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A growing number of evidence-based interventions have offered treatment for adults with Borderline Personality Disorder. Dialectical Behavior Therapy and Mentalization Based Therapy are both evidence-based treatments initially developed for chronically suicidal adults and have been adapted for adolescents relatively recently. There is increasing interest in treatment for Borderline Personality Disorder traits for adolescents using these two therapies. This article provides the results of a review of treatment outcomes for Dialectical Behavior Therapy versus Mentalization Based Therapy for adolescents. These interventions target Borderline Personality Disorder symptoms, self-harm and suicidal behavior. Adolescents with Borderline Personality traits are at considerable risk for suicide or long-term negative adult psychosocial outcomes. In order to assist clinicians and service providers in choosing the most appropriate treatment, six main electronic databases were searched from inception to April 11, 2019, to identify relevant studies. Twenty-five studies were included in this review; twenty-one on Dialectical Behavior Therapy for Adolescents and four concerning Mentalization Based Therapy for Adolescents. Significant improvements in suicidal ideation, suicidal attempts, self-harm (with or without suicidal intention), Borderline Personality Disorder symptoms, depressive symptoms, trauma, behavior problems and general functioning were reported for both interventions. In addition to outcome comparisons, this review contrasts the theoretical background and implementation issues of these two important psychological treatments for adolescents with Borderline Personality Disorder symptoms.

Background and Aims Multiple national guidelines stress the importance for clinicians to possess good therapeutic skills for working with patients with significant relational difficulties (who may receive a diagnosis of personality disorder). Training clinicians in mentalization‐based treatment skills (MBT‐S) is one approach to address this. The main outcome measure used in MBT‐S studies is the Knowledge and Application of MBT Questionnaire (KAMQ). However, an absence of research into the properties and validity of the KAMQ has limited the methodological quality of MBT‐S evaluations so far. The aim of this study was therefore to investigate the factor structure, internal consistency, reliability, and validity of the KAMQ.Methods Using an existing multiprofessional sample of 217 clinicians from 2014 to 2016, we undertook exploratory factor analysis to determine the factor structure and internal consistency of the KAMQ. Convergent validity of the measure with the Attitudes to Personality Disorder Questionnaire (APDQ) was assessed in a subset of this dataset where both questionnaires had been administered (n = 92). Additionally, by recruiting a new sample of 70 clinicians, we assessed the measure's test‐retest reliability.Results Factor analysis found three factors underlying 17 of the 20 KAMQ items, relating to therapeutic skills in mentalizing, beliefs about applying MBT in practice, and specific MBT knowledge. The KAMQ was revised following the factor analysis to form the KAMQ‐2 with 17 items. Internal consistency (α = .85, 95% confidence interval [CI] = 0.80‐0.89) and test‐retest reliability (ICC = 0.84, 95% CI = 0.73‐0.91) were good. In correlation analyses, the KAMQ‐2 showed convergent validity with the main factor from the APDQ (n = 48; rs = 0.39, P Conclusion The KAMQ‐2 provides a short, reliable self‐report instrument which probes clinicians' knowledge about mentalizing skills, and beliefs about using these. There was preliminary evidence for validity. The properties of the KAMQ‐2 mean that more robust evaluation and development of MBT‐S is now possible.

Psychological and psychosocial interventions have significant potential to treat the mental health and criminogenic needs of forensic mental health patients. However, due to a dearth of high-quality evaluation studies there is limited evidence on the effectiveness of these interventions with this population. This review aimed to quantitatively summarise the effectiveness of psychological therapies delivered in forensic hospitals. The literature was systematically searched to identify controlled evaluations of psychological interventions delivered within inpatient forensic psychiatric settings. Twenty-eight studies were included. Methodological quality was assessed using the SIGN Methodology Checklists. Pooled effect sizes were calculated for fourteen outcome domains. Small effect sizes were found favouring psychological treatment over the comparator condition in increasing insight into mental illness, ameliorating symptoms, improving problem-solving ability, reducing pro-criminal attitudes and improving ward behaviour. A medium effect size was found for treatment increasing patients' knowledge of their mental illness. There were few outcomes for which psychological therapy was associated with improvements beyond that of comparison treatment, and these improvements were generally small. Despite more frequent adoption of a randomised-controlled design, methodological quality remains problematic and more well-designed trials are needed to determine the effectiveness of psychological interventions across outcome domains relevant to forensic patients' recovery.

Recent neurobiological accounts of schizophrenia have included an emphasis on changes in sensory processing. These sensory and perceptual deficits can have a cascading effect onto higher-level cognitive processes and clinical symptoms. One form of sensory dysfunction that has been consistently observed in schizophrenia is altered temporal processing. In this study, we investigated temporal processing within and across the auditory and visual modalities in individuals with schizophrenia (SCZ) and age-matched healthy controls. Individuals with SCZ showed auditory and visual temporal processing abnormalities, as well as multisensory temporal processing dysfunction that extended beyond that attributable to unisensory processing dysfunction. Most importantly, these multisensory temporal deficits were associated with the severity of hallucinations. This link between atypical multisensory temporal perception and clinical symptomatology suggests that clinical symptoms of schizophrenia may be at least partly a result of cascading effects from (multi)sensory disturbances. These results are discussed in terms of underlying neural bases and the possible implications for remediation.

Computational and theoretical accounts hypothesize the basal ganglia play a supramodal "gating" role in the maintenance of working memory representations, especially in preservation from distractor interference. There are currently two major limitations to this account. The first is that supporting experiments have focused exclusively on the visuospatial domain, leaving questions as to whether such "gating" is domain-specific. The second is that current evidence relies on correlational measures, as it is extremely difficult to causally and reversibly manipulate subcortical structures in humans. To address these shortcomings, we examined non-spatial, auditory working memory performance during reversible modulation of the basal ganglia, an approach afforded by deep brain stimulation of the subthalamic nucleus. We found that subthalamic nucleus stimulation impaired auditory working memory performance, specifically in the group tested in the presence of distractors, even though the distractors were predictable and completely irrelevant to the encoding of the task stimuli. This study provides key causal evidence that the basal ganglia act as a supramodal filter in working memory processes, further adding to our growing understanding of their role in cognition.

Social impairment is a core feature of schizophrenia, present from the pre-morbid stage and predictive of outcome, but the etiology of this deficit remains poorly understood. Successful and adaptive social interactions depend on one's ability to make rapid and accurate judgments about others in real time. Our surprising ability to form accurate first impressions from brief exposures, known as "thin slices" of behavior has been studied very extensively in healthy participants. We sought to examine affect and social trait judgment from thin slices of static or video stimuli in order to investigate the ability of schizophrenic individuals to form reliable social impressions of others. 21 individuals with schizophrenia (SZ) and 20 matched healthy participants (HC) were asked to identify emotions and social traits for actors in standardized face stimuli as well as brief video clips. Sound was removed from videos to remove all verbal cues. Clinical symptoms in SZ and delusional ideation in both groups were measured. Results showed a general impairment in affect recognition for both types of stimuli in SZ. However, the two groups did not differ in the judgments of trustworthiness, approachability, attractiveness, and intelligence. Interestingly, in SZ, the severity of positive symptoms was correlated with higher ratings of attractiveness, trustworthiness, and approachability. Finally, increased delusional ideation in SZ was associated with a tendency to rate others as more trustworthy, while the opposite was true for HC. These findings suggest that complex social judgments in SZ are affected by symptomatology.

Self-disturbances were central to Bleuler’s concept of schizophrenia. While explicit self-processing deficits have been reported in the schizophrenia-spectrum, phenomenological experiences of the self are poorly understood. Study 1 analyzed 82 First-Person-Accounts (FPAs), collected across three decades by coding for self/body disturbances with the Perceptual Aberration Scale. Study 2 investigated the role of self-disturbances including out-of-body experiences (OBE), in relation to social isolation and parietal functioning in the schizophrenia-spectrum. 55% of the FPAs reported anomalous self/body disturbances. Dissociative experiences were vastly increased in the schizophrenia-spectrum and were exacerbated by loneliness. Patients and high-schizotypes reported OBEs at 5 times the rate of controls. Interestingly, superior mental rotation ability was linked to a weakened sense of self. FPAs provide valuable insight into the phenomenological self-experiences. Self-disturbances, heightened by social isolation, may be central to the schizophrenia-spectrum. Lastly, the relationship between enhanced imagery and self-disturbances highlight the importance of the parietal regions in schizophrenia.