A Temperament-Attachment-Mentalization-Based (TAM) Theory of Personality and Its Disorders

Theories of personality and its disorders need, from time to time, to be revised and updated according to new empirical and conceptual developments. Such development has taken place in the realms of affective neuroscience, evolution, and social cognition. In this article, we outline a new personality theory, which claims that phenomena we usually ascribe to the concept personality are best understood by postulating a web consisting of three major constituents: temperament (mainly primary emotions), attachment, and self-consciousness (mentalizing). We describe these constituents, their neurobiological underpinnings, the subjective experiences they evoke, and their behavioral implications. We discuss the relevance of the espoused theory in the field of personality disorders with references to borderline, narcissistic, and avoidant personality disorders as well as the DSM-5 alternative model. Implications for social psychology, psychotherapy, and common sense self-understanding are outlined. The theory aims to bridge previous contradictions between natural sciences and hermeneutics by its propositions of the evolution of self-consciousness

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

In this article, the authors provide a narrative review of the mounting evidence base on personality disorder in childhood and adolescence. Topics covered include diagnostic validity, prevalence, developmental issues, comorbidity, risk and protective factors, and treatment. Novel indicated prevention and early intervention programs for borderline personality disorder in adolescence are given special priority. To conclude, directions for future research are provided

Improving treatment outcomes for adolescents with borderline personality disorder through a socioecological approach

Background There is a dearth of studies evaluating treatment efficacy for adolescents diagnosed with borderline personality disorder. The few available randomized controlled trials that have been conducted show modest results and treatments appear to have equivalent effects. The current paper draws on (a) the lessons learnt from the last 50 years of psychotherapy research in general and (b) recent advances in mentalization-based understanding of why treatment works, which together point to the importance of following a socioecological approach in the treatment of personality problems in adolescence – a developmental period that insists on a treatment approach that goes beyond the therapist-client dyad. Case presentation Here, we describe such an approach, and offer a clinical case example with a young 16-year old girl diagnosed with borderline personality disorder, to illustrate what a shift toward a more socioecological approach would entail. Conclusions The clinical impact of the socioecological approach and the potential benefits as illustrated in the current case illustration, offers a framework that justifies and allows for the expansion of service delivery for youth with borderline personality disorder beyond dyadic therapist-client work

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

In this article, the authors provide a narrative review of the mounting evidence base on personality disorder in childhood and adolescence. Topics covered include diagnostic validity, prevalence, developmental issues, comorbidity, risk and protective factors, and treatment. Novel indicated prevention and early intervention programs for borderline personality disorder in adolescence are given special priority. To conclude, directions for future research are provided

Psychotherapies for borderline personality disorder : a focused systematic review and meta-analysis

Background: A recently updated Cochrane review supports the efficacy of psychotherapy for borderline personality disorder (BPD). Aims: To evaluate the effects of standalone and add-on psychotherapeutic treatments more concisely. Method: We applied the same methods as the 2020 Cochrane review, but focused on adult samples and comparisons of active treatments and unspecific control conditions. Standalone treatments (i.e. necessarily including individual psychotherapy as either the sole or one of several treatment components) and add-on interventions (i.e. complementing any ongoing individual BPD treatment) were analysed separately. Primary outcomes were BPD severity, self-harm, suicide-related outcomes and psychosocial functioning. Secondary outcomes were remaining BPD diagnostic criteria, depression and attrition. Results: Thirty-one randomised controlled trials totalling 1870 participants were identified. Among standalone treatments, statistically significant effects of low overall certainty were observed for dialectical behaviour therapy (self-harm: standardised mean difference (SMD) −0.54, P = 0.006; psychosocial functioning: SMD −0.51, P = 0.01) and mentalisation-based treatment (self-harm: risk ratio 0.51, P < 0.0007; suicide-related outcomes: risk ratio 0.10, P < 0.0001). For adjunctive interventions, moderate-quality evidence of beneficial effects was observed for DBT skills training (BPD severity: SMD −0.66, P = 0.002; psychosocial functioning: SMD −0.45, P = 0.002), and statistically significant low-certainty evidence was observed for the emotion regulation group (BPD severity: mean difference −8.49, P < 0.00001), manual-assisted cognitive therapy (self-harm: mean difference −3.03, P = 0.03; suicide-related outcomes: SMD −0.96, P = 0.005) and the systems training for emotional predictability and problem-solving (BPD severity: SMD −0.48, P = 0.002). Conclusions: There is reasonable evidence to conclude that psychotherapeutic interventions are helpful for individuals with BPD. Replication studies are needed to enhance the certainty of findings

Psychological therapies for people with borderline personality disorder

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of psychological therapies for people with borderline personality disorder (BPD)

Low Vocational Outcome Among People Diagnosed With Borderline Personality Disorder During First Admission to Mental Health Services in Denmark:A Nationwide 9-Year Register-Based Study

Earlier studies report that although people with borderline personality disorder (BPD) experience symptom reduction in the long term, they continue to have difficulties in work recovery. This nationwide 9-year register-based study (N = 67,075) investigated the long-term labor-market attachment of all individuals diagnosed with BPD during first admission to Danish mental health services in comparison with other psychiatric disorders. Controlling for baseline characteristics and co-occurring secondary psychiatric diagnoses, the BPD group had 32% lower odds (OR = 0.68; 95% CI [0.61, 0.76]) of being in work/under education after 9 years. Individuals diagnosed with BPD also showed more impairment in long-term vocational outcome than other personality disorders, and lower labor-market attachment than other psychiatric disorders except for schizophrenia, schizotypal and delusional disorders, and mental and behavioral disorders due to psychoactive substance use. Intervention programs addressing social psychiatric aspects of BPD in terms of work functioning is henceforth an important area for future research. </jats:p