Psychoeducational Videos and Digital Assessments for BPD

Study Overview
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Brief Summary
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In this study, 100 adults who were recently diagnosed with borderline personality disorder (BPD) will be randomized to either receive educational videos about BPD or educational videos about other topics. All participants in both conditions will complete daily surveys about their emotions and social interactions, and they will respond to surveys and complete cognitive tests at 4 different time points. Some participants will receive feedback about their cognitive test performance, and others will not. The investigators are interested in learning about how accurate education about BPD and enhanced knowledge about cognitive abilities might help people manage their BPD symptoms. The investigators expect that participants who received psychoeducation about BPD will have lower levels of BPD and depressive symptoms than other participants, and that participants who received feedback on their cognitive tests will also have lower symptoms.

Detailed Description
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In this study, 100 adults who were diagnosed with BPD within the past three months will be randomly assigned to receive psychoeducational videos (12 minutes each) about the development, symptoms, naturalistic trajectory, and treatment of BPD (75% of participants) or matched-length videos about non-BPD, health-related topics (25% of participants). One video will be delivered every business day for two weeks. Participants will respond to 5-minute surveys on their recent social interactions, their feelings of threat, connectedness, and aloneness, and will complete a 1-minute version of the Continuous Performance Test (CPT), every day for 30 days. Participants will complete additional full-length surveys and cognitive tests at 4 time points: baseline (Day 1), Time 2 (day 15), Time 3 (Day 30), and Follow-up (day 60). The primary outcome is BPD symptom severity, and the secondary outcome is depressive symptom severity. The investigators expect that BPD-focused psychoeducation and personalized neuropsychological feedback will each lead to separate, measurable reductions in BPD and depressive symptom severity. The investigators also expect that the relationship between psychoeducation and symptom reduction will be mediated by increased knowledge about BPD, and that the relationship between neuropsychological feedback and symptom reduction will be mediated by increased cognitive control.

Official Title
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Online Psychoeducational Videos and Digital Assessments as a Method for Broadening Access to Care for Borderline Personality Disorder

Conditions
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Borderline Personality Disorder

Intervention / Treatment
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* Other: Psychoeducational Videos
* Other: Neuropsychological Feedback
* Other: Non-BPD-related Educational Videos


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: reliable access to a smartphone with a data plan for the duration of the study ability to speak and understand English age 18 years or older diagnosis of BPD within the past 3 months awake and able to complete EMA surveys between 9:00am and 9:00pm on most days located within Massachusetts. Exclusion Criteria: cognitive disability that impedes ability to participate in the study current psychiatric symptoms that interfere with the individual's ability to provide consent or complete the research procedures (e.g., acute mania, acute psychosis, eating disorder threatening medical stability).

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: This study includes two randomization branching points: (1) BPD-related videos vs. non-BPD-related videos, and (2) receive neuropsychological feedback vs. not. At branching point (1), 75% of participants will be directed to the BPD-video condition, and 25% to the non-BPD-video condition. Only the participants in the BPD-video condition will be randomized to receive feedback or not (50% each condition). No non-BPD-video participants will receive feedback.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: BPD Videos and Feedback<br>Ten daily 12-minute psychoeducational videos about BPD and personalized feedback about performance on neuropsychological tasks. | Other: Psychoeducational Videos<br>* A total of ten videos will be delivered daily Monday-Friday over approximately 2 weeks (days 1-15). The videos will each feature a mental health professional who is an expert in BPD explaining the topic in relatable language that can be understood by the general public. Each video will be approximately 10-12 minutes long, for a total of  120 minutes of video. Videos will be shared via a hyperlink in a text message. The psychoeducational videos will cover the following topics: the history of the diagnosis of BPD and current diagnostic criteria, challenging BPD-related stigma, developmental pathways to BPD and biological predisposition, prevalence of BPD and its common comorbid disorders, the naturalistic course of BPD without treatment, available psychotherapeutic treatment options for BPD, current research on the neurobiological and genetic markers related to BPD, the interpersonal hypersensitivity model of BPD, lifestyle changes that are beneficial for people with BPD<br>Other: Neuropsychological Feedback<br>* In the second phase of the study, participants randomized to the Feedback condition will receive an email with a personalized summary of their symptom endorsement and neuropsychological performance. The feedback will include the relevant scores or sub-scores for each cognitive test (CPT, RMET, BEST, DST) from all time points. For each score and sub-score, there will be a description of the cognitive domain that the metric assesses (e.g., attention span in the CPT). The investigators will tailor the feedback to each participant's scores. The investigators may adjust the format or wording of the feedback based on participant responses (i.e., if a participant alerts the investigators that some wording is unclear or confusing). The investigators may also alter the feedback if they learn new information about the relevance or interpretability of these cognitive tests, as this is a growing field of research.<br>|
| Experimental: BPD Videos and No Feedback<br>Ten daily 12-minute psychoeducational videos about BPD. | Other: Psychoeducational Videos<br>* A total of ten videos will be delivered daily Monday-Friday over approximately 2 weeks (days 1-15). The videos will each feature a mental health professional who is an expert in BPD explaining the topic in relatable language that can be understood by the general public. Each video will be approximately 10-12 minutes long, for a total of  120 minutes of video. Videos will be shared via a hyperlink in a text message. The psychoeducational videos will cover the following topics: the history of the diagnosis of BPD and current diagnostic criteria, challenging BPD-related stigma, developmental pathways to BPD and biological predisposition, prevalence of BPD and its common comorbid disorders, the naturalistic course of BPD without treatment, available psychotherapeutic treatment options for BPD, current research on the neurobiological and genetic markers related to BPD, the interpersonal hypersensitivity model of BPD, lifestyle changes that are beneficial for people with BPD<br>|
| Sham Comparator: Non-BPD Videos and No Feedback<br>Ten daily 12-minute educational videos about health-related topics other than BPD. | Other: Non-BPD-related Educational Videos<br>* The non-BPD-related educational videos will be matched in length and frequency to the BPD-related videos. These videos will discuss aspects of mental and physical health that are not related to BPD. Examples may include: nutrition and healthy eating, lifestyle changes to combat stress, what is psychotherapy?, prevalence of depression and anxiety in the general population, healthy sleep habits.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Borderline Symptom List 23 (BSL-23) | Change (increase or decrease) in BSL-23 mean score (average score across all 23 items) at time 2, time 3, and follow-up, as compared to baseline. Minimum score = 0, maximum score = 4. A higher score indicates more severe BPD symptoms. | Baseline (day 1), Time 2 (day 15), Time 3 (day 30), Follow-Up (day 60) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Health Questionnaire (PHQ-9) | Change (increase or decrease) in PHQ-9 total score at time 2, time 3, and follow-up, as compared to baseline. Minimum score = 0, maximum score = 27. A higher score indicates more severe depressive symptoms. | Baseline (day 1), Time 2 (day 15), Time 3 (day 30), Follow-Up (day 60) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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borderline personality disorder, ecological momentary assessment, psychoeducation, neuropsychological feedback, symptom tracking