link is observed between the increase in metacognition and symptom reduction at 6-month follow-up.
Results invite to further investigate the role of metacognition in therapy change through different modalities and in longer-term treatments.
The development of metacognitive processes and their links with symptom change were examined during a short-term treatment in 37 borderline patients Improvement was found in capacities to understand others' mind, to take a critical distance from own rigid and maladaptive beliefs, and to use behavioural and attentional strategies even in a short-term treatment Controlling for marital status, only the ability to take a critical distance from representations remained significant A link was observed between increase in metacognition and symptom reduction at 6-month follow-up Understanding and tailoring interventions to specific metacognitive difficulties could be associated with symptom change during treatment for BPD patients.
Keywords
borderline personality disorder, mechanism of change, metacognition, outcome, short-term treatment
Pubmed
Web of science
Open Access
Yes
Create date
17/01/2019 9:49
Last modification date
13/06/2020 6:20
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