Scenario set-up and forcing data for impact model evaluation and impact attribution within the third round of the Inter-Sectoral Model Intercomparison Project (ISIMIP3a)

This paper describes the rationale and the protocol of the first component of the third simulation round of the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP3a, www.isimip.org) and the associated set of climate-related and direct human forcing data (CRF and DHF, respectively). The observation-based climate-related forcings for the first time include high-resolution observational climate forcings derived by orographic downscaling, monthly to hourly coastal water levels, and wind fields associated with historical tropical cyclones. The DHFs include land use patterns, population densities, information about water and agricultural management, and fishing intensities. The ISIMIP3a impact model simulations driven by these observation-based climate-related and direct human forcings are designed to test to what degree the impact models can explain observed changes in natural and human systems. In a second set of ISIMIP3a experiments the participating impact models are forced by the same DHFs but a counterfactual set of atmospheric forcings and coastal water levels where observed trends have been removed. These experiments are designed to allow for the attribution of observed changes in natural, human and managed systems to climate change, rising CH4 and CO2 concentrations, and sea level rise according to the definition of the Working Group II contribution to the IPCC AR6

Attentional Bias for Emotional Stimuli in Borderline Personality Disorder:A Meta-Analysis

BACKGROUND: In borderline personality disorder (BPD), attentional bias (AB) to emotional stimuli may be a core component in disorder pathogenesis and maintenance. SAMPLING: 11 emotional Stroop task (EST) studies with 244 BPD patients, 255 nonpatients (NPs) and 95 clinical controls and 4 visual dot-probe task (VDPT) studies with 151 BPD patients or subjects with BPD features and 62 NPs were included. METHODS: We conducted two separate meta-analyses for AB in BPD. One meta-analysis focused on the EST for generally negative and BPD-specific/personally relevant negative words. The other meta-analysis concentrated on the VDPT for negative and positive facial stimuli. RESULTS: There is evidence for an AB towards generally negative emotional words compared to NPs (standardized mean difference, SMD = 0.311) and to other psychiatric disorders (SMD = 0.374) in the EST studies. Regarding BPD-specific/personally relevant negative words, BPD patients reveal an even stronger AB than NPs (SMD = 0.454). The VDPT studies indicate a tendency towards an AB to positive facial stimuli but not negative stimuli in BPD patients compared to NPs. CONCLUSIONS: The findings rather reflect an AB in BPD to generally negative and BPD-specific/personally relevant negative words rather than an AB in BPD towards facial stimuli, and/or a biased allocation of covert attentional resources to negative emotional stimuli in BPD and not a bias in focus of visual attention. Further research regarding the role of childhood traumatization and comorbid anxiety disorders may improve the understanding of these underlying processes

SHAME - Entwicklung eines Fragebogens zur Erfassung positiver und negativer Aspekte von Scham

Hintergrund: Scham wird mit unterschiedlichen psychischen Störungen, insbesondere mit der Borderline-Persönlichkeitsstörung (BPS), aber auch mit der Einhaltung sozialer Normen und der Selbstregulation in Zusammenhang gebracht. Fragestellung: Können mit einem Instrument positive wie negative Schamaspekte erfasst werden? Methode: Ein Fragebogen (SHAME) wurde entwickelt, der körperliche und kognitive Scham als adaptive sowie existenzielle Scham als pathologisch-dysfunktionale Subskala konzipiert und itemanalytisch (Stichprobe 1) überprüft, sowie an Gesunden (Stichprobe 2) und BPS-Patientinnen (Stichprobe 3) getestet. Ergebnisse: In einer Validierungsstudie (N= 506, Stichprobe 2) weist der SHAME gute Reliabilität sowie eine stabile Faktorstruktur auf. Frauen berichteten insgesamt höhere Schamwerte als Männer. Im Vergleich zu gesunden Frauen erreichten BPS-Patientinnen insgesamt und insbesondere hinsichtlich existenzieller Scham höhere Werte. Schlussfolgerungen: Der Fragebogen SHAME erscheint geeignet für die Erfassung verschiedener Schamaspekte. Dabei kann durch existenzielle Scham ein dysfunktionaler Schamaspekt abgebildet werden, wohingegen die mittleren Ausprägungen körperlicher und kognitiver Scham in Stichprobe zwei auf funktionale Aspekte hindeuten. Zusammenfassung (englisch) Background: Shame is connected to different mental disorders, but seems to have a positive impact on the acceptance of social norms and self-regulation. Notably, shame is a relevant emotion for borderline personality disorder (BPD). Objective: Can one instrument assess positive and negative aspects of shame? Methods: Based on scientific literature, the questionnaire SHAME was developed. An item analysis was conducted (Sample 1) and the questionnaire was tested with a community sample (Sample 2) and BPD patients (Sample 3). It includes bodily and cognitive shame as adaptive subscales and existential shame, developed to measure pathological-dysfunctional shame. Results: A validation study (N = 506) showed good reliability and stable factor structure. Women reached an overall higher shame level than men. Overall and especially concerning existential shame, a significant difference appeared between healthy women and female BPD patients. Conclusions: The idea of existential shame as a maladaptive aspect of shame is underpinned. The moderate scores of bodily and cognitive shame in Sample 2 support their meaning as functional aspects of shame

Integration of e-Health Tools Into Face-to-Face Psychotherapy for Borderline Personality Disorder:A Chance to Close the Gap Between Demand and Supply?

Borderline personality disorder (BPD) is a severe, highly prevalent mental disorder. Effective psychological treatments for BPD are available. However, most patients do not receive evidence-based treatments partly because of high treatment delivery costs and lack of specialized therapists. By integrating specialized e-health tools into BPD-specific treatments, treatment intensity can be increased, frequency of face-to-face sessions and burden for psychotherapists can be reduced, and implementation of new skills and experiences in the everyday life of these patients can be promoted. This bears great potential to increase the availability of evidenced-based psychotherapy for BPD patients and close the gap between demand and supply. In this article we present such an innovative e-health tool, priovi, which has been developed for schema therapy. The concept and application of priovi are described and illustrated with a case example

Integration of e-Health Tools Into Face-to-Face Psychotherapy for Borderline Personality Disorder: A Chance to Close the Gap Between Demand and Supply?

Borderline personality disorder (BPD) is a severe, highly prevalent mental disorder. Effective psychological treatments for BPD are available. However, most patients do not receive evidence-based treatments partly because of high treatment delivery costs and lack of specialized therapists. By integrating specialized e-health tools into BPD-specific treatments, treatment intensity can be increased, frequency of face-to-face sessions and burden for psychotherapists can be reduced, and implementation of new skills and experiences in the everyday life of these patients can be promoted. This bears great potential to increase the availability of evidenced-based psychotherapy for BPD patients and close the gap between demand and supply. In this article we present such an innovative e-health tool, priovi, which has been developed for schema therapy. The concept and application of priovi are described and illustrated with a case example

Patient-reported outcomes in borderline personality disorder.

Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes

Patient-reported outcomes in borderline personality disorder.

Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes

Effects of shame induction in borderline personality disorder

Shame is a powerful emotion with a strong link to borderline personality disorder. This study investigates shame levels in borderline personality disorder, compared to major depressive disorder and healthy women. A total of 25 women with borderline personality disorder, 25 women with major depression and 23 healthy women underwent a shame induction exercise. The self-reported intensity of shame, anger, anxiety, sadness, joy, annoyance, and boredom, was measured five times. Compared to participants with major depression and healthy women, patients with borderline personality disorder had higher baseline levels of shame, but there was no evidence of greater emotional intensity or a prolonged return to baseline after shame induction. They were the only group to express increased anger following the exercise. These findings strengthen the view of stronger emotional negativity in borderline personality disorder. The differences in the impact of shame on anger may contribute toward understanding emotion regulation difficulties in borderline personality disorder