Women with attention-deficit/hyperactivity disorder (ADHD) are also often diagnosed with personality disorders, yet research on reliable and valid assessments of personality pathology in this population has been limited. In this study, the psychometric properties of the Level of Personality Functioning Scale- Brief Form - 2.0 (LPFS-BF 2.0) were examined in a sample of 171 adult women with ADHD. A two-factor structure was identified, with one factor, LPF-self, comprised of six items, reflecting impairment in self functioning; the second factor, LPF-interpersonal, comprised of six items, reflecting impairment in interpersonal functioning. LPFS-BF 2.0 factors contributed unique variance to functional impairment beyond the effects of co-occurring depression, anxiety, and ADHD. These findings suggest the LPFS-BF 2.0 may be important to include in clinical care for women with ADHD, to identify those women with ADHD who may require adjunctive intervention for personality pathology.

Disruptions in epistemic trust have been recognised as key sequelae of trauma and as markers of vulnerability to borderline personality pathology. However, prior research has relied primarily on self-reports and lacks behavioural measures of epistemic stance. The present pre-registered studies introduce a novel behavioural task-the Balloon Analogue Risk Task for Epistemic Trust (BART-ET)-and examine its associations with borderline personality features, trauma history, and psychological distress. Two cross-sectional studies were conducted with a combined sample of 273 young adults aged 18-25 (Study 1: N = 120; Study 2: N = 153). Participants completed self-report measures of borderline personality features (PAI-BOR) and epistemic trust, mistrust, and credulity (ETMCQ). Study 2 additionally included the Childhood Trauma Questionnaire (CTQ) and the Brief Symptom Inventory (BSI-GSI). All participants completed the BART-ET in a laboratory setting, which operationalised epistemic mistrust as the degree of deviation from a confederate experimenter's advice during a risk-taking task. Analyses involved correlational tests and structural equation modelling (SEM) to evaluate hypothesised associations and mediation pathways. As expected, across both studies, higher levels of borderline personality traits were associated with greater epistemic mistrust-both behaviourally (on the BART-ET) and via self-report (ETMCQ)-and with greater epistemic credulity, but not with epistemic trust, as measured with the ETMCQ. Behavioural and self-report measures of mistrust were significantly correlated, suggesting convergent validity of the BART-ET as an index of epistemic mistrust. In Study 2, childhood trauma exposure was associated with borderline features and with epistemic mistrust assessed behaviourally and via self-report. Preregistered mediation models controlling for general distress (BSI-GSI) suggested that the association between childhood trauma and epistemic mistrust was not unique to BPD features. These findings suggest that epistemic mistrust-rather than a simple absence of trust-is a social-cognitive correlate of borderline personality vulnerability and trauma exposure in young adults. The results also indicate that the BART-ET may be a useful behavioural tool for studying epistemic mistrust in clinical contexts, though further validation is needed.

BackgroundMothers with borderline personality disorder face unique challenges in parenting, as borderline symptoms have been shown to negatively affect parent-child relationships. These challenges can lead to non-supportive reactions to children’s negative emotions, a form of parent emotion socialization (PES) that has been linked to negative outcomes in children. Given the inherent emotional arousal evoked by parenting, emotion dysregulation likely influences the type of PES parents utilize. However, few studies have specifically examined how emotion dysregulation affects PES in mothers with borderline pathology. Against this background, this study aims to (1) investigate the link between maternal emotion dysregulation and PES strategies and (2) assess if emotion dysregulation moderates the relationship between presence of significant borderline pathology and PES.MethodsThe study sample was comprised of 148 mothers (Mage = 34.92). Of these mothers, 53 had significant borderline features—that is, they either met full diagnostic criteria or exhibited marked subthreshold symptoms. Emotion regulation was evaluated using the Difficulties in Emotion Regulation Scale – Short Form, and PES was assessed using the Coping with Children’s Negative Emotion Scale. Significant borderline features were determined using the Personality Assessment Inventory Borderline Scale. As a part of aim 1, bivariate correlations were conducted to examine relationships between emotion dysregulation and two PES strategies: supportive and non-supportive. The moderating role of emotion dysregulation on the relationships between borderline features and supportive and non-supportive PES was assessed using two moderation models.ResultsResults from the first aim revealed a small, negative correlation between emotion dysregulation and supportive PES and a medium, positive correlation between emotion dysregulation and non-supportive PES. Emotion dysregulation was found to be a significant moderator of the relationship between borderline pathology and non-supportive PES.ConclusionsThe current study significantly contributes to the literature by further elucidating the relationship between maternal borderline pathology and PES and its underlying mechanisms.

BackgroundSuicide profoundly impacts not only individuals but also their relatives, who often experience high levels of burden, distress, and isolation. Yet the interplay between risk and protective factors in this population remains understudied. This study explored the network structure of caregivers’ emotional states, focusing on meaning in life, perceived burden, family empowerment, emotion dysregulation, anxiety, stress, depressive symptoms, and quality of life.MethodsA cross-sectional study was conducted with 185 Spanish relatives (139 women, 75.1%, and 46 men, 24.9%) age-ranged between 18 and 73 years old (M = 50.26, SD = 10.23) of individuals with suicide attempts or suicidal behavior disorder in the past two years. Networks were estimated with EBICglasso after redundant node analysis.ResultsThe network included 11 nodes and 30 edges. Depressive symptoms emerged as the most central node, followed by stress and anxiety, indicating that emotional distress is a central component of caregivers’ functioning. Emotion dysregulation bridged distress with subjective burden. In contrast, meaning in life (especially its experiential dimension of Meaning) and quality of life appeared as protective but peripheral. Family empowerment also occupied a peripheral role, while objective and subjective burden were closely interconnected but less structurally influential.ConclusionFindings highlight the central position of depressive symptoms within caregivers’ emotional networks, suggesting that future research should further explore how distress and protective resources such as meaning in life and quality of life interact in shaping caregivers’ well-being.

BackgroundImpairments in mentalizing, the capacity for understanding mental states, are central to borderline personality disorder (BPD). This study examined a brief mentalizing intervention aiming to enhance the capacity and motivation for mentalizing in BPD.MethodsForty-eight adults with BPD (Sex: 81% female; Gender: 75% female) were randomized to a brief, single-session mentalizing or a control intervention. The mentalizing intervention involved prompts and practice in considering mental states underlying behaviors in interpersonal situations, while the control group involved an emotional sharing intervention. An observer-rated measure of mentalizing ability and a self-report measure of motivation for mentalizing were administered before and after the intervention. Self-report measures of subjective distress and the acceptability of the intervention were collected following the intervention.ResultsA significant improvement in mentalizing abilities was observed following mentalizing-enhancement (d = 0.69, p = .002), but not emotional sharing (d = -0.07, p = .64). Participants in the mentalizing-enhancement group reported significantly lower post-intervention distress than the emotional sharing group (d = 0.64, p = .03). Unexpectedly, the motivation for mentalizing decreased in both groups (mentalizing-enhancement/emotional sharing: d = -1.62/-1.16, respectively, ps < 0.001).DiscussionBrief and focused mentalizing interventions may enhance mentalizing and reduce distress in BPD and could be utilized for tailoring interventions for specific BPD deficits.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40479-025-00331-1.

BackgroundExtant data suggest that children of mothers with borderline personality disorder (BPD) are at risk for a variety of poor psychosocial outcomes, including psychopathology. One avenue for interrupting intergenerational transmission of psychopathology is through scaffolding parenting. The Mediational Intervention for Sensitizing Caregivers (MISC) has been used with other high-risk groups and holds promise for this population. The objective of the current study was to evaluate the feasibility and acceptability of MISC for mothers with BPD, and to identify key modifications for future adaptation of MISC for this population.MethodsThis objective was accomplished via three aims following a best-practice adaptation model for evidence-based psychosocial interventions. Aim 1 consisted of quantitative assessment (phase 1) of need for parenting support with n = 88 mothers with BPD and n = 195 without, and qualitative assessment (phase 2) of the lived experience of parenting among 15 mothers with BPD. Aim 2 consisted of integration of mixed methods results from Aim 1, and the decision to proceed with adaptation of MISC for mothers with BPD. Aim 3 consisted of focus groups and theatre testing of MISC, with n = 14 mothers with BPD.ResultsAim 1 findings showed significant group differences on quantitative measures between mothers with and without BPD. Qualitative themes provided information about perceived need and desire for parenting support from the patient perspective. Aim 2 integration provided preliminary support for the feasibility and utility of MISC for mothers with BPD. Results of Aim 3 focus groups identified qualitative evidence in support of the acceptability of MISC for mothers with BPD. Additionally, participant feedback identified feasible and actionable modifications to MISC that can be implemented in future work with this population.ConclusionsThe current study suggests that MISC is a potentially feasible and acceptable alternative for mothers with BPD who are interested in receiving professional parenting support services.

Numerous studies have demonstrated that the Alternative Model for Personality Disorders (AMPD) outperforms traditional categorical nosology (i.e., Section II) in predicting an array of salient clinical outcomes. However, despite the centrality of social-cognitive impairments in personality disorder, few studies have examined the superiority of the AMPD over Section II in predicting social-cognitive deficits. The current study addresses this gap by evaluating the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features in predicting mentalizing - a social-cognitive construct proposed to underlie the development of personality disorder. Participants included 267 university students (Mage = 20.49, SD = 1.74) who completed self-report measures of LPF, borderline personality features, and two measures of mentalizing: the Reflective Functioning Questionnaire (RFQ) and the Mentalization Scale (MentS). Hierarchical regressions revealed that LPF explained additional variance in the RFQ beyond borderline features and internalizing psychopathology. Although borderline features also incremented LPF in predicting the RFQ, additional variance explained was less than half that contributed by the LPF over borderline features. LPF also incremented the variance explained in the MentS total score and subscales over and above borderline features and internalizing symptoms, whereas borderline features did not increment LPF in predicting any of the MentS variables. These results strengthen the evidence base for the superiority of the AMPD over Section II and suggest that mentalizing deficits are better captured by LPF than borderline personality disorder symptoms. Findings support the extension of mentalization-based treatment to AMPD-defined personality disorder, which should be explored in future research.

BackgroundEven if it was first described in borderline personality disorder, emotion dysregulation (ED) is increasingly recognized as a transdiagnostic and dimensional construct, best understood along a continuum of severity rather than as a discrete category. Prior cluster-analytic studies have consistently explored heterogeneity within this continuum by identifying patient subgroups, but most were conducted in populations defined by specific diagnostic categories, limiting their generalizability. To better capture ED’s core components, studies conducted in clinically heterogeneous adult populations are needed.MethodsIn this context, we conducted a latent profile analysis on 349 adults referred for ED-related difficulties at a specialized outpatient clinic. Profiles were derived from the six subscales of the Difficulties in Emotion Regulation Scale. Patients were assessed on sociodemographic variables, emotion regulation difficulties and strategies, mentalizing abilities, comorbid psychopathology, and well-being.ResultsA two-class solution was retained. Subgroups did not align with any specific diagnostic category but rather emerged along a severity continuum. Cluster 1 (n = 267) was characterized by more severe ED in every domain, higher use of non-adaptive regulation strategies, lower self-mentalizing abilities, greater comorbid psychopathology, and lower well-being. Cluster 2 (n = 82) displayed comparatively preserved emotion regulation abilities and strategies, higher self-mentalizing, fewer comorbidities, and greater well-being.ConclusionsOur findings provide further evidence for the existence and characterization of subgroups in patients with ED, reflecting gradations along a severity continuum. While exploratory, they also suggest that core mechanisms targeted by DBT and MBT (i.e., maladaptive emotion regulation strategies and self-mentalizing abilities) may be relevant therapeutic targets across a broader transdiagnostic spectrum.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40479-025-00319-x.

Narrative speech production (NSP), i.e., the conceptualization, linguistic formulation, and articulation of a story, is a multifaceted process underpinned by cognitive functions and mentalization ability, often impaired in individuals with borderline personality disorder (BPD). This study examines differences in linguistic formulation between individuals with BPD and healthy controls (HCs), and explores how task type influences linguistic formulation, as well as how linguistic formulation relates to temporal parameters of speech uniquely in BPD. Speech of 33 BPD and 31 HC individuals was recorded in three task types: telling their previous day, retelling a story, and picture sequences. Features of linguistic formulation were extracted with natural language processing methods, while temporal parameters were extracted using automatic speech recognition. Hypothesis-driven generalized linear mixed-effects models (GLMMs) were applied to test predefined group differences in four linguistic features (content words, first- and third-person singular verbs, and syntactic complexity). Additional exploratory GLMMs examined other linguistic features and task effects. Within-group Spearman correlations assessed associations between linguistic and temporal measures, controlling for task. Hypothesis testing showed that the NSP in BPD is characterized by fewer content words, more first-person singular verbs, and lower syntactic complexity than that of HCs. Exploratory analyses revealed that individuals with BPD used pronouns more frequently than HCs, particularly demonstrative pronouns (e.g., this) and first-person singular pronouns (e.g., I). In BPD, higher first-person singular reference (pronouns and verbs) correlated with fewer silent pauses, while greater syntactic complexity correlated with more filled pauses. Task modulated verbosity and the use of other pronoun types. Findings suggest that NSP in BPD is characterized by dominant self-referential thought content, reflected in elevated first-person singular reference, and by qualitatively impoverished language use, marked by reduced content word production, increased pronoun use, and lower syntactic complexity. Heightened self-focus may hinder the efficient allocation of cognitive resources required for cohesive, listener-oriented NSP.