Brin F S Grenyer

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Verified

Brin verified their affiliation via an institutional email.

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• PhD
• Senior Professor at University of Wollongong

Although recovery from borderline personality disorder (BPD) is common, not all individuals improve over time. This study sought to examine the features that contribute to response or non‐response for individuals at different stages of recovery from BPD over a longitudinal follow‐up. Participants were individuals with a diagnosis of BPD that were f...

Background: Although there is growing evidence that stepped models of care are useful for providing appropriate, person centered care, there are very few studies applied to personality disorders. A brief, four session, psychological treatment intervention for personality disorder within a whole of service stepped care model was evaluated. The inte...

Background The relative burden and risk of readmission for people with personality disorders in hospital settings is unknown. Aims To compare hospital use of people with personality disorder with that of people with other mental health diagnoses, such as psychoses and affective disorders. Method Naturalistic study of hospital presentations for me...

Background and objectives People with personality disorders are prevalent in emergency and inpatient mental health services. We examined whether implementing a stepped care model of psychological therapy reduces demand on hospital units by people with personality disorder, in a cluster randomized controlled trial. Method A total of 642 inpatients...

Personality disorders are a highly prevalent mental health condition. Historically, clinician attitudes have been negative, and only a small number have specialised training. This study evaluated clinician attitudes and confidence in working with people with personality disorder following the combination of training and implementation of a stepped...

Background Narcissistic personality disorder (NPD) is known to comprise two distinct but connected phenotypes related to ‘grandiosity’ and ‘vulnerability’, respectively. While evidence suggests differing countertransference responses to narcissism subtype expression, no study has examined this using a qualitative methodology and explored associatio...

Background While the majority of personality disorder research focuses on adults, research shows that borderline personality disorder (BPD) often emerges in adolescence, highlighting the importance of early intervention for this population. Despite this, there are limited intervention programs tailored specifically for adolescents with BPD, and no...

Individuals with borderline personality disorder (BPD) often hold pervasive and negative self-views and experience feelings of low connectedness toward others despite effective treatment. This study aimed to identify neural and affective mechanisms of identity disturbance in BPD that contribute to difficulties in relating to others. Participants di...

Introduction: Consumers with personality disorder/vulnerabilities and their carers may not always receive appropriate, compassionate care through health services. Aim/Question: To study experiences of the emergency department, inpatient and outpatient services from the perspectives of people with lived experience of personality disorder/vulnerabili...

Borderline personality disorder (BPD) is a psychological disorder that is diagnosed predominantly in females yet is equally as prevalent in males. Many empirical research studies on the treatment of BPD have been conducted with only female participants. We aimed to investigate the impact of current treatments for BPD on men compared to women. Using...

Objectives Narcissistic personality disorder as captured in categorical diagnostic systems (e.g., DSM‐5) emphasizes grandiose features more associated with masculine norms and under‐emphasizes vulnerable features more associated with femininity. This poses significant implications in diagnostic outcome and clinical treatment in women with narcissis...

Modern diagnostic and classification frameworks such as the ICD‐11 and DSM‐5‐AMPD have adopted a dimensional approach to diagnosing personality disorder using a dual “severity” and “trait” model. As narcissistic personality has historically struggled to be adequately captured in dominant diagnostic systems, this study investigated the utility of th...

Introduction A disturbed, negative sense of self is associated with various interpersonal difficulties and is characteristic of disorders such as borderline personality disorder (BPD). Negative self-views may affect an individuals’ ability to build positive relationships, including a therapeutic relationship. However, it is not yet well understood...

Borderline personality disorder (BPD) is a severe mental health disorder that is subject to significant stigmatisation. With language being a key reinforcer of stigma, this co‐produced study aims to explore the language use regarding BPD and its effect on those with BPD and carers. Recommendations to reduce stigmatisation are provided for both clin...

Objective There are few studies on the efficacy and acceptability of psychotherapy conducted via telehealth technology for people with personality disorder. This study aims to examine clinician perspectives on virtual psychotherapy. Method Twenty multidisciplinary mental health clinicians (85% female, average age 42 years) with at least 2 years of...

Borderline personality disorder (BPD) is a severe mental health condition marked by impairments in self and interpersonal functioning. Stigma from health staff may often result in a reluctance to diagnose, impacting recovery trajectories. Qualitative interviews were conducted with participants (N = 15; M Age = 36.4 years, SD = 7.5; 93.3% female) wi...

The value that carer peer workers may offer family members with lived experience of BPD has not been investigated thoroughly to date. This study aims to investigate the unique contributions of carer peer workers in supporting family members who care for consumers with BPD. Mixed method questionnaires were completed by family members, consumers, car...

Identifying correlates of treatment response may help to improve outcomes for adolescents and young people with substance use disorder (SUD). We assessed treatment response in an adolescent/young person-specific community-based residential SUD programme located in NSW, Australia. Participants (N = 100) were aged 16–24 years and recruited between 20...

Background: Adolescents with depression exhibit negative biases in autobiographical memory with detrimental consequences for their self-concept and well-being. Investigating how adolescents relive positive autobiographical memories and activate the underlying neural networks could reveal mechanisms that drive such biases. This study investigated n...

Background Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following...

Background Despite increasing evidence for the effectiveness of psychotherapy for Borderline Personality Disorder (BPD), estimates show that approximately half of those in treatment do not clinically improve or reach reliable change criteria. There are limited qualitative descriptions of treatment factors associated with non-response from the persp...

The Psychodynamic Diagnostic Manual–2nd edition (PDM-2) stresses the importance of putting the complex person back at the center of the diagnostic, therapeutic, and research process, fostering the integration between categorical and dimensional classifications, and emphasizing both individual variations and commonalities. Accordingly, the manual ai...

Background: Self-harm presents significant risk for individuals with borderline personality disorder (BPD). Both self-harm and BPD are associated with deficits in mindfulness and emotion dysregulation. Previous research suggests that thought suppression and emotional inexpressivity may underpin self-harm in people with BPD, suggesting potential li...

Borderline Personality Disorder (BPD) is often perceived to be a female-predominant disorder in both research and clinical contexts. Although there is growing recognition of possible sex differences, the current literature remains fragmented and inconclusive. This scoping review aimed to synthesize available research evidence on potential sex diffe...

Objective We developed and piloted a novel art-based online skills program led by a peer mental health professional with lived experience of complex mental health, including Borderline Personality Disorder (BPD). Key challenges of living with BPD and emotion dysregulation were addressed through artmaking informed by a dialectical framework and skil...

Research suggests that the incidents of self-harm among young people are increasing and age of onset of self-harm is decreasing. There is limited understanding of how widespread the problem of self-harm among younger school students is, and how schools respond to these incidents. This study used an in-depth qualitative approach to understand self-h...

Purpose of review: Borderline personality disorder (BPD) is a severe and common psychiatric disorder and though evidence-based psychotherapies are effective, rates of treatment nonresponse are as high as 50%. Treatment studies may benefit from interdisciplinary approaches from neuroscience and genetics research that could generate novel insights i...

Background Low personal agency is the concept of attributing successes and failures to external factors rather than personal characteristics. Previous research supported links between low personal agency and symptoms of borderline personality disorder (BPD). The present research followed patients in an outpatient dialectical behavioural therapy (DB...

Background Both the latest edition of the DSM-5 as well as the new ICD-11 have established a new focus in the diagnosis of personality disorders: the assessment of personality functioning. This recent shift in focus converges with long-standing psychodynamic conceptualizations of personality pathology, particularly Kernberg’s object relations model...

The Psychodynamic Diagnostic Manual - Second Edition (PDM-2) has emerging evidence supporting its clinical utility, yet one of the main limitations remains the conjecture that considerable training and experience is required. It also remains unclear how the PDM-2 framework compares with current DSM measures of personality pathology such as the Leve...

Background: Despite increasing evidence for the effectiveness of psychotherapy for Borderline Personality Disorder (BPD), estimates show that approximately half of those in treatment do not clinically improve or reach reliable change criteria. There are limited qualitative descriptions of treatment factors associated with non-response from the pers...

Self-harm in children and adolescents is a growing public health issue. Parents are forefront in identifying, responding to and supporting their child to seek help. A sequential mixed-method study which included an online survey ( N = 37) and a semi-structured interview ( n = 10) was conducted to understand parents’ experiences of supporting and ac...

An important component of case formulation is to understand the patient's difficulties in the context of their relationships. The Core Conflictual Relationship Theme (CCRT) method provides a clinical guide for understanding the narratives of relationship conflicts told during therapy. We follow the case of Barbara, a 60 year old with a long history...

Background Pathological narcissism is a severe mental health condition that includes disturbances in interpersonal functioning. Interpersonal difficulties by those affected include aggressive, domineering, cold and coercive behaviours which often result in strong negative reactions from others. We sought to examine the moment-to-moment patterns tha...

Adolescent self-harm is a significant public health issue. We aimed to understand how parent stress response styles to their child’s self-harm affects their wellbeing and functioning and the wider family. Thirty-seven participants in Australia (parents; 92% female) completed a mixed methods survey regarding their adolescent child’s self-harm. We co...

Objective Peer support may be a valuable way to support recovery in borderline personality disorder (BPD). This study investigates the role of peer workers in services supporting consumers with BPD. Method We studied peer work delivered in five different types of mental health services, including outpatient mental health and independent peer-run s...

Pathological narcissism is marked by deficits in psychosocial functioning. Difficulties in relationships include instances of aggression, devaluation and control; however, few studies have examined these relationships from the perspective of partners and family members. We studied participants who were in relationships with relatives high in narcis...

Highlight This is the first systematic review to investigate non-response to psychotherapy for borderline personality disorder. Background Psychotherapy is the recommended treatment for borderline personality disorder. While systematic reviews have demonstrated the effectiveness of psychotherapy for borderline personality disorder, effect sizes re...

Background Chronic feelings of emptiness are significant in the lives of people with Borderline Personality Disorder (BPD). Feelings of emptiness have been linked to impulsivity, self-harm, suicidal behaviour and impaired psychosocial function. This study aimed to understand the experience of chronic emptiness, the cognitions, emotions and behaviou...

Background Borderline Personality Disorder (BPD) is a prevalent and serious mental health condition. People can experience recovery or remission after receiving psychotherapy for BPD; however, it is estimated that about 45% of people in well conducted treatment trials do not respond adequately to current psychological treatments. Aim To further ad...

Background Reducing substance use in youth is a global health priority. We compared two cohorts from the same 12-week residential substance use disorder (SUD) facility over a ten year period: Cohort A (2008-2009) and Cohort B (2018-2020). The essential components of the program remained the same with the primary treatment being dialectical behaviou...

Background: Aspects of pathological narcissism, such as grandiosity, vulnerability and entitlement, tend be enacted in therapeutic settings, negatively influencing outcome and alliance between the clients and therapist. This research took an experimental approach to understanding the interplay between the emotional reactions of individuals with a p...

At least one in four patients with substance use disorder (SUD) meet criteria for personality disorder and overlapping neurocognitive deficits may reflect shared neurobiological mechanisms. We studied neurocognition in females attending residential SUD treatment by comparing SUD with (n = 20) or without (n = 30) comorbid personality disorder. Neuro...

Background Personal agency- the degree to which one believes they have control over their life- is thought to influence how people understand their interpersonal relationships. Links between adult attachment and personal agency are theoretically relevant to the experience of borderline personality disorder (BPD) but this has yet to be empirically e...

Background Borderline personality disorder (BPD) is a high prevalence and serious mental health disorder that has historically challenged the finite resources of health services. Despite empirical evidence supporting structured psychological therapy as the first line of treatment, there remains significant barriers in providing timely access to evi...

Narcissism is a complex personality construct associated with childhood invalidation and self and relational difficulties in adulthood. Research has examined the association between pathological narcissism and childhood invalidation, but not between invalidation and other aspects of the narcissistic spectrum. This study examines how remembered inva...

Background Young people with pathological narcissistic traits may have more maladaptive ways of relating to themselves and others. In this study, we investigated how the experience of shame may be a mechanism by which vulnerable and grandiose pathological narcissism relates to negative and positive internalised models of the self and others, manife...

In recent years, the necessity of providing online interventions for adolescents, as an alternative to face-to-face interventions, has become apparent due to several barriers some adolescents face in accessing treatment. This need has become more critical with the coronavirus disease 2019 (COVID-19) global pandemic impacting the delivery of psychot...

School communities face challenges in responding effectively to the rising incidence of student self-harm. Evidence-informed guidelines may provide a platform for schools to provide better responses and improve the outcomes of students who engage in self-harm. This paper critically reviews policies published in English targeted for schools or educ...

School staff have a unique opportunity to detect and respond to mental health issues including self-harm and suicidal behaviour in adolescents. There is limited knowledge about how these incidents are managed in schools. This study aims to understand the incidence rates, perceived severity and management of self-harm and suicidal behaviour incident...

Background: Despite effective treatments for personality disorders being developed, consumers and carers often report negative experiences of mental health services, including challenges accessing these treatments. Methods: This qualitative study used separate focus groups to compare the unique perspectives of consumer and carers, and to investi...

Background: Peer support is a recovery oriented approach where consumers and carers are introduced to people with lived experience of the disorder who have recovered. Paid roles within health services for such consumer peer workers and carer peer workers (or 'specialists') are increasingly common. To date specific studies on such peer support for...

Background: Research into the personality trait of narcissism have advanced further understanding of the pathological concomitants of grandiosity, vulnerability and interpersonal antagonism. Recent research has established some of the interpersonal impacts on others from being in a close relationship with someone having such traits of pathological...

Borderline personality disorder (BPD) is associated with paradoxical trust cognitions and behaviours. While BPD is associated with difficulty forming trust and maintaining cooperation in trust-based exchanges, design and analytical methodology best suited to reveal the temporal ebb and flow of trust have been underutilized. We used an economic game...

Background Chronic feelings of emptiness is an under-researched symptom of borderline personality disorder (BPD), despite indications it may be central to the conceptualisation, course, and outcome of BPD treatment. This systematic review aimed to provide a comprehensive overview of chronic feelings of emptiness in BPD, identify key findings, and c...

Background Improvements to service provision for personality disorder has been predominately explored through the perspectives of clinicians, with limited understanding of the views of consumers and carers. The aim of the present study was to understand the priorities for service improvement through multiple perspectives. Method Twelve roundtables...

Multimethod approaches are a common form of methodology employed in social sciences, however are less commonly used in the examination of clinical interventions for mental health conditions. This case study outlines the strengths and challenges of applying a multimethod approach to the examination of a brief intervention for personality disorder wi...

Background: Elevated narcissism in young people often sets up a cascade of interpersonal and mental health challenges, reinforcing the need to understand its concomitants. Experiences of maltreatment and different parenting styles have been implicated but findings to date are inconclusive. By simultaneously considering multiple remembered parentin...

Background: Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. These difficulties have been shown to impact their children, and may be implicated in the potential intergenerational transmission of personality vulne...

The Psychodynamic Diagnostic Manual—Second Edition (PDM-2) stresses the importance of the integration between a descriptive and functional understanding of clinical phenomena in order to enhance a person-based nosology. The present article aims to discuss a clinical case of a patient suffering from generalized anxiety disorder, currently considered...

Background Satisfaction with childbirth is associated with a number of factors prior to and during birth, including perceived control during labour, and has implications for postnatal psychological health. Methods A total of 38 pregnant women recruited prior to 20-weeks gestation completed questionnaires regarding perceptions of control during, an...

Pathological narcissism has a long history dating back 2000 years, that has evolved into contemporary clinical psychology as a trait that may require clinical attention (Grenyer, 2013). Traditionally, Narcissistic personality disorder (NPD) is one of the 10 identified personality disorders in the Diagnostic and Statistical Manual of Mental Disorder...

Background: Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. These difficulties have been shown to impact their children, and may be implicated in the potential intergenerational transmission of personal vulnerabi...

Background: Individuals with borderline personality disorder (BPD) may experience additional challenges in their parenting role, including increased stress and lower self-efficacy and satisfaction. These difficulties have been shown to impact their children, and may be implicated in the potential intergenerational transmission of personality vulner...

PhD (Clinical Psychology) candidate Kayla Steele talks about her PhD research on parenting with Borderline Personality Disorder for the Universities Australia 'Pitch it Clever' competition. To view and vote for our submission click here: https://www.thinkable.org/submission_entries/vqawBv8J

Objectives To understand complaint risk among mental health practitioners compared with physical health practitioners. Design Retrospective cohort study, using incidence rate ratios (IRRs) to analyse complaint risk and a multivariate regression model to identify predictors of complaints. Setting National study using complaints data from health re...

Background/Objectives Maladaptive parenting (including childhood maltreatment, abuse and neglect) has been implicated in the scientific literature exploring the aetiology of personality disorder, particularly borderline personality disorder (BPD). Our primary objective was to summarise the evidence on the relationship between parenting and personal...

The perinatal period is a time of significant transition for women, with changes in maternal mental health from pregnancy to 18 months' postpartum. This study specifically analyzes maternal self-criticism and mindfulness during pregnancy and at 18 months' postpartum, and their associations with bonding. A longitudinal study (30 weeks' gestation-18...

Background Individuals with personality disorders—particularly borderline personality disorder—are high users of mental health treatment services. Emergency service responses often focus on crisis management, and there are limited opportunities to provide appropriate longer term evidence‐based treatment. Many individuals with personality disorders...

Background/Objective Intolerance of aloneness is considered a core feature of borderline personality disorder (BPD) that is clinically significant, yet under-researched. This study developed a measure of aloneness for individuals with BPD. Method Interviews investigating the experience of aloneness for BPD participants (n = 12) formed the basis fo...

Background: The concept of recovery in borderline personality disorder (BPD) is not well defined. Whilst clinical approaches emphasise symptom reduction and functioning, consumers advocate for a holistic approach. The consumer perspective on recovery and comparisons of individuals at varying stages have been minimally explored. Method: Fourteen na...

Objective: Depressed personality disorder patients showing an early rapid response (or sudden gain) in psychotherapy have better outcomes. Early responders are five times more likely to recover, despite equivalent ratings of working alliance. We explored core conflictual relationship themes (CCRTs) of early responders compared to others to further...

Significance Pregnancy is a unique physiological state involving biological stresses that promote protein damage (misfolding) within the maternal body. Currently, little is known regarding how the maternal body copes with elevated protein misfolding in pregnancy. This is important, because the accumulation of misfolded proteins underlies many human...

Outcome measurement has progressed in the field of personality disorders. While the majority of trials have evaluated outcomes on the basis of symptom and diagnostic indices, what is considered a meaningful and valued outcome to individuals has seldom been investigated. Self-generated treatment goals were collected from 102 individuals seeking trea...

Background There is a strong interest in the concept of developmental origins of health and disease and their influence on various factors “from cradle to grave”. Despite the increasing appreciation of this lifelong legacy across the human life course, many gaps remain in the scientific understanding of mechanisms influencing these formative phases...

Pathological narcissism is characterized by impaired interpersonal functioning, but few studies have examined the impact of the disorder on those living in a close relationship. Participants (N = 683; comprising romantic partners [77.8%], mothers [8.5%] or other family members [10%]) in a close relationship with a relative with pathological narciss...

Background The school environment offers an ideal opportunity for early identification and intervention for youth with self-harm and complex mental health issues, such as borderline personality disorder (BPD). Yet, class teachers often report minimal knowledge, feeling ill-equipped to respond, and experience high levels of stress when exposed to su...

Objective: This study examined the use of metacommunication in supervision from supervisees' perspectives. Method: A total of 129 supervisees completed the Metacommunication in Supervision Questionnaire-MSQ, a measure devised for the purpose of this study to explore the frequency and willingness to use various forms of metacommunication in clini...

Studies of neurobiological mechanisms in borderline personality disorder (BPD) have increased our understanding of the pathophysiology of its development and course. Less is known about how psychotherapy may influence these neurobiological factors, and also whether biomarkers may predict psychotherapy outcomes. We conducted a systematic review usin...