Mentalization and epigenetic changes in psycotherapy of adolescents diagnosed with borderline personality disorder
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Date
2021
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Abstract
Genetic and early environmental factors are interwoven in the etiopathogenesis of
Borderline Personality Disorder (BPD). Epigenetic mechanisms, allow the molecular
machinery to adapt to environmental conditions. There are gaps in the knowledge of how
epigenetic mechanisms are involved in the effects of early affective environment, development
of BPD and psychotherapy response. This work aims to explore changes in DNA methylation
of FKBP5 gene, which encodes for a stress response protein, in relation to psychotherapy, on
symptomatology and underlying psychological processes in a sample of 11 female adolescents
diagnosed with BPD. For this purpose, measures of early trauma, borderline and depressive
symptoms, psychotherapy outcome, mentalization and emotional regulation were studied
longitudinally at baseline, 3 and 6 months. Percentage DNA methylation levels of FKBP5
gene intron 7 were measured at the same times.
A significant reduction of borderline and depressive symptoms was found. No significant
change was observed in emotional regulation and mentalization.
A reduction in the average DNA methylation was observed over time. Additionally, it was
observed that this decrease in methylation occurred only in those individuals who reported the
presence of early trauma and responded to psychotherapy.
The results support an effect of psychotherapy on epigenetic mechanisms associated with
the stress response, specifically DNA methylation of FKBP5, which is concordant with
previous studies in other phenotypes. The fact that the epigenetic change occurred only in the
presence of early trauma is suggestive of a specific molecular mechanism of recovery.
The results should be taken with caution given the small sample size. Further research is
needed to include covariates that modify DNA methylation and incorporate endocrinological
markers and therapeutic process variables.
Psychotherapy focused on personality pathology could lead to changes in DNA
methylation causing permanent reprogramming of phenotypic adaptation to the interpersonal
environment.
Description
Tesis (Doctor en Psicoterapía)--Pontificia Universidad Católica de Chile, 2021