Background and aims
Borderline personality disorder (BPD) is a disorder characterized by strong emotional fluctuations, high symptom pressure, self-destructive behaviors, identity problems, and unstable relationships with other people. The concept of mentalization includes the understanding of one's own and other people's actions as expressions of mental states (thoughts, feelings, desires, dreams). Poor or unstable capacity for mentalization is believed to contribute strongly to emotional and relational difficulties. Mentalization-based therapy (MBT) is a recognized and evidence-based therapy for patients with BPD. It aims to develop patients’ capacity for mentalizing.
Aims
The first aim of the current project is to investigate how mentalizing can be assessed feasibly, reliably, and validly in clinical samples. After completed data collection, the main project aims to investigate how patients' mentalizing ability relates to clinical outcomes in MBT, how mentalizing ability develops through treatment, and how interactions between patient and therapist contribute to treatment processes and development.
Method
The project is a prospective naturalistic study of outpatients with borderline personality disorder treated in a three-year MBT program. Before treatment, patients undergo a thorough evaluation that includes mapping of symptoms, relational difficulties and personality functioning, as well as special interviews for assessment of mentalizing ability. They are then followed up with systematic evaluations every 6 months during treatment, including video recordings of therapy sessions.
The project includes a follow-up examination approximately three months after the end of treatment, with re-evaluation of symptoms and repetition of special interviews to assess mentalizing ability. Some participants will also be invited to a qualitative interview about the experiences with the treatment.
The project has been approved by the Regional Committee for Research Ethics.
Expected time schedule
- Competed patient inclusion scheduled in 2022
- Data collection completed in 2025
Scope
From 2022 the project is basis for a PhD project, focusing on the development and evaluation of methods for assessment of mentalizing.
Collaboration
The project is a collaboration between
- Outpatient unit, Section for Personality Psychiatry and Specialized Treatments, Oslo University Hospital
- Department for Research and Innovation, Oslo University Hospital
- Unit for adult psychiatry, Institute for Clinical Medicine, University of Oslo
- Psychotherapy quality lab, Oslo University Hospital.
- International consultant: Prof. Dr. Svenja Taubner, Director of the Institute of Psychosocial Prevention University Heidelberg
- External researcher: Merete Selsbakk Johansen
Funding
Oslo University Hospital.
Contact
Principle Investigator and main PhD supervisor: Theresa Wilberg
PhD candidate: Dag Anders Ulvestad
Co-supervisor: Geir Pedersen
Clinical site: Outpatient unit: Personlighetspoliklinikken, Section for Personality Psychiatry and Specialized Treatments, Oslo University Hospital, Unit leader: Jane Fjermestad-Noll.
Research group: Personality Psychiatry
Publications
- Ulvestad, D. A., Johansen, M. S., Kvarstein, E. H., Pedersen, G., & Wilberg, T. (2022): A borderline focused Reflective Functioning measure – Interrater reliability of the Mentalization Breakdown Interview. Nordic Journal of Psychiatry, DOI: 10.1080/08039488.2022.2123040