A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog.
Saved in:
| Title: | A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog. |
|---|---|
| Authors: | Al-Shamali, Huda F, Winkler, Olga, Talarico, Fernanda, Greenshaw, Andrew J, Forner, Christine, Zhang, Yanbo, Vermetten, Eric, Burback, Lisa |
| Source: | Australian & New Zealand Journal of Psychiatry. Oct2022, Vol. 56 Issue 10, p1252-1264. 13p. |
| Subjects: | Psychological stress, Obesity risk factors, Cognition disorder risk factors, Risk factors of self-injurious behavior, Treatment of borderline personality disorder, Suicide risk factors, Psychology information storage & retrieval systems, CINAHL database, Medical information storage & retrieval systems, Dissociative disorders, Borderline personality disorder, Systematic reviews, Severity of illness index, Risk assessment, Treatment effectiveness, Descriptive statistics, MEDLINE, Thematic analysis, Self-mutilation, Psychotherapy |
| Abstract: | Background: Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD. Objective: A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps. Methods: Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines. Results: Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression. Conclusion: BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes. [ABSTRACT FROM AUTHOR] |
| Copyright of Australian & New Zealand Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 159306437 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Al-Shamali%2C+Huda+F%22">Al-Shamali, Huda F</searchLink><br /><searchLink fieldCode="AR" term="%22Winkler%2C+Olga%22">Winkler, Olga</searchLink><br /><searchLink fieldCode="AR" term="%22Talarico%2C+Fernanda%22">Talarico, Fernanda</searchLink><br /><searchLink fieldCode="AR" term="%22Greenshaw%2C+Andrew+J%22">Greenshaw, Andrew J</searchLink><br /><searchLink fieldCode="AR" term="%22Forner%2C+Christine%22">Forner, Christine</searchLink><br /><searchLink fieldCode="AR" term="%22Zhang%2C+Yanbo%22">Zhang, Yanbo</searchLink><br /><searchLink fieldCode="AR" term="%22Vermetten%2C+Eric%22">Vermetten, Eric</searchLink><br /><searchLink fieldCode="AR" term="%22Burback%2C+Lisa%22">Burback, Lisa</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Australian+%26+New+Zealand+Journal+of+Psychiatry%22">Australian & New Zealand Journal of Psychiatry</searchLink>. Oct2022, Vol. 56 Issue 10, p1252-1264. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Psychological+stress%22">Psychological stress</searchLink><br /><searchLink fieldCode="DE" term="%22Obesity+risk+factors%22">Obesity risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Cognition+disorder+risk+factors%22">Cognition disorder risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+factors+of+self-injurious+behavior%22">Risk factors of self-injurious behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+borderline+personality+disorder%22">Treatment of borderline personality disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Suicide+risk+factors%22">Suicide risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+information+storage+%26+retrieval+systems%22">Psychology information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22CINAHL+database%22">CINAHL database</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+information+storage+%26+retrieval+systems%22">Medical information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Dissociative+disorders%22">Dissociative disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Borderline+personality+disorder%22">Borderline personality disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Thematic+analysis%22">Thematic analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Self-mutilation%22">Self-mutilation</searchLink><br /><searchLink fieldCode="DE" term="%22Psychotherapy%22">Psychotherapy</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD. Objective: A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps. Methods: Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines. Results: Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression. Conclusion: BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Australian & New Zealand Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=159306437 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1177/00048674221077029 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 1252 Subjects: – SubjectFull: Psychological stress Type: general – SubjectFull: Obesity risk factors Type: general – SubjectFull: Cognition disorder risk factors Type: general – SubjectFull: Risk factors of self-injurious behavior Type: general – SubjectFull: Treatment of borderline personality disorder Type: general – SubjectFull: Suicide risk factors Type: general – SubjectFull: Psychology information storage & retrieval systems Type: general – SubjectFull: CINAHL database Type: general – SubjectFull: Medical information storage & retrieval systems Type: general – SubjectFull: Dissociative disorders Type: general – SubjectFull: Borderline personality disorder Type: general – SubjectFull: Systematic reviews Type: general – SubjectFull: Severity of illness index Type: general – SubjectFull: Risk assessment Type: general – SubjectFull: Treatment effectiveness Type: general – SubjectFull: Descriptive statistics Type: general – SubjectFull: MEDLINE Type: general – SubjectFull: Thematic analysis Type: general – SubjectFull: Self-mutilation Type: general – SubjectFull: Psychotherapy Type: general Titles: – TitleFull: A systematic scoping review of dissociation in borderline personality disorder and implications for research and clinical practice: Exploring the fog. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Al-Shamali, Huda F – PersonEntity: Name: NameFull: Winkler, Olga – PersonEntity: Name: NameFull: Talarico, Fernanda – PersonEntity: Name: NameFull: Greenshaw, Andrew J – PersonEntity: Name: NameFull: Forner, Christine – PersonEntity: Name: NameFull: Zhang, Yanbo – PersonEntity: Name: NameFull: Vermetten, Eric – PersonEntity: Name: NameFull: Burback, Lisa IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Text: Oct2022 Type: published Y: 2022 Identifiers: – Type: issn-print Value: 00048674 Numbering: – Type: volume Value: 56 – Type: issue Value: 10 Titles: – TitleFull: Australian & New Zealand Journal of Psychiatry Type: main |
| ResultId | 1 |
