Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, University of Ramon-Llull, Barcelona, Spain,
Adult Outpatient Mental Health Center, Consorci Sanitari del Maresme, Hospital of Mataró, Mataró, Spain,
Psychopathology. 2020;53(5-6):254-263. doi: 10.1159/000511349. Epub 2020 Nov 9.
Evidence-based psychosocial interventions for borderline personality disorder (BPD) still face multiple challenges regarding treatment accessibility, adherence, duration, and economic costs. Over the last decade, technology has addressed these concerns from different disciplines. The current scoping review aimed to delineate novel and ongoing clinical research on technology-based psychosocial interventions for patients with BPD. Online databases (PubMed, Cochrane Library, EMBASE, Web of Science, PsycInfo, and Google Scholar) were searched up to June 2020. Technology-based psychosocial treatments included innovative communication (eHealth) and computational (e.g., artificial intelligence), computing (e.g., computer-based), or medical (e.g., functional magnetic resonance imaging [fMRI]) software. Clinical research encompassed any testing stage (e.g., feasibility, efficacy). Fifteen studies met the inclusion criteria. The main findings were the following: almost two-thirds of the studies (9/15) tested software explicitly conceived as adjunctive interventions to conventional therapy; nearly half of the studies (7/15) were referred to as dialectical behavior therapy-based software; most studies (13/15) were focused on the initial stage of the clinical research cycle (feasibility/acceptance/usability testing), reporting good results at this point; more than one-third of the studies (6/15) tested mobile apps; there is emerging evidence for Internet-based interventions and real-time fMRI biofeedback but only little evidence for mHealth interventions, virtual and augmented reality, and computer-based interventions; there was no computational technology-based clinical research; and there was no satisfaction/preference, security/safety, or efficiency testing for any software. Taken together, the results suggest that there is a growing but still incipient amount of technology-based psychosocial interventions for BPD supported by some kind of clinical evidence. The limitations and directions for future research are discussed.
基于证据的边缘型人格障碍(BPD)心理社会干预在治疗可及性、依从性、持续时间和经济成本方面仍然面临多重挑战。在过去的十年中,技术已经从不同的学科解决了这些问题。本综述旨在描绘 BPD 患者基于技术的心理社会干预的新颖和正在进行的临床研究。截至 2020 年 6 月,在线数据库(PubMed、Cochrane Library、EMBASE、Web of Science、PsycInfo 和 Google Scholar)进行了搜索。基于技术的心理社会治疗包括创新的交流(电子健康)和计算(例如,人工智能)、计算(例如,基于计算机的)或医学(例如,功能磁共振成像 [fMRI])软件。临床研究包括任何测试阶段(例如,可行性、疗效)。符合纳入标准的研究有 15 项。主要发现如下:近三分之二的研究(9/15)测试了明确设计为辅助常规治疗的软件;近一半的研究(7/15)被称为基于辩证行为疗法的软件;大多数研究(13/15)集中在临床研究周期的初始阶段(可行性/可接受性/可用性测试),在这一点上报告了良好的结果;超过三分之一的研究(6/15)测试了移动应用程序;有基于互联网的干预和实时 fMRI 生物反馈的新兴证据,但只有很少的 mHealth 干预、虚拟和增强现实以及基于计算机的干预的证据;没有基于计算的技术的临床研究;并且没有针对任何软件进行满意度/偏好、安全性/安全性或效率测试。综上所述,结果表明,有越来越多的基于技术的心理社会干预 BPD 得到了某种临床证据的支持,但仍处于萌芽阶段。讨论了限制和未来研究的方向。