blog

In recognition of Mental Health Awareness Week, Johanna Hepp, is May’s Associate Faculty Member of the Month. Johanna is a doctoral student and psychotherapist in training in the Department of Pychosomatic Medicine and Psychotherapy headed by Professor Christian Schmahl at the Central Institute of Mental Health (CIMH) in Mannheim, Germany. She obtained a BSc in Psychology from Mannheim University in 2011 and an MSc in Clinical and Developmental Psychology from Heidelberg University in 2014.

Beyond her ongoing projects at the CIMH on social cognition in Borderline Personality Disorder (BPD), Johanna researches BPD symptoms in daily life with her collaborators from the University of Missouri and Purdue University. Johanna was awarded the F1000 Associate Faculty Member travel grant for 2017, which she used towards furthering these collaborations.

In this Q&A, Johanna talks about her research on social cognition and a character trait, pointed out to her by a patient, that has shown to be a useful asset in Johanna’s chosen field of research.

Can you tell us about your work and research interests?

In my dissertation, I investigate how social cognitive processes contribute to interpersonal problems in individuals with BPD. Beyond this, I am interested in the nature of non-suicidal self-injury as well as dimensional concepts of personality pathology, and enjoy researching these questions with both experimental and ambulatory assessment (studying people in their natural environment through self-reports, observation and behaviour) methods.

In ambulatory assessment studies, we give participants smartphones that prompt them to provide data several times a day, while they go about their normal lives in their natural environments. The latest projects in our work group rely heavily on this method, with which we hope to further understand the natural covariation of symptoms in the daily lives of various patient groups. Beyond BPD, our samples include individuals with transdiagnostic symptoms such as non-suicidal self-injury, pseudo-neurological symptoms, and consequences of childhood trauma.

What triggered your interest in social cognition?

In 2010, I completed an undergraduate internship in the BPD treatment program at CIMH, during which a woman with BPD told me that she loved working with me, because my face was ‘an open book’. As an undergraduate, I obviously did not think being this easy to read was a good thing, but to her it made me predictable and in some way trustworthy.

I found this puzzling, but did not dwell on it that much more until I started working on my Bachelor’s thesis, which was supervised by Dr. Inga Niedtfeld (CIMH), who has a long-standing interest in social cognition and who I still work with today.

Inspired by Dr. Niedtfeld’s work, I investigated whether individuals with BPD are more sensitive (or biased) towards detecting negative facial expressions. While reading the vast literature in this field, I learned that ambiguous facial expressions are actually very unsettling for people with BPD and that my being an ‘open book’ wasn’t so bad after all.

What do you most enjoy about your work?

What I greatly enjoy about my work is the combination of clinical and research practice and how they inform each other. Many of the BPD patients I have treated were extremely well informed about their disorder and asked some fantastic research questions.

I also get exceedingly excited when my data and my patients tell the same story. What I enjoy most about the research part of my work is the teamwork with my colleagues within CIMH as well as the collaborations with Prof. Trulls group at the University of Missouri, who taught me everything about ambulatory assessment research, and with Prof. Lane at Purdue University, who tirelessly keeps expanding my methodological toolbox.

Please tell us about one of the recent articles you and your supervisor Christian Schmahl recommended on F1000Prime?

Christian and I recently recommended a meta-analysis by Wilson and colleagues on interpersonal dysfunction in personality disorders published in Psychological Bulletin, which we considered to be an important piece of research in light of the ongoing diagnostic reform of personality disorders. Our current diagnostic systems suggest that personality disorders are characterised by marked problems in interpersonal functioning, but this basic assumption has not been extensively tested.

We know from longitudinal studies that interpersonal problems are among the most stable symptoms of BPD and that even those who are in remission often do not participate in working life and continue to have small social networks. Therefore, large-scale studies, which synthesize previous findings like this one, are extremely important to further our understanding of interpersonal dysfunction in personality pathology.

What, in your opinion, should be the main focus of research on Borderline personality disorder?

With the current reconceptualization of personality disorders in the International Classification of Diseases and similar suggestions in the research section of Diagnostic and Statistical Manual of Mental Disorders, I believe one of the major challenges for the field will be a reform of the personality disorder nosology and a furthering of our understanding of personality pathology in dimensional ways.

The identification of biological markers will be a challenging next step for the field. Beyond the diagnostic issue, I am increasingly seeing efforts to connect different types of data in personality disorder research, particularly the combination of data obtained in the lab and data collected in daily life via ambulatory assessment.

Beyond the exciting new discoveries that will undoubtedly be made, I personally deem it very important that more efforts are made towards replicating previous findings and thus refining our knowledge base.