Effectiveness of EMDR in Borderline Personality Disorder (EMBODIER)

Effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) Applied to Borderline Personality Disorder: an Interventional Prospective Case Control Study in a Real-world Care Setting

Borderline personality disorder (BPD) is a severe mental disorder characterized by four major symptomatological domains: interpersonal instability, perceptive and identity disorders, emotional and behavioural dysregulation. Considering a multifactorial etiological model, it has been suggested that the interaction between behavioral, environmental and genetic factors may promote the development of BPD. Early life stress events (ELS) in childhood and adolescence are highly prevalent in this population and constitute an environmental risk factor for the development of BPD. This correlates with the fact that Post-traumatic Stress Disorder (PTSD) is frequently comorbid in BPD leading to more severe symptoms and worse psychosocial functioning. At the therapeutic level, the treatment of BPD is an open challenge as psychotherapeutic interventions are of limited effectiveness and characterized by high drop-out rates. Eye Movement Desensitization and Reprocessing (EMDR) is the gold standard for treating PTSD. However, scientific evidence on the application of EMDR in patients with BPD is limited. This study aims to assess the feasibility and effectiveness of an EMDR protocol on the nuclear symptomatology of BPD (emotional and behavioral dysregulation) in a group of DBP patients with/without PTSD comorbidity, through a systematic assessment of the peculiar dimensions of the disorder. The basic hypothesis is that EMDR, through a short-term intervention, can act both on the traumatic PTSD-like experiences reported by patients and on the clinical manifestations peculiar to DBP, in particular by improving the emotional regulation capacity of patients with BPD.

Study Overview

• Status: Recruiting
• Conditions: Borderline Personality Disorder
• Intervention / Treatment: Other: Trauma focused psychotherapy: EMDR

• Study Type: Interventional
• Enrollment (Estimated): 56
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alessandra Minelli, Prof; Phone Number: +39 380 3503413; Email: alessandra.minelli@unibs.it
• Study Contact Backup: Name: Stefano Barlati, Prof; Phone Number: +39 338 2027373l; Email: stefano.barlati@unibs.it

Study Locations

• Italy
  • Brescia
    • Brescia, Brescia, Italy, 25123
      • Recruiting
      • ASST Spedali Civili Brescia
      • Contact: Stefano Barlati, Prof; Email: stefano.barlati@unibs.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients must be over 18 years old
• A current diagnosis of PBD according to the DSM-5 was confirmed using the SCID-5-CV and SCID-5-PD diagnostic scale

Exclusion Criteria:

• Suicidal ideation in the last 3 months (suicidal thoughts active intentionally but without specific planning or suicidal thoughts active with planning and intentionality)
• Intellectual disability
• Any active disturbance from use of substances or alcohol
• Any other diagnosis of Axis I, except for Depressive Disorders, Anxious Spectrum Disorders, Obsessive-Compulsive Disorder.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: EMDR intervention; 14 sessions of psychotherapy with EMDR will be carried out with patients. One session per week, lasting 90 minutes. The first two sessions will be used for the description of the EMDR method and for stabilization, then there will be treatment sessions.	Other: Trauma focused psychotherapy: EMDR; 14 sessions of psychotherapy with EMDR will be carried out with patients. One session per week, lasting 90 minutes. The first two sessions will be used for the description of the EMDR method and for stabilization, then there will be treatment sessions.
No Intervention: Waiting List; Treatment as usual

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Core symptoms of BPD	The primary outcome is the improvement of the core symptoms of BPD, measured by the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). The scale ranges from 0 to 36, with higher scores indicating greater severity.	4 timepoints: baseline (T0), after 6 (T6), 12 (T12), 18 (T18) weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self perception of BPD symptoms	Self perception of BPD symptoms measured by the Borderline Symptom List 23 (BSL-23). The scale ranges from 0 to 4, with higher scores indicating greater severity.	4 timepoints: baseline (T0), after 6 (T6), 12 (T12), 18 (T18) weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emotion disregulation	Emotion disregulation measured by the Difficulties in emotion regulation scale (DERS-36). The scale ranges from 36 to 180, with higher scores indicating greater difficulties in emotion regulation.	4 timepoints: baseline (T0), after 6 (T6), 12 (T12), 18 (T18) weeks
Ruminative thinking	Ruminative thinking measured by the Rumination Response Scale (RRS). The scale ranges from 22 to 88, with higher scores indicating greater rumination.	4 timepoints: baseline (T0), after 6 (T6), 12 (T12), 18 (T18) weeks
Dissociative symptoms	Dissociative symptoms measured by the Dissociative Experiences Scale (DES). The scale ranges from 0 to 100, with higher scores indicating greater dissociative experiences.	4 timepoints: baseline (T0), after 6 (T6), 12 (T12), 18 (T18) weeks

Collaborators and Investigators

• Sponsor: Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
• Investigators: Principal Investigator: Alessandra Minelli, Prof, Università degli Studi di Brescia

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2024
• Primary Completion (Estimated): May 31, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: July 2, 2024
• First Submitted That Met QC Criteria: July 2, 2024
• First Posted (Actual): July 10, 2024

Study Record Updates

• Last Update Posted (Actual): February 25, 2026
• Last Update Submitted That Met QC Criteria: February 23, 2026
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Personality Disorders; Borderline Personality Disorder
• Other Study ID Numbers: EMDR2023-02

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No