Metacognition as a Predictor of Change in the Treatment for Borderline Personality Disorder: A Preliminary Pilot Study

There is evidence that a key feature in borderline personality disorder (BPD) is the difficulty to reflect on one's own as well as on other people's state of mind. So far, no study has examined the link between metacognition and symptom change presented by BPD patients across treatment. This preliminary pilot study represents a first step in describing impairments in different dimensions of metacognition and their connection with the symptoms presented by a N = 10 BPD sample. The transcripts from the first and the penultimate session of a 10-session version of Good Psychiatric Management were analyzed. The global score and the 3 subscales of the Metacognition Assessment Scale-Revised were used to assess metacognitive abilities: Understanding of one's own mind, Understanding of other's mind, and Mastery. Symptoms were assessed with the Outcome Questionnaire-45.2. Results show a general low level of metacognition. Therapy sessions with BPD patients seem to be characterized by impairments in metacognition, notably in the reflection on other's states of mind and in the use of this information to solve conflicts and problems. Moreover, sessions highlighting a higher level of the Understanding of other's mind at the onset of treatment were linked with better outcome compared to sessions showing poorer metacognitive abilities in this area. Implications for an integrated treatment for BPD and future research are discussed. La metacognición como predictor del cambio en el tratamiento del trastorno límite de la personalidad: un estudio piloto preliminar Hay evidencia de que una característica clave en el Trastorno Límite de la Personalidad (TLP) es la dificultad de reflexionar sobre el estado de ánimo propio y sobre el estado de ánimo de otras personas. Hasta el momento, ningún estudio ha examinado el vínculo entre la metacognición y el cambio de síntomas presentado por pacientes con TLP durante el tratamiento. Este estudio piloto preliminar representa un primer paso para describir los impedimentos en diferentes dimensiones de la metacognición y su conexión con los síntomas presentados por una muestra de N = 10 TLP. Se analizaron las transcripciones de la primera y la penúltima sesión de una versión de diez sesiones de Good Psychiatric Management. El puntaje global y las tres subescalas de la Escala de Evaluación de Metacognición-Revisada (MAS-R) se utilizaron para evaluar las habilidades metacognitivas: Comprensión de la propia Mente, Comprensión de la Mente de Otr