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Background: Mentalization‐based treatment (MBT) is an evidence based treatment for patients diagnosed with borderline personality disorder (BPD). Although MBT is effective, on average, for individuals with BPD, there are large individual differences in treatment outcomes. Research on predictors of the treatment effect of MBT, such as intelligence, is needed to determine which treatment is most effective for which 'category' of BPD patients, providing more knowledge about optimal indications. Objective: The study aimed to investigate whether intelligence is associated with MBT outcomes in patients with BPD and exploratively studying the difference between two variants of MBT. Methods and Procedures: A pre‐post intervention design was used to examine the effects of MBT on BPD severity. Personal and social recovery were measured as secondary outcome measures. The association between intelligence and the degree of recovery was examined. Results: No significant correlation was found between intelligence level and treatment efficacy. In addition, a negative correlation between IQ and personal and social recovery was found, indicating that, as IQ increased, the level of recovery decreased. Secondary subanalyses showed the treatment effect of MBT was large and significant in reducing BPD symptoms (Cohen's d = 1.5) and that there was no significant difference between the 2‐day MBT and 3‐day MBT programmes in terms of a decrease in BPD severity. However, a significant medium positive correlational relationship was found between intelligence and a decrease in BPD severity level for the 3‐day MBT, which was not found for the 2‐day MBT programme. This indicates that in the 3‐day MBT programme, the higher the IQ, the higher the decrease in BPD severity level. Conclusions and Implications: This study is the first to examine the association between intelligence and the outcome of MBT in BPD patients. It shows that patients with a wide range of intelligence (72–124) can equally benefit from MBT and that effectiveness of MBT was not influenced negatively by lower intelligence. Secondary subanalyses showed that this was particularly evident when the intervention was delivered within the context of a 2‐day MBT programme. Nevertheless, further randomized studies are required to ascertain the relationship between IQ and treatment effectiveness, as well as other predictors of MBT outcomes. [ABSTRACT FROM AUTHOR]

The present study was aimed at investigating the relationships among attachment styles, autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations), alexithymia, and anti-social behavior among 202 college students (67 men and 135 women). We were particularly interested in sex differences in the levels of these variables as well as their associations. Sex differences were expected in types of insecure attachment styles, patterns of autonomy-connectedness, and levels of self-reported antisocial and passive-aggressive behavior. All expected sex differences were indeed found. Furthermore, the model that we hypothesized was partly confirmed: For men, anxious attachment had a stronger direct and positive effect on antisocial behavior than for women, and the positive effect of anxious attachment on passive-aggressive behavior was smaller for women than for men. Interestingly, capacity for managing new situations had a main and mediating effect on antisocial behavior. Sensitivity to others appeared as a mediator between anxious attachment style and passive-aggressive behavior. Contrary to expectations, fantasizing (a component of alexithymia) had a strong, negative association with antisocial behavior. The results are discussed against the background of other recent findings concerning alexithymia and autonomy-connectedness. Keywords: gender differences; autonomy; gender identity; connectedness; young adults; attachment style; antisocial behavior; antisocial personality disorder; alexithymia

Objectives: In the current study we investigated the relationship of sex and autonomy-connectedness with internalizing and externalizing personality disorder symptoms (PDS), coping and axis-I pathology in older age. Method: A path model was tested which was based on neo-analytical object relation, attachment- and primary-personality theory, among 100 clinical and 106 non-clinical elderly. Results: In line with our model, autonomy-connectedness (self-awareness and capacity of managing new situations) was strongly associated to internalizing PDS in both groups. In both groups, neither sex nor autonomy-connectedness predicted externalizing PDS. Sex, internalizing as well as externalizing PDS and reactive defensive coping were associated to axis-I psychopathology. Conclusions: We conclude that sex and autonomy-connectedness were, similarly as in adult populations, associated to internalizing PDS and axis-I pathology. Treatment of elderly with internalizing PDS and axis-I psychopathology should therefore focus on enhancing autonomy-connectedness. [ABSTRACT FROM AUTHOR]

Objective Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Method Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. Results The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. Conclusions The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. Practitioner points The study confirmed the relevance of autonomy-connectedness in anxiety and depression., In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others., Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this research were to investigate gender differences in levels of autonomy-connectedness, Axis I Psychopathology, and higher order factors of internalizing and externalizing personality psychopathology and, second, to investigate the association between these variables. Design The design of this research is cross-sectional and multicentered. Methods: We used self-report questionnaires, factor analysis, and regression analysis. Results: We found evidence for a significant role of autonomy-connectedness in Axis I Psychopathology. This was especially true for women, who were found to be more sensitive to others and sensitivity to others was strongly associated with Axis I Psychopathology. Maybe due to the research sample no evidence was found for an association of autonomy-connectedness with externalizing psychopathology. As to the role of autonomy-connectedness in internalizing psychopathology, we found that a lack of self-awareness or a capacity of managing new situations, combined with a high sensitivity to others, were associated with internalizing psychopathology. Women appeared to be more sensitive to others and to report higher levels of Axis I Psychopathology than men. Conclusion: We conclude that autonomy-connectedness plays an important role in Axis I Psychopathology as well as in internalizing Axis II pathology. Treatment of Axis I and internalizing Axis II psychopathology should therefore also focus on autonomy problems. [ABSTRACT FROM AUTHOR]

Objective: To examine the safety and efficacy of a brief cognitive dual-task (using eye movements) add-on module to treatment as usual (TAU) in reducing the severity and frequency of intrusive suicidal mental images and suicidal ideation., Method: We conducted a single-blind, parallel multicenter randomized trial (No. NTR7563) among adult psychiatric outpatients ( N = 91; M age = 34.4, SD = 13.54; 68% female) with elevated depressive symptoms and experiencing distressing suicidal intrusions in the Netherlands. Primary outcome was the severity (Suicidal Intrusions Attributes Scale) and frequency (Clinical Interview for Suicidal Intrusions) of suicidal mental imagery intrusions at 1-week posttreatment and 3-month follow-up. Primary analysis was intention-to-treat., Results: Between November 27, 2018 and September 13, 2021, 91 patients were included and randomly assigned to intervention group (Cognitive Dual Task Add-on + TAU) ( n = 46) or TAU-only ( n = 45). Cognitive Dual Task Add-on + TAU had greater reductions in severity (mean difference, -15.50, 95% CI [23.81, -7.19]; p < .001, d = 0.60), and frequency (geometric mean difference, 0.47, 95% CI [0.29, 0.79]; p = .004) of suicidal intrusions over time than TAU-alone. Cognitive Dual Task Add-on + TAU patients also showed lower suicidal ideation over time ( p = .008, d = 0.42). There were no significant group differences in reductions in depressive symptoms, rumination, or hopelessness. Four serious adverse events occurred (three Cognitive Dual Task Add-on + TAU; one TAU-only); all unlikely attributable to intervention/trial., Conclusions: Findings provide support for the effectiveness of adding a cognitive dual-task module to the treatment of psychiatric outpatients with elevated depressive symptoms in reducing suicidal intrusions and ideation and can be executed safely. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Knowledge of treatment predictors and moderators is important for improving the effectiveness of treatment for PTSD due to childhood abuse. Objective: The first aim of this study was to test the potential predictive value of variables commonly associated with PTSD resulting from a history of repeated childhood abuse, in relation to treatment outcomes. The second aim was to examine if complex PTSD symptoms act as potential moderators between treatment conditions and outcomes. Method: Data were obtained from a randomized controlled trial comparing a phase-based treatment (Skills Training in Affect and Interpersonal Regulation [STAIR] followed by Eye Movement Desensitization and Reprocessing [EMDR] therapy; n  = 57) with a direct trauma-focused treatment (EMDR therapy only; n  = 64) in people with PTSD due to childhood abuse. The possible predictive effects of the presence of borderline personality disorder, dissociative symptoms, and suicidal and self-injurious behaviours were examined. In addition, it was determined whether symptoms of emotion regulation difficulties, self-esteem, and interpersonal problems moderated the relation between the treatment condition and PTSD post-treatment, corrected for pre-treatment PTSD severity. Results: Pre-treatment PTSD severity proved to be a significant predictor of less profitable PTSD treatment outcomes. The same was true for the severity of dissociative symptoms, but only post-treatment, and not when corrected for false positives. Complex PTSD symptoms did not moderate the relationship between the treatment conditions and PTSD treatment outcomes. Conclusions: The current findings suggest that regardless of the common comorbid symptoms studied, immediate trauma-focused treatment is a safe and effective option for individuals with childhood-related PTSD. However, individuals experiencing severe symptoms of PTSD may benefit from additional treatment sessions or the addition of other evidence-based PTSD treatment approaches. The predictive influence of dissociative sequelae needs further research.The study design was registered in The Dutch trial register (https://www.trialregister.nl/trialreg/admin/rctview.asp?TC = 5991) NTR5991 and was approved by the medical ethics committee of Twente NL 56641.044.16 CCMO.