Pattern, Preferences, Barriers, and Correlates of Self-Reported Physical Activity in Adults With Borderline Personality Disorder An Online Survey in Western Countries
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Abstract
Borderline personality disorder (BPD) is characterized by an instability of self-image, interpersonal relationships, and emotions and is highly comorbid with other disorders. Physical activity has shown great results in treating these disorders. Physical activity intervention should be built considering the preferences and barriers of the targeted individuals. However, to this day no study analyzed the preferences and barriers to physical activity in individuals with BPD, which is the goal of this study. We used an online survey to question 192 adults with a self-reported diagnosis of BPD from Canada, France, the United States, England, Switzerland, and New Zealand. Participants complete 607 minutes of physical activity weekly on average. They prefer walking (66.7%), biking (33.3%), aquatic activities (29.0%), and running (24.2%). Their main barriers to physical activity are having a friend over, having other engagements, and recovering from an injury. Additionally, they prefer engaging in individually supervised physical activities outside, typically in long sessions of moderate intensity. Finally, a majority of participants are interested in receiving physical activity advice, but most did not receive any. The professionals from whom they would prefer to receive advice are trainers, psychiatrists, physical therapists, and psychologists. These findings are crucial for tailoring future physical activity interventions for adults with BPD.
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References
Abrantes, A. M., Battle, C. L., Strong, D. R., Ing, E., Dubreuil, M. E., Gordon, A., & Brown, R. A. (2011). Exercise preferences of patients in substance abuse treatment. Mental Health and Physical Activity, 4(2), 79–87. https://doi.org/10.1016/j.mhpa.2011.08.002
Adler, N., Singh-Manoux, A., Schwartz, J., Stewart, J., Matthews, K., & Marmot, M. G. (2008). Social status and health: A comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA. Social Science and Medicine, 66(5), 1034–1045. https://doi.org/10.1016/j.socscimed.2007.11.031
Armstrong, T., & Bull, F. (2006). Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). Journal of Public Health, 14(2), 66–70. https://doi.org/10.1007/s10389-006-0024-x
Bastien, C. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297–307. https://doi.org/10.1016/s1389-9457(00)00065-4
Batterham, P. J. (2014). Recruitment of mental health survey participants using Internet advertising: content, characteristics and cost effectiveness. International Journal of Methods in Psychiatric Research, 23(2), 184–191. https://doi.org/10.1002/mpr.1421
Beeney, J. E., Hallquist, M. N., Clifton, A. D., Lazarus, S. A., & Pilkonis, P. A. (2018). Social disadvantage and borderline personality disorder: A study of social networks. Personality Disorders: Theory, Research, and Treatment, 9(1), 62–72. https://doi.org/10.1037/per0000234
Biskin, R. S. (2015). The Lifetime Course of Borderline Personality Disorder. The Canadian Journal of Psychiatry, 60(7), 303–308. https://doi.org/10.1177/070674371506000702
Blum, N., M.S.W., St. John, D., M.A., P.A., Pfohl, B., M.D., Stuart, S., M.D., McCormick, B., M.A., Allen, J., Ph.D., Arndt, S., Ph.D., & Black, D. W., M.D. (2008). Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Outpatients With Borderline Personality Disorder: A Randomized Controlled Trial and 1-Year Follow-Up. American Journal of Psychiatry, 165(4), 468–478. https://doi.org/10.1176/appi.ajp.2007.07071079
Bohus, M., Kleindienst, N., Limberger, M. F., Stieglitz, R.-D., Domsalla, M., Chapman, A. L., Steil, R., Philipsen, A., & Wolf, M. (2008). The Short Version of the Borderline Symptom List (BSL-23): Development and Initial Data on Psychometric Properties. Psychopathology, 42(1), 32–39. https://doi.org/10.1159/000173701
Cabassa, L. J., Stefancic, A., Wang, X., Guo, S., Lu, N. Y., & Weatherly, C. (2020). Correlates of Physical Activity and Cardiorespiratory Fitness in Racially and Ethnically Diverse People with Serious Mental Illness in Supportive Housing. Community Mental Health Journal, 56(6), 1139–1152. https://doi.org/10.1007/s10597-020-00610-x
Cailhol, L., Pelletier, É., Rochette, L., Laporte, L., David, P., Villeneuve, É., Paris, J., & Lesage, A. (2017). Prevalence, Mortality, and Health Care Use among Patients with Cluster B Personality Disorders Clinically Diagnosed in Quebec: A Provincial Cohort Study, 2001-2012. The Canadian Journal of Psychiatry, 62(5), 336–342. https://doi.org/10.1177/0706743717700818
Castle, D. J. (2019). The complexities of the borderline patient: how much more complex when considering physical health? Australasian Psychiatry, 27(6), 552–555. https://doi.org/10.1177/1039856219848833
Choi, I., Milne, D. N., Glozier, N., Peters, D., Harvey, S. B., & Calvo, R. A. (2017). Using different Facebook advertisements to recruit men for an online mental health study: Engagement and selection bias. Internet Interventions, 8, 27–34. https://doi.org/10.1016/j.invent.2017.02.002
Colley, R. C., Butler, G., Garriguet, D., Prince, S. A., & Roberts, K. C. (2018). Comparison of self-reported and accelerometer-measured physical activity in Canadian adults. Health Reports, 29(1), 3–15.https://pubmed.ncbi.nlm.nih.gov/30566204/
Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending linehan’s theory. Psychological Bulletin, 135(3), 495–510. https://doi.org/10.1037/a0015616
DeShong, H. L., & Tucker, R. P. (2019). Borderline personality disorder traits and suicide risk: The mediating role of insomnia and nightmares. Journal of Affective Disorders, 244, 85–91. https://doi.org/10.1016/j.jad.2018.10.097
El-Gabalawy, R., Katz, L. Y., & Sareen, J. (2010). Comorbidity and Associated Severity of Borderline Personality Disorder and Physical Health Conditions in a Nationally Representative Sample. Psychosomatic Medicine, 72(7), 641–647. https://doi.org/10.1097/psy.0b013e3181e10c7b
Euler, S., Nolte, T., Constantinou, M., Griem, J., Montague, P. R., Fonagy, P. (2021). Interpersonal Problems in Borderline Personality Disorder: Associations With Mentalizing, Emotion Regulation, and Impulsiveness. Journal of Personality Disorders, 35(2), 177–193. https://doi.org/10.1521/pedi_2019_33_427
Firth, J., Cotter, J., Elliott, R., French, P., & Yung, A. R. (2015). A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychological Medicine, 45(7), 1343–1361. https://doi.org/10.1017/s0033291714003110
Furlanetto, L. M., Mendlowicz, M. V., & Romildo Bueno, J. (2005). The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. Journal of Affective Disorders, 86(1), 87–91. https://doi.org/10.1016/j.jad.2004.12.011
Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S., & Zanarini, M. C. (2018). Borderline personality disorder. Nature Reviews Disease Primers, 4(1). https://doi.org/10.1038/nrdp.2018.29
Kuo, C.-J., Chen, W.-Y., Tsai, S.-Y., Chen, P.-H., Ko, K.-T., & Chen, C.-C. (2018). Excessive mortality and causes of death among patients with personality disorder with comorbid psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology, 54(1), 121–130. https://doi.org/10.1007/s00127-018-1587-x
Lawn, S., & McMahon, J. (2015). Experiences of care by Australians with a diagnosis of borderline personality disorder. Journal of Psychiatric and Mental Health Nursing, 22(7), 510–521. https://doi.org/10.1111/jpm.12226
Linehan, M. (2014). In DBT? Skills Training Manual. Guilford Publications.
Mehren, A., Reichert, M., Coghill, D., Müller, H. H. O., Braun, N., & Philipsen, A. (2020). Physical exercise in attention deficit hyperactivity disorder – evidence and implications for the treatment of borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 7(1). https://doi.org/10.1186/s40479-019-0115-2
Patil, I. (2021). Visualizations with statistical details: The “ggstatsplot” approach. Journal of Open Source Software, 6(61), 3167. https://doi.org/10.21105/joss.03167
Ravindran, A. V., Balneaves, L. G., Faulkner, G., Ortiz, A., McIntosh, D., Morehouse, R. L., Ravindran, L., Yatham, L. N., Kennedy, S. H., Lam, R. W., MacQueen, G. M., Milev, R. V., Parikh, S. V. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder. The Canadian Journal of Psychiatry, 61(9), 576–587. https://doi.org/10.1177/0706743716660290
Romain, A. J., & Bernard, P. (2018). Behavioral and Psychological Approaches in Exercise-Based Interventions in Severe Mental Illness. In Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment (pp. 187–217). Academic Press. https://doi.org/10.1016/B978-0-12-812605-9.00010-1
Romain, A. J., Bernard, P., Akrass, Z., St-Amour, S., Lachance, J.-P., Hains-Monfette, G., Atoui, S., Kingsbury, C., Dubois, E., Karelis, A. D., & Abdel-Baki, A. (2020). Motivational theory-based interventions on health of people with several mental illness: A systematic review and meta-analysis. Schizophrenia Research, 222, 31–41. https://doi.org/10.1016/j.schres.2020.05.049
Romain, A. J., Longpré-Poirier, C., Tannous, M., & Abdel-Baki, A. (2020). Physical activity for patients with severe mental illness: Preferences, barriers and perceptions of counselling. Science and Sports, 35(5), 289–299. https://doi.org/10.1016/j.scispo.2020.03.005
Schuch, F., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P., Reichert, T., Bagatini, N. C., Bgeginski, R., & Stubbs, B. (2017). Physical activity and sedentary behavior in people with major depressive disorder: A systematic review and meta-analysis. Journal of Affective Disorders, 210, 139–150. https://doi.org/10.1016/j.jad.2016.10.050
Shah, R., & Zanarini, M. C. (2018). Comorbidity of Borderline Personality Disorder. Psychiatric Clinics of North America, 41(4), 583–593. https://doi.org/10.1016/j.psc.2018.07.009
Soloff, P. H., Lynch, K. G., & Kelly, T. M. (2002). Childhood Abuse as a Risk Factor For Suicidal Behavior in Borderline Personality Disorder. Journal of Personality Disorders, 16(3), 201–214. https://doi.org/10.1521/pedi.16.3.201.22542
Spittaels, H., Foster, C., Oppert, J.-M., Rutter, H., Oja, P., Sjöström, M., & De Bourdeaudhuij, I. (2009). Assessment of environmental correlates of physical activity: development of a European questionnaire. International Journal of Behavioral Nutrition and Physical Activity, 6(1). https://doi.org/10.1186/1479-5868-6-39
St-Amour, S., Cailhol, L., Ruocco, A. C., & Bernard, P. (2021). Could physical exercise be an effective treatment for adults with borderline personality disorder? Psychiatry Research, 295, 113625. https://doi.org/10.1016/j.psychres.2020.113625
St-Amour, S., Cailhol, L., Ruocco, A. C., & Bernard, P. (2022). Acute effect of physical exercise on negative affect in borderline personality disorder: A pilot study. Clinical Psychology in Europe, 4(2). https://doi.org/10.32872/cpe.7495
St‐Amour, S., Bérubé, F., Cailhol, L., & Le Corff, C. (2022). Are physical activity and nutrition linked to personality disorders? Health habits and personality disorders: A scoping review. Personality and Mental Health, 17(2), 147–156. https://doi.org/10.1002/pmh.1568
Statistics Canada, Prince, S. A., Roberts, K. C., Reed, J. L., Biswas, A., Colley, R. C., & Thompson, W. (2020). Daily physical activity and sedentary behaviour across occupational classifications in Canadian adults. Government of Canada. https://doi.org/10.25318/82-003-X202000900002-ENG
Stubbs, B., & Rosenbaum, S. (2018). In Exercise-Based Interventions for Mental Illness: Physical Activity as Part of Clinical Treatment. Academic Press.
Vancampfort, D., De Hert, M., Stubbs, B., Soundy, A., De Herdt, A., Detraux, J., & Probst, M. (2015). A Systematic Review of Physical Activity Correlates in Alcohol Use Disorders. Archives of Psychiatric Nursing, 29(4), 196–201. https://doi.org/10.1016/j.apnu.2014.08.006
Vancampfort, D., Firth, J., Schuch, F. B., Rosenbaum, S., Mugisha, J., Hallgren, M., Probst, M., Ward, P. B., Gaughran, F., De Hert, M., Carvalho, A. F., & Stubbs, B. (2017). Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta‐analysis. World Psychiatry, 16(3), 308–315. https://doi.org/10.1002/wps.20458
Vancampfort, D., Hallgren, M., Firth, J., Rosenbaum, S., Schuch, F. B., Mugisha, J., Probst, M., Van Damme, T., Carvalho, A. F., & Stubbs, B. (2018). Physical activity and suicidal ideation: A systematic review and meta-analysis. Journal of Affective Disorders, 225, 438–448. https://doi.org/10.1016/j.jad.2017.08.070
Vancampfort, D., Knapen, J., Probst, M., Scheewe, T., Remans, S., & De Hert, M. (2011). A systematic review of correlates of physical activity in patients with schizophrenia. Acta Psychiatrica Scandinavica, 125(5), 352–362. https://doi.org/10.1111/j.1600-0447.2011.01814.x
Vancampfort, D., Probst, M., Scheewe, T., De Herdt, A., Sweers, K., Knapen, J., van Winkel, R., & De Hert, M. (2013). Relationships between physical fitness, physical activity, smoking and metabolic and mental health parameters in people with schizophrenia. Psychiatry Research, 207(1-2), 25–32. https://doi.org/10.1016/j.psychres.2012.09.026
Victor, S. E., & Klonsky, E. D. (2016). Validation of a Brief Version of the Difficulties in Emotion Regulation Scale (DERS-18) in Five Samples. Journal of Psychopathology and Behavioral Assessment, 38(4), 582–589. https://doi.org/10.1007/s10862-016-9547-9
WHO ASSIST Working Group. (2002). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction, 97(9), 1183–1194. https://doi.org/10.1046/j.1360-0443.2002.00185.x
Zhang, Z. (2016). Variable selection with stepwise and best subset approaches. Annals of Translational Medicine, 4(7), 136–136. https://doi.org/10.21037/atm.2016.03.35