Cognitive Reappraisal Training Targeting Emotion Circuits As a Therapeutic Intervention in Borderline Patients

What this Trial Is About

Borderline Personality Disorder (BPD) is a common and serious psychiatric condition characterized by extreme mood swings and emotional instability, affecting about 2% to 5.9% of people. It poses high risks including suicidality and impaired daily functioning. This research aims to refine and test a focused cognitive reappraisal training method called reappraisal-by-distancing to see if it can improve neural and behavioral responses related to emotional regulation and enhance clinical outcomes in BPD patients. The study compares two behavioral treatments given twice weekly over 6 weeks: one group receives cognitive reappraisal-by-distancing training involving practice with negative emotional pictures guided by a therapist, while the other group practices their usual emotion regulation strategies under therapist guidance. The initial phase tests 2-, 4-, and 6-week treatment durations to identify the optimal dose using brain imaging and clinical ratings. The follow-up phase uses the optimal 6-week dose to confirm results and assess clinical improvements at treatment end and up to 4 months later. Participants attend regular sessions during the treatment period and undergo assessments including fMRI brain scans, clinical rating scales, and questionnaires evaluating emotion regulation, stress, mood, and anxiety at baseline, during treatment, and at follow-ups. The primary outcome is change in brain activity linked to emotional response, while secondary outcomes include changes in borderline symptoms and emotional regulation measures. Safety and clinical progress are monitored throughout the study, which lasts several months including follow-up periods.

Cognitive Reappraisal Training for Borderline Personality (BPD)