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Daily mindfulness, relaxation exercises ease symptoms in youth with borderline personality disorder

Tristan Manalac
17 Aug 2019
Yoga as an alternative to exercise

Daily engagement in brief, self-guided mindfulness and relaxation practices eases symptoms of borderline personality disorder (BPD) in young adults, according to a recent Singapore study.

“Compared to the no-practice control condition, mindfulness practice resulted in significant improvements in trait mindfulness and self-compassion, whereas relaxation practice led to reductions in difficulties with emotion regulation,” said researchers, noting that relaxation techniques may have a slight advantage over mindfulness.

Eighty-seven young adults (mean age, 22±2.94 years; 64 percent female) were enrolled in the study. Twenty-eight received the mindfulness intervention, 30 were assigned to relaxation practices and 29 underwent the control condition. The mean score in the Personality Assessment Inventory–Borderline Features (PAI-BOR) was 44.33. [Psychiatry Res 2019;280:112485]

Compared to control conditions, the mindfulness intervention resulted in significantly higher improvements in trait mindfulness (effect size, 0.99; p<0.01), driven mostly by changes in the awareness domain of the Five Facet Mindfulness Questionnaire (p<0.001). Mindfulness practices also significantly improved self-compassion (effect size, 0.86; p<0.01) and shame (effect size, –0.61; p<0.05) relative to controls.

Relaxation interventions, in comparison, led to a significant drop in the Difficulties with Emotion Regulation Scale total score (effect size, –1.22; p<0.01) relative to controls. Similar significant changes were reported for depression (effect size, –0.44), anxiety (effect size, –0.45), stress (effect size, –0.62), mindfulness (effect size, 0.84) and self-compassion (effect size, 0.78; p<0.05 for all).

Participants performed the mindfulness and relaxation practices at home for an average duration of 101.18±46.65 and 99.77±31.08 minutes, respectively. Comparing the effects of mindfulness and relaxation interventions did not reveal any significant superiority of one method over the other.

Within-group comparisons further confirmed the principal findings. Mindfulness practices led to significant improvements in anxiety (p<0.05), stress (p<0.05), shame (p<0.01), trait mindfulness (p<0.01) and self-compassion (p<0.01) over time. On the other hand, the relaxation intervention elicited significant temporal improvements in all domains tested.

Researchers pointed out that contrary to expectations, no immediate benefits were observed in terms of psychological symptoms, as compared to the control condition.

“The lack of effect may be due to the fact that the study’s sample consists of a subclinical population with elevated BPD symptoms, who may benefit from a more intensive mindfulness intervention,” they explained. “Nevertheless, results from within-group analyses demonstrate beneficial changes across all outcome variables in each experimental condition, suggesting that the practices are not entirely without benefit to the participants.”

Aside from the measures explored in the present study, future efforts should expand the analysis to include other domains, such as attention and functioning, according to researchers. These may reveal more differences between mindfulness and relaxation practices.

“Lastly, as mindfulness is typically taught as a set of behavioural skills in the context of [dialectical behaviour therapy], future research could examine and compare the effects of different forms of mindfulness practices on symptoms and correlates of BPD,” they added.

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