Recruiting

Cognitive Reappraisal Training

Sponsor:

Icahn School of Medicine at Mount Sinai

Code:

NCT06772831

Conditions

Borderline Personality Disorder

Eligibility Criteria

Sex: All

Age: 18 - 55

Healthy Volunteers: Not accepted

Interventions

Cognitive Reappraisal by Distancing

Downregulate condition

Study Details

Brief summary:

Previous work by the group convinced the researchers to pursue development of focused cognitive reappraisal training as a novel approach to treatment of BPD, either as stand-alone treatment or in concert with evidence-based treatments of BPD. The present proposal aims to refine and test a proposed clinical intervention for BPD patients, training in reappraisal-by-distancing, in terms of its ability to influence hypothesized neural and behavioral targets and, once that is established, to demonstrate its ability improve clinically relevant outcome measures.

Conditions

Borderline Personality Disorder

Study ID

NCT06772831

Start date

Nov 15, 2024

Status verified date

Sep, 2026

Completion date

Jul 31, 2027

Anticipated

Primary completion date

Jul 31, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 55

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Medically healthy men and women with Borderline Personality Disorder who are mentally competent and give informed voluntary written consent.
  • Participants will be between the ages of 18 and 55.
  • Within these requirements, the inclusion and exclusion criteria do not reflect participation based on gender or racial/ethnic group. The targeted/planned enrollment is a reflection of previous recruitment of female and ethnic minorities in other studies conducted by the PI and their colleagues and includes representations of both genders and all minorities.
  • Participants with comorbid avoidant personality disorder will be included.
  • Participants who meet criteria for PTSD will be included as long as they are not actively experiencing symptoms.

Exclusion Criteria:

  • Participants will not meet criteria for Schizotypal Personality Disorder.
  • Participants currently meeting criteria for Major Depressive Disorder will be excluded.
  • BPD participants will not meet DSM-5 criteria for present PTSD, bipolar I disorder, schizophrenia, schizoaffective disorder, substance use disorder within the past 6 months, organic mental syndromes, head trauma, schizotypal personality disorder, avoidant personality disorder, CNS neurological disease, or seizure disorder. Participants meeting criteria for a non-IV substance use disorder more than 6 months prior to enrollment will not be excluded. This study allows patients who are currently taking psychotropic medications or are in psychotherapy, so long as there has been no change in medication or psychotherapy over the preceding two months.
  • Participants currently meeting criteria for major depressive disorder.
  • Participants meeting criteria for substance use disorder within the last 6 months or of an IV-substance use disorder at any time.
  • Participants may not have a pacemaker, surgical clips, any metallic implants, or shrapnel fragments that would contraindicate MRI scanning.
  • Pregnant women.

Study Design

Enrollment

130 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Cognitive Reappraisal-by-Distancing (CRD)

Patients will be coached to use cognitive reappraisal-by-distancing to downregulate their negative reactions to aversive emotional pictures using practice pictures.

active comparator: Downregulate Condition (CD)

Patients will be coached to practice their customary emotion regulatory techniques in a treatment occurring twice a week for 6 weeks.

Interventions

Cognitive Reappraisal by Distancing

Reappraisal-by-distancing treatment. Patients meet 2 times a week for 6 weeks to learn reappraisal by distancing through repeated practice with negative emotional pictures. The therapist will help model and shape the technique.

Downregulate condition

Patients either meet 2x a week for 6- weeks to gain added practice, under the guidance of a therapist, using their customary emotion regulatory strategies to downregulate their negative reactions to aversive pictures.

Primary outcome measure

  • Change in Picture Induced Negative Emotion Signature (PINES) Network Activity [ Time Frame: Baseline and 6 weeks of treatment ]

Central Contacts and Locations

Central contacts

Harold W Koenigsberg, MD

718-584-9000harold.koenigsberg@mssm.edu

Olivia Berin, BA

212-585-4649olivia.berin@mssm.edu

Locations

Icahn School of Medicine at Mount Sinai

Recruiting

New York, New York, United States, 10029

Principal Investigator:

Harold W Koenigsberg

More Information

Sponsor

Icahn School of Medicine at Mount Sinai

Last update posted

Sep 9, 2026

Last verified

Sep, 2026

Keywords

  • BPD
  • Treatment
  • fMRI
  • Cognitive Reappraisal
  • Emotion Regulation
  • Borderline Personality

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Icahn School of Medicine at Mount Sinai on 2026-09-09.