Potential psychological processes linking mindfulness to borderline personality disorder symptoms: a systematic...

Borderline personality disorder (BPD) is characterized by pervasive instability in affect regulation, impulse control, and interpersonal functioning. Mindfulness has been increasingly examined as a key construct associated with BPD; however, existing research has primarily focused on direct associations rather than on the psychological processes that may account for this relationship.

This systematic review aimed to identify and synthesize empirical evidence on the potential psychological processes associated with the relationship between mindfulness and borderline personality disorder symptoms.

The review was conducted in accordance with PRISMA guidelines, and the protocol was registered with PROSPERO. A systematic search was performed across PsycINFO, PubMed, Scopus, Web of Science, EBSCO, and Google Scholar for studies published between 2010 and April 2026. Quantitative studies examining mindfulness in relation to BPD symptoms or related clinical outcomes were included. A total of 31 studies met the eligibility criteria and were included in the review. Data were extracted using a structured form, and findings were synthesized using a narrative and thematic approach due to methodological heterogeneity.

The included studies identified several psychological processes that may contribute to the relationship between mindfulness and BPD symptoms, although the strength of evidence varied across study designs and analytical approaches. Emotion regulation emerged as the most consistently supported candidate pathway, alongside other potentially relevant processes, including mindfulness facets (e.g., nonjudging and acting with awareness), self-related processes (e.g., self-compassion), cognitive-control processes (e.g., decentering and attentional control), and interpersonal factors (e.g., attachment and rejection sensitivity). Behavioral outcomes such as nonsuicidal self-injury, aggression, and treatment dropout were also associated with these processes. The findings suggest that these candidate processes may operate as interconnected pathways rather than as isolated variables.

The literature suggests that studies examining the relationship between mindfulness and borderline personality disorder symptoms, including both direct associations and studies assessing potential psychological processes. However, existing studies remain fragmented and typically examine single pathways in isolation. This review provides a structured synthesis of these potential processes within a coherent conceptual framework, while highlighting the need for further longitudinal and process-focused research before firm mechanistic conclusions can be drawn.

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