Search

Impulsive, maladaptive, and potentially self-damaging behaviors are a hallmark feature of borderline personality (BP) pathology. Difficulties with emotion regulation have been implicated in both BP pathology and maladaptive behaviors. One facet of emotion regulation that may be particularly important in the relation between BP pathology and urges for maladaptive behaviors is emotion differentiation. Over 1 day, 84 participants high (n = 34) and low (n = 50) in BP pathology responded to questions regarding state emotions and urges to engage in maladaptive behaviors using handheld computers, in addition to a measure of emotion-related difficulties controlling impulsive behaviors. Results revealed that individuals high in BP pathology reported greater emotion-related impulsivity as well as daily urges to engage in maladaptive behaviors. However, the association between BP group and both baseline emotion-related impulsivity and daily urges for maladaptive behaviors was strongest among individuals who had low levels of positive emotion differentiation. Conversely, negative emotion differentiation did not significantly moderate the relationships between BP group and either emotion-related difficulties controlling impulsive behaviors or state urges for maladaptive behaviors. Limitations to the present study include the reliance upon an analogue sample and the relatively brief monitoring period. Despite limitations, these results suggest that, among individuals with high BP pathology, the ability to differentiate between positive emotions may be a particularly important target in the reduction of maladaptive behaviors.

Despite evidence for the efficacy of several treatments for deliberate self-harm (DSH) within borderline personality disorder (BPD), predictors of response to these treatments remain unknown. This study examined baseline demographic, clinical, and diagnostic predictors of treatment response to an adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. A recent RCT provided evidence for the efficacy of this ERGT (relative to a treatment-as-usual only waitlist condition). Participants in this study include the full intent-to-treat sample who began ERGT (across treatment and waitlist conditions; N=51). Baseline diagnostic and clinical data were collected at the initial assessment, and outcome measures of DSH and self-destructive behaviors, emotion dysregulation/avoidance, and BPD symptoms (among others) were administered at pre-treatment, post-treatment, and 3- and 9-months post-treatment. Notably, both demographic variables and characteristics of participants’ ongoing therapy in the community had minimal impact on treatment response. However, several indicators of greater severity in domains relevant to this ERGT (i.e., baseline emotion dysregulation and BPD criteria, lifetime and recent DSH, and past-year hospitalization and suicide attempts) predicted better responses during treatment and follow-up across the primary targets of treatment. Likewise, several co-occurring disorders (i.e., social phobia, panic disorder, and a cluster B personality disorder) predicted greater improvements in BPD symptoms during treatment or follow-up. Finally, although co-occurring generalized anxiety disorder, posttraumatic stress disorder, and cluster A and C personality disorders were associated with poorer treatment response during follow-up, most of these effects reflected a lack of continued improvements during this period (vs. worsening of symptoms).

Adolescence marks a period of high-risk for the onset of self-injurious behaviors (SIB), including both deliberate self-harm (DSH) and suicidal behaviors. Adolescents with BPD constitute a particularly vulnerable population for SIB, with research revealing robust associations between SIB and BPD pathology in adolescents. Further, developmental theories suggest that SIB may be an early indicator of BPD in adolescents, reflecting a key step for some youth in the developmental trajectory toward BPD. According to Crowell and colleagues’ (2008; 2009) developmental model of SIB and BPD, trait impulsivity and emotion dysregulation are the key features underlying the development of both BPD and SIB. A review of the research literature supports this theory, revealing significant associations between SIB and both self-reported and biological indices of emotion dysregulation and, with a few exceptions, trait impulsivity among adolescents in general (as well as adolescents with BPD in particular). As such, both theoretical and empirical literature support the role of impulsivity and emotion dysregulation as key mechanisms contributing to SIB among adolescents with BPD. Clinical implications of this research are discussed, as are needed future directions in this line of inquiry.

Background Despite increasing evidence for a relation between posttraumatic stress disorder (PTSD) and self-injurious behaviors (SIB), limited research has examined the factors that may moderate the associations between PTSD and both nonsuicidal SIB (deliberate self-harm; DSH) and suicidal SIB (suicide attempts). Nonetheless, research suggests that characteristics of the traumatic event, co-occurring borderline personality disorder (BPD), and emotion dysregulation may influence the relations between PTSD and SIB. Methods Thus, the aim of this study was to examine the moderating role of these factors in the association between PTSD and SIB (including history and frequency of DSH and suicide attempts, and DSH versatility) among a sample of substance use disorder inpatients with ( n =116) and without ( n =130) a history of PTSD. Results Results from stepwise regression analyses indicate that sexual assault-related PTSD predicted suicide attempt frequency and DSH versatility among those with PTSD. Furthermore, results from hierarchical linear and logistic regression analyses suggest that co-occurring BPD moderates the relationship between PTSD and both DSH history and versatility and emotion dysregulation moderates the relationship between PTSD and DSH frequency. Specifically, the relations between PTSD and DSH outcomes were stronger among participants with co-occurring BPD and higher levels of emotion dysregulation. Limitations This study is limited by its reliance on cross-sectional, self-report data. Conclusions Despite limitations, findings suggest distinct risk factors for suicide attempts and DSH, and highlight the importance of examining characteristics of the trauma and associated BPD and emotion dysregulation in assessing risk for SIB in PTSD.

Despite the increasing interest in the study of emotion regulation strategies and psychopathology, researchers have predominantly focused on covert emotion regulation strategies-that is, those strategies that occur within the individual (e.g., cognitive reappraisal, suppression). Conversely, less attention has been devoted to the examination of the relationship between psychopathology and overt emotion regulation strategies (e.g., drinking alcohol, seeking advice). This has resulted in a limited understanding of the complex repertoire of emotion regulation strategies that individuals possess, and how patterns in the use of strategies might relate to psychopathology. We asked 218 undergraduates to report on their habitual use of 15 covert and overt emotion regulation strategies and symptoms of seven different mental disorders. Overt strategies were associated with symptoms and, at times, they predicted psychopathology above and beyond the more frequently studied covert strategies. These findings have implications for developing a more sophisticated understanding of patterns of adaptive and maladaptive emotion regulation.

The present study examined the emotional reactivity of persons with heightened borderline personality (BP) features to social rejection and negative evaluation in the laboratory. Individuals with high levels of BP features (n = 30) and controls with low levels of BP features (n = 44) were randomly assigned to a condition involving negative evaluation based on writing (negative evaluation/academic), or a condition involving negative evaluation based on personal characteristics as well as social rejection (negative evaluation/social rejection). Hypothesis 1 was that high-BP individuals, but not low-BP controls, would show greater emotional reactivity to the negative evaluation/social rejection stressor, compared with the negative evaluation/academic (writing) stressor. Hypothesis 2 was that high-BP individuals would specifically show greater reactivity of shame- and anger-related emotions to the negative evaluation/social rejection stressor compared with the negative evaluation/academic stressor. Findings indicated that high-BP individuals showed heightened emotional reactivity to the social rejection stressor but not to the negative evaluation stressor, but the opposite pattern occurred for controls. In addition, there was evidence for heightened reactivity of irritability, distress, and shame for the high-BP group, specifically in the social rejection condition.

Background and Objectives The purpose of this study was to examine the mediating role of interpersonal vulnerabilities in the association of borderline personality (BP) features with emotional reactivity to an interpersonal stressor. Methods For this study, female university students with high (N = 23), mid (N = 23), and low (N = 22) BP features completed the Inventory of Interpersonal Problems-Personality Disorders-25 (IIP-PD-25). Self-reported emotions, skin conductance responses (SCRs), interbeat intervals, and heart rate variability measured emotional reactivity to a social rejection stressor. Results BP features were positively associated with interpersonal dysfunction and predicted greater SCR reactivity and self-reported emotional reactivity. Interpersonal dysfunction mediated the association between BP features and physiological (SCRs), but not self-reported, emotional reactivity. In particular, scores on the interpersonal ambivalence subscale of the IIP-PD-25 mediated the association of BP features with SCR reactivity. Limitations This study examined BP features in a non-clinical sample, and relied on a relatively small sample. Furthermore, the design of the present study does not capture the potential transaction between interpersonal vulnerabilities and emotional dysfunction. Conclusions The findings of this study illuminate one potential mechanism underlying the heightened reactivity of persons with BP features to rejection, suggesting that interpersonal ambivalence plays a particularly important role in physiological reactivity.