A pilot randomized controlled study of a brief mentalizing enhancement intervention for borderline personality...

Impairments 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.

Forty-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.

A 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).

Brief and focused mentalizing interventions may enhance mentalizing and reduce distress in BPD and could be utilized for tailoring interventions for specific BPD deficits.