Salivary testosterone and cortisol levels in borderline personality disorder before and after a 12-week group dialectical behavior therapy intervention

BackgroundBorderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment.MethodsParticipants with BPD (n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels.ResultsParticipants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change.ConclusionsThis study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018

Mindfulness and emotional regulation as sequential mediators in the relationship between attachment security and depression

Depression is a significant global health issue that has previously been associated with negative early care experiences and insecure attachment styles. This has led to much interest in identifying variables that may interrupt this relationship and prevent detrimental personal, social and economic outcomes. Recent research has indicated associations between the two seemingly distinct constructs of secure attachment and mindfulness, with similar positive outcomes. One hundred and forty eight participants completed an online survey exploring a possible sequential cognitive processing model, which predicted that higher levels of mindfulness and then emotional regulation would mediate the relationship between attachment and depression. Full mediation was found in regards to secure, preoccupied and dismissive attachment, whereas partial mediation was identified in the case of fearful attachment. The results support the possibility of an alternative cognitive processing pathway that may interrupt the association between negative early care experiences and concomitant negative mental health outcomes. Further exploration of this relationship is indicated

Evaluation of the helping hands volunteer program for people with mental illness

Volunteer programs have been used to alter attitudes, provide long-term knowledge towards mental illness and increase the quality of life of consumers receiving volunteer services. Sixteen volunteers completed an 18-hour training program and in pairs worked with 11 consumers over 4 months. Sixteen volunteers completed training measures of knowledge and attitudes scales. Pre and post program quality of life and behavioural functioning measures were taken on 5 consumers. Volunteers maintained their knowledge of mental illness over 6 months and had significant increases in their comfort in interactions with people who have mental illness. Case managers, consumers and volunteers all reported high levels of satisfaction with the program but there were no significant changes in behavioural functioning or quality of life for consumers over 4 months of receiving volunteer support. High levels of client disability and the need for longer term follow-up were identified as factors needing to be addressed in future studies

Improving Outcomes for Military Families with Young Children: Effects of a Novel Dyadic Coaching-Based Parenting Intervention in Two Exploratory Case Studies

This article presents an intervention model for military families with young children reintegrating after deployment that aims to strengthen parent-child relationships and improve family outcomes. The Coaching and Parent Emotion Support (CaPES) program integrates emotion and behavioural regulation principles, within an intensive, dyadic, coaching-based delivery format. We outline the application and outcomes of CaPES in two case studies of Australian Defence Force (ADF) families. The results offer preliminary evidence of the efficacy of CaPES in improving parent-child relationship quality, parental mental health and wellbeing, and children’s behavioural and emotional outcomes in military families with young children

A qualitative examination of the reintegration experiences of Australian Defense Force families

The profound development that occurs during the first five years of a child’s life may contribute to military families with young children facing unique challenges during reintegration. Yet, little is known about the reintegration experiences of military families with young children, and less so from the perspectives of non-deployed parents and families outside of the US. In this qualitative study, we explored the reintegration experiences of Australian Defense Force (ADF) families with young children (five years and younger). Through written responses to open-ended prompts, ADF service members (n = 9) and their non-deployed spouses (n = 38) reflected on periods of reintegration and discussed their family’s adaption during this time. Using thematic analysis, six themes representing the reintegration experiences of these families were generated from the data. Four themes were generated from the combined experiences of service members and non-deployed parents, while a further two themes were generated from the experiences of non-deployed parents only. Relational and parenting challenges were at the forefront of reintegration experiences. These findings offer meaningful implications for practice and research to improve the quality of parent-child relationships and enhance outcomes for military families with young children during reintegration

Mind the Family: Acceptability and Outcomes for a Mindfulness- and Imagery-Enhanced Behavioral Parenting Program

Enhanced parenting programs aim to meet broader family needs. Past research shows mixed effects for standard programs across differing family characteristics. We evaluate pre- to post-intervention improvements for fathers (n = 115) and mothers (n = 223) of children aged 3 to 12 years with externalizing behaviors who participated in an 8-week mindfulness- and imagery-enhanced behavioral parenting group program. Parents reported high acceptability and significant pre- to post-intervention improvements, with large effect sizes, in parent well-being, parenting approach, mindful parenting, and child behavior. Fathers attended the same number of sessions as mothers and demonstrated similar improvements. Blending imagery and mindfulness with behavioral skills appears helpful, including for fathers

What aspects of mindfulness and emotion regulation underpin self-harm in individuals with borderline personality disorder?

Background: Self-harm presents significant risk for individuals with borderline personality disorder (BPD). Both self-harm and BPD are associated with deficits in mindfulness and emotion dysregulation. Previous research suggests that thought suppression and emotional inexpressivity may underpin self-harm in people with BPD, suggesting potential links to self-harm functions common for those with BPD. More research is needed to strengthen our understanding of this relationship. Aims: This study examines how BPD symptoms, mindfulness, emotion dysregulation and self-harm functions are related. Methods: Australian community outpatients diagnosed with BPD (N = 110) completed measures of mindfulness, emotion dysregulation and self-harm functions. Serial mediation analyses were conducted to examine relationships between variables. Results: BPD symptoms, chronic emptiness, mindfulness skills, describing and non-reacting, emotion dysregulation areas of emotion regulation strategies and poor emotional clarity were associated with recent self-harm. Various combinations of describing, strategies and clarity mediated the path between emptiness and self-harm functions more likely to be endorsed by individuals with a diagnosis of BPD. Describing was associated with all but anti-suicide function, while strategies was associated with all but anti-dissociation. Conclusion: The study highlights how individuals with BPD experiencing chronic emptiness may benefit from treatment targeting describing skills and adaptive emotion regulation strategies