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Gómez-Bujedo J, Dacosta-Sánchez D, Pérez-Moreno PJ, García García A, Díaz-Batanero C, Fernández-Calderón F, Delgado-Rico E, Moraleda-Barreno E. Comparison of Emotional Processing Between Patients with Substance Use Disorder and Those with Dual Diagnosis: Relationship with Severity of Dependence and Use During Treatment. J Psychoactive Drugs 2024; 56:97-108. [PMID: 36827487 DOI: 10.1080/02791072.2023.2181241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 02/26/2023]
Abstract
This study analyzed, in a Spanish sample, the differences in emotional processing in patients diagnosed with substance use disorder (SUD) and patients with a dual diagnosis (DD), and tested whether alterations in emotional regulation were related to the severity of dependence and consumption during treatment. A descriptive follow-up study was conducted with 88 adult outpatients (83% men) who were receiving treatment for alcohol and cocaine SUD. Of the sample, 43.2% presented dual diagnosis according to DSM-IV-TR criteria. Emotional processing was assessed with the IAPS, and dependence severity with the SDSS. Consumption was determined with self-reports and toxicological tests. Regression analyses revealed that the DD group had more difficulties in identifying the valence and arousal of the images than patients with SUD. Patients with DD presented more difficulty in identifying images in which valence was manipulated, but not in those in which arousal was manipulated. Cocaine use during treatment was associated with difficulties in identifying unpleasant (U = 734.0; p < .05) and arousing (U = 723.5; p < .05) images. Although these results are preliminary, findings suggest that impaired emotional processing is aggravated in dual patients, although it may be a common transdiagnostic factor in SUD and other comorbid mental disorders. Findings highlight the importance of evaluating emotional regulation to better understand its possible role in the maintenance of substance use.
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Affiliation(s)
- Jesús Gómez-Bujedo
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | | | - Pedro J Pérez-Moreno
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | | | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Elena Delgado-Rico
- Department of Educational Psychology and Psychobiology, International University of La Rioja, Logroño, Spain
| | - Enrique Moraleda-Barreno
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center in Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
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2
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Specker P, Nickerson A. Investigating the effectiveness of instructing emotion regulation flexibility to individuals with low and high anxiety. ANXIETY, STRESS, AND COPING 2024; 37:143-156. [PMID: 37120826 DOI: 10.1080/10615806.2023.2205641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/31/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Psychopathology has been associated with a deficit in emotion regulation (ER) flexibility - the ability to flexibly utilize ER strategies that are appropriate to situational demands. Yet, whether anxious individuals can be taught ER flexibility, or whether ER flexibility is effective in managing negative affect, remains unknown. We investigated the impact of instructed ER flexibility on emotional responding among individuals with differing levels of anxiety. DESIGN AND METHODS Participants (N = 109) were taught two ER strategies (reappraisal, distraction) and randomized to be instructed in either flexible or inflexible ER while viewing images that differed in negative emotional intensity. RESULTS When averaged over anxiety, or for participants with low anxiety, negative affect did not differ between conditions. However, among anxious participants, those in the flexible regulatory conditions - those who were instructed to flexibly switch between strategies - reported lower negative affect than those in the inflexible Reappraisal only condition, but not the Distraction only condition. The effectiveness of the two flexible conditions did not significantly differ. CONCLUSIONS Anxious individuals benefitted from being instructed in either ER flexibility or distraction. This finding supports literature on the adaptiveness of distraction and provides preliminary evidence linking instructed ER flexibility and improved emotional responding.
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Affiliation(s)
- Philippa Specker
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, Australia
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3
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Pizarro-Campagna E, Terrett G, Jovev M, Rendell PG, Henry JD, Chanen AM. Cognitive Reappraisal Impairs Negative Affect Regulation in the Context of Social Rejection for Youth With Early-Stage Borderline Personality Disorder. J Pers Disord 2023; 37:156-176. [PMID: 37002936 DOI: 10.1521/pedi.2023.37.2.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Application of emotion regulation strategies might be susceptible to the context of social rejection for individuals with borderline personality disorder (BPD). This study compared the ability of 27 outpatient youths (15-25 years old) with early-stage BPD and 37 healthy controls (HC) to apply expressive suppression and cognitive reappraisal in standard and socially rejecting laboratory contexts. BPD youths were largely as able as HCs to regulate negative affect across instruction and contexts. However, cognitive reappraisal in the context of social rejection heightened BPD negative facial expression relative to HCs. Thus, while BPD emotion regulation ability was largely normative, cognitive reappraisal might be ineffective in the context of social rejection for this group, with social rejection acting as an accelerant that heightens the expression of negative affect. Given the common experience of perceived and actual social rejection for this group, clinicians should carefully consider treatments that include cognitive reappraisal strategies because they might be contraindicated.
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Affiliation(s)
| | - Gill Terrett
- School of Psychology, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Martina Jovev
- Orygen, Parkville Victoria, Australia, and Centre for Youth Mental Health, The University of Melbourne, Parkville Victoria, Australia
| | - Peter G Rendell
- School of Psychology, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew M Chanen
- Orygen, Parkville Victoria, Australia, and Centre for Youth Mental Health, The University of Melbourne, Parkville Victoria, Australia
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4
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Southward MW, Howard KP, Cheavens JS. Less is more: Decreasing the frequency of maladaptive coping predicts improvements in DBT more consistently than increasing the frequency of adaptive coping. Behav Res Ther 2023; 163:104288. [PMID: 36893659 PMCID: PMC10089667 DOI: 10.1016/j.brat.2023.104288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 01/25/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
It is well-established that participation in dialectical behavior therapy (DBT) results in patients using adaptive coping strategies more frequently. Although coping skill instruction may be necessary to promote decreases in symptoms and behavioral targets in DBT, it is unclear if the frequency with which patients use adaptive coping skills leads to these outcomes. Alternatively, it is possible that DBT also leads patients to use maladaptive strategies less frequently and that these reductions more consistently predict improvements in treatment. We recruited 87 participants with elevated emotion dysregulation (Mage = 30.56; 83.9% female; 75.9% White) to participate in a 6-month course of full-model DBT delivered by advanced graduate students. Participants completed measures of adaptive and maladaptive strategy use, emotion dysregulation, interpersonal problems, distress tolerance, and mindfulness at baseline and after three DBT skills training modules. Both within- and between-person maladaptive strategy use significantly predicted module-to-module changes in all outcomes whereas adaptive strategy use significantly predicted changes in emotion dysregulation and distress tolerance, although the size of these effects did not significantly differ between adaptive and maladaptive strategy use. We discuss the limitations and implications of these results for optimizing DBT.
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5
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Bud S, Nechita D, Szentagotai Tatar A. Emotion regulation strategies in borderline personality disorder: a meta-analysis. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2152668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Samuel Bud
- Evidence-Based Assessment and Psychological Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca, Romania
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Diana Nechita
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentagotai Tatar
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
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6
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Moyal N, Stelmach-Lask L, Anholt GE, Henik A. Choosing an Emotion Regulation Strategy - The Importance of Emotional Category. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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7
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Zhang N, Zhang K, Wang J, Sun X. Distract or Reappraise? The Mechanism of Cognitive Emotion Regulation Choice and Its Influential Factors. Psychol Res Behav Manag 2022; 15:3699-3708. [PMID: 36560960 PMCID: PMC9767025 DOI: 10.2147/prbm.s389835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Previous research on emotion regulation has focused more on the regulation effects corresponding to a particular emotion regulation strategy, yet the same regulation strategy may produce different regulation effects in different contexts. Similarly, one regulation strategy may not be applicable to all situations. Emotion regulation choice refers to the process by which individuals choose different regulation strategies in different contexts. Executive control and the level of engagement-disengagement considerations are the cognitive mechanisms of emotion regulation choice, while the neural mechanisms of emotion regulation choice still need to be explored more directly and deeply. Studies have found that affective, cognitive, and motivational factors have different degrees of influence on emotion regulation choice. However, there is still a lack of a reliable framework to systematically investigate the relationship between these influences and the outcome of their combined effect on emotion regulation choices. Future research needs to further explore the neurophysiological basis of emotion regulation choice by using different techniques and constructing a complete model based on multiple factors to more accurately grasp the dynamic process of emotion regulation choice.
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Affiliation(s)
- Ni Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin, People’s Republic of China,Mental Health Education for College Students, Weifang Medical University, Weifang, People’s Republic of China
| | - Kuo Zhang
- Department of Social Psychology, Nankai University, Tianjin, People’s Republic of China,Correspondence: Kuo Zhang; Xuechuan Sun, Email ;
| | - Jingxin Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin, People’s Republic of China,Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, People’s Republic of China
| | - Xuechuan Sun
- Department of Information Engineering, Tianjin University of Commerce, Tianjin, People’s Republic of China
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8
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The Impact of Emotion Regulation on the Relationship Between Momentary Negative Affect and End-of-Day Worry and Rumination. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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9
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Sorgi-Wilson KM, McCloskey MS. Emotion regulation strategies among individuals with borderline personality disorder relative to other groups: A review. Clin Psychol Psychother 2022; 29:1655-1678. [PMID: 35366040 DOI: 10.1002/cpp.2738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/28/2022] [Accepted: 03/29/2022] [Indexed: 11/11/2022]
Abstract
Borderline personality disorder (BPD) is associated with difficulties in emotion regulation (ER) abilities. Investigations of ER strategies in BPD have been less robust. This systematic review identified 55 studies comparing ER strategy use between individuals diagnosed with BPD versus psychiatric and non-psychiatric comparison groups. Individuals with BPD reported more frequent maladaptive and less frequent adaptive ER strategy use than non-psychiatric controls. Results were less consistent relative to psychiatric comparison groups, though individuals with BPD reported greater self-criticism and avoidance. Groups responded comparably to instructed use of adaptive (but not maladaptive) ER strategies. This body of research would benefit from further examination of the roles of psychiatric comorbidity and problematic behaviours in the relationship between BPD and ER strategies.
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Affiliation(s)
- Kristen M Sorgi-Wilson
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Michael S McCloskey
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
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10
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Fitzpatrick S, Kuo JR. Predicting the effectiveness of engagement and disengagement emotion regulation based on emotional reactivity in borderline personality disorder. Cogn Emot 2021; 36:473-491. [PMID: 34931942 DOI: 10.1080/02699931.2021.2018291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Improving emotion regulation is central to borderline personality disorder (BPD) treatment, but little research indicates which emotion regulation strategies are optimally effective and when. Basic emotion science suggests that engagement emotion regulation strategies that process emotional content become less effective as emotional intensity increases, whereas disengagement strategies that disengage from it do not. This study examined whether emotional reactivity to emotional stimuli predicts the effectiveness of engagement and disengagement emotion regulation across self-report, general physiologic (heart rate), sympathetic (skin conductance responses), and parasympathetic (respiratory sinus arrythmia) emotion in BPD, healthy, and clinical control (i.e. generalized anxiety disorder; GAD) groups. 120 participants (40 per group) were exposed to emotion inductions and then instructed to implement engagement (mindful awareness) and disengagement (distraction) strategies while self-report and physiological emotion measurements were taken. In the BPD and GAD groups, higher heart rate or respiratory sinus arrythmia reactivity, respectively, predicted improved mindful awareness effectiveness. Higher skin conductance reactivity predicted worsened distraction effectiveness in BPD. Higher reactivity may potentiate engagement emotion regulation, and exacerbate disengagement from emotional content, in BPD. Future research should examine other domains of emotion regulation that may be influenced by emotional intensity, and other forms of emotional intensity that may influence them.
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Affiliation(s)
| | - Janice R Kuo
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
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11
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Dyadic Emotion Regulation in Women with Borderline Personality Disorder. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10206-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
Background
Emotion regulation (ER) and interpersonal dysfunction constitute key features of borderline personality disorder (BPD). Here, we tested if females with BPD show impairments in dyadic ER, that is in their support seeking and creation of closeness. We investigated if women with BPD might over-rely on their male partner by excessive support seeking and establishing of closeness, during conversations with personally and relationship-threatening topics.
Methods
Thirty couples in which the women were diagnosed with BPD and 34 healthy control (HC) couples were videotaped while discussing neutral, personally threatening, and relationship-threatening topics. Support seeking was rated by three independent raters, using a naïve observer method. The creation of closeness was rated using a continuous video-rating. Perceived emotions were assessed using self-report after each conversation.
Results
Women with BPD engaged in more support seeking than HC women, especially in more negative behaviors to elicit support, they created less closeness to their partner than HCs and reported a greater decline of positive emotions in both threatening conditions. Women with BPD displayed more fluctuations than controls between creating closeness and distance in the personally-threatening situation. They reported a larger increase in negative emotions after the relationship threatening conversation compared to female HC.
Conclusions
The present study indicates an increased demand of dyadic ER in BPD. Increased negative support seeking and less creation of closeness to the partner might reflect ineffective strategies to actually receive support from the partner.
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12
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Horner CK, Allard ES. Attentional Tendencies That Impact Emotion Regulation Success Within a Borderline Personality Disorder Framework. J Pers Disord 2021; 35:936-949. [PMID: 34124948 DOI: 10.1521/pedi_2021_35_527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Emotion regulation difficulties are key to borderline personality disorder (BPD) symptomatology. Literature indicates that attentional distraction, particularly within an interpersonal context, is common in BPD. Conversely, reappraisal tactics are less prevalent. The goal of the current study was to examine whether this discrepancy is observed when individuals reporting varying levels of BPD tendencies are given the choice of a preferred emotion regulation tactic when confronted with BPD-relevant stressors. Attentional engagement patterns, affective responses, and strategy success were also examined. Participants (N = 103) reported BPD tendencies as assessed by the Personality Assessment Inventory and were instructed to choose either to "distract" or to "reappraise" in response to affective images. Results revealed more instances of failing to implement distraction among individuals with higher BPD tendencies, which was also reflected in greater fixation biases to distressing content within those images. Results are discussed in terms of the malleability of emotion regulation in BPD contexts.
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Affiliation(s)
| | - Eric S Allard
- Department of Psychology, Cleveland State University, Cleveland, Ohio
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13
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More and Better: Reappraisal Quality Partially Explains the Effect of Reappraisal Use on Changes in Positive and Negative Affect. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10255-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Emotion regulation, mindfulness, and self-compassion among patients with borderline personality disorder, compared to healthy control subjects. PLoS One 2021; 16:e0248409. [PMID: 33730065 PMCID: PMC7968662 DOI: 10.1371/journal.pone.0248409] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/26/2021] [Indexed: 12/27/2022] Open
Abstract
Objectives Emotion regulation difficulties are a major characteristic of personality disorders. Our study investigated emotion regulation difficulties that are characteristic of borderline personality disorder (BPD), compared to a healthy control group. Methods Patients with BPD (N = 59) and healthy participants (N = 70) filled out four self-report questionnaires (Cognitive Emotion Regulation Questionnaire, Difficulties in Emotion Regulation Scale, Five Facet Mindfulness Questionnaire, Self-Compassion Scale) that measured the presence or lack of different emotion-regulation strategies. Differences between the BPD and the healthy control group were investigated by Multivariate Analysis of Variance (MANOVA) and univariate post-hoc F-test statistics. Results People suffering from BPD had statistically significantly (p<0.05) higher levels of emotional dysregulation and used more maladaptive emotion-regulation strategies, as well as lower levels of mindfulness and self-compassion compared to the HC group. Conclusion In comparison to a healthy control group, BPD patients show deficits in the following areas: mindfulness, self-compassion and adaptive emotion-regulation strategies. Based on these results, we suggest that teaching emotion-regulation, mindfulness, and self-compassion skills to patients can be crucial in the treatment of borderline personality disorder.
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15
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Fitzpatrick S, Liebman RE, Monson CM. The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder. Clin Psychol Rev 2021; 84:101983. [PMID: 33517245 DOI: 10.1016/j.cpr.2021.101983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.
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Affiliation(s)
- Skye Fitzpatrick
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Rachel E Liebman
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada; Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
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16
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Barnow S, Pruessner L, Schulze K. Flexible Emotionsregulation: Theoretische Modelle und Empirische Befunde. PSYCHOLOGISCHE RUNDSCHAU 2020. [DOI: 10.1026/0033-3042/a000494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Zusammenfassung. Emotionsregulationsstrategien werden häufig unabhängig von dem Kontext der Verwendung in adaptiv und maladaptiv klassifiziert. Aktuelle empirische Studien und theoretische Modelle der flexiblen Emotionsregulation hinterfragen diese Kategorisierung und versuchen, die Adaptivität von regulatorischen Strategien stärker kontextbezogen zu untersuchen. In dem vorliegenden Artikel geben wir eine selektive Übersicht über dieses Forschungsgebiet und gehen dabei auf folgende zwei Fragestellungen ein: (1) Welche Rolle spielen Kontextfaktoren bei der Adaptivität von Emotionsregulationsstrategien? (2) Wie kann flexible Emotionsregulation konzeptualisiert und erfasst werden? Aus den vorgestellten empirischen Befunden und theoretischen Modellen leiten wir Implikationen für zukünftige ambulatorische und experimentelle Untersuchungen flexibler Emotionsregulation ab.
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Affiliation(s)
- Sven Barnow
- Psychologisches Institut, Universität Heidelberg
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17
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A Meta-analysis and Systematic Review of Emotion-Regulation Strategies in Borderline Personality Disorder. Harv Rev Psychiatry 2020; 27:217-232. [PMID: 31219881 DOI: 10.1097/hrp.0000000000000212] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Emotion dysregulation is often considered a core characteristic of individuals with borderline personality disorder (BPD). With the development and strength of a contemporary affective-science model that encompasses both healthy emotion regulation (ER) and emotion dysregulation, this model has increasingly been used to understand the affective experiences of people with BPD. In this meta-analysis and review, we systematically review six of the most commonly studied ER strategies and determine their relative endorsement in individuals with elevated symptoms of BPD compared to individuals with low symptoms of BPD and healthy controls, as well as to individuals with other mental disorders. Results from 93 unique studies and 213 different effect-size estimates indicated that symptoms of BPD were associated with less frequent use of ER strategies that would be considered more effective at reducing negative affect (i.e., cognitive reappraisal, problem solving, and acceptance) and more frequent use of ER strategies considered less effective at reducing negative affect (i.e., suppression, rumination, and avoidance). When compared to individuals with other mental disorders, people with BPD endorsed higher rates of rumination and avoidance, and lower rates of problem solving and acceptance. We also review important contributions from studies of ER in BPD that we were unable to incorporate into our meta-analysis. We conclude by discussing how the pattern of using ER strategies in BPD contributes to emotion dysregulation and also the potential reasons for this pattern, integrating both Gross's extended process model of ER and Linehan's updated theoretical account on the development of emotion dysregulation.
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Daros AR, Rodrigo AH, Norouzian N, Darboh BS, McRae K, Ruocco AC. Cognitive Reappraisal of Negative Emotional Images in Borderline Personality Disorder: Content Analysis, Perceived Effectiveness, and Diagnostic Specificity. J Pers Disord 2020; 34:199-215. [PMID: 30179574 DOI: 10.1521/pedi_2018_32_390] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Individuals with borderline personality disorder (BPD) report using cognitive reappraisal less often than healthy individuals despite the long-term benefits of the emotion regulation strategy on emotional stability. Individuals with BPD, mixed anxiety and/or depressive disorders (MAD), and healthy controls (HC) completed an experimental task to investigate the tactics contained in cognitive reappraisal statements vocalized for high and low emotional intensity photographs. Self-reported effectiveness after using cognitive reappraisal to decrease negative emotions was also evaluated. Although BPD and MAD used a similar number of cognitive reappraisal tactics, they perceived themselves as less effective at reducing their negative emotions compared to HC. During cognitive reappraisal, BPD and MAD uttered fewer words versus HC, while BPD uttered fewer words versus MAD. Results suggest that individuals with BPD and MAD are less fluent and perceive themselves as less effective than HC when using cognitive reappraisal to lower negative emotions regardless of stimulus intensity.
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Affiliation(s)
- Alexander R Daros
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Achala H Rodrigo
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Nikoo Norouzian
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Bri S Darboh
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Kateri McRae
- Department of Psychology, University of Denver, Denver, Colorado
| | - Anthony C Ruocco
- Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada
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19
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Seow LLY, Page AC, Hooke GR. Severity of borderline personality disorder symptoms as a moderator of the association between the use of dialectical behaviour therapy skills and treatment outcomes. Psychother Res 2020; 30:920-933. [PMID: 32013808 DOI: 10.1080/10503307.2020.1720931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
A core aspect of Dialectical Behaviour Therapy (DBT) is the acquisition and use of DBT skills to replace maladaptive behaviours. However, it is unclear whether DBT skill use is associated with differential reductions in psychological distress across individuals with varying severities of borderline personality disorder (BPD) symptoms. In the current study, moderated mediation analyses were conducted to examine the relationships among DBT skill use and attitudes towards skill use, pre-treatment BPD symptom severity and changes in psychological distress over the course of a 12-week DBT-informed program in a sample of outpatients with mixed psychopathology (N = 102), including a minority with BPD (N = 16). It was predicted that (i) self-reported use of the four types of DBT skills (mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness) and (ii) patient attitudes towards these skills (confidence and perceived effectiveness) would be associated with greater improvements in psychological distress in individuals with higher levels of BPD symptoms compared to individuals with lower levels of BPD symptoms. Results supported this hypothesis, indicating that self-reported DBT skill use and attitudes towards DBT skills are associated with differential patterns of reductions in psychological distress.
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Affiliation(s)
- Lillian L Y Seow
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Andrew C Page
- School of Psychological Science, The University of Western Australia, Crawley, Australia
| | - Geoff R Hooke
- School of Psychological Science, The University of Western Australia, Crawley, Australia.,Perth Clinic, West Perth, Australia
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Current progress in real-time functional magnetic resonance-based neurofeedback: Methodological challenges and achievements. Neuroimage 2019; 202:116107. [DOI: 10.1016/j.neuroimage.2019.116107] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
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Van Bockstaele B, Atticciati L, Hiekkaranta AP, Larsen H, Verschuere B. Choose change: Situation modification, distraction, and reappraisal in mild versus intense negative situations. MOTIVATION AND EMOTION 2019. [DOI: 10.1007/s11031-019-09811-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Despite the theoretical importance and applied potential of situation modification as an emotion regulation strategy, empirical research on how people change situations to regulate their emotions is scarce. Meanwhile, existing paradigms typically allowed participants to avoid the entire situation, thus confounding situation modification with situation selection. In our current experiments, participants could choose between partially modifying their negative emotional environment without avoiding it entirely and two well-established emotion regulation strategies (reappraisal and distraction). Participants did choose situation modification (Experiments 1–2) and they did so more often for intense than for mild stimuli in Experiment 2. In addition, modifying the stimulus display effectively helped downregulating negative affect (Experiments 1–2). Finally, in both experiments, participants opted more for distraction for intense compared to mild stimuli, while they opted more for reappraisal for mild compared to intense stimuli. Presenting a first step in developing a paradigm that allows people to exert control over but to not avoid emotion-provoking situations, we thus show that changing one’s environment helps regulating one’s emotions. More generally, our findings indicate that people prefer to regulate their emotions using disengagement strategies (situation modification and distraction) with high-intensity relative to low-intensity negative situations, while they prefer engagement strategies (reappraisal) with low-intensity relative to high-intensity negative situations.
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López-Pérez B, McCagh J. How do I want to feel? The link between emotion goals and difficulties in emotion regulation in borderline personality disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:96-114. [PMID: 31553067 DOI: 10.1111/bjc.12235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/21/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Appropriate contextualized emotion goals (i.e., desired emotional endpoints that facilitate goal attainment) are fundamental to emotion regulation, as they may determine the direction of regulation efforts. Given that difficulties in emotion regulation are prevalent in borderline personality disorder (BPD), we explored whether BPD traits (Study 1) and BPD diagnosis (Study 2) presented specific contextualized emotion goals, and whether these emotion goals may be linked to difficulties in emotion regulation. METHODS In Study 1, 358 individuals were recruited via Amazon Mechanical Turk and assessed on the presence of borderline traits, emotion regulation ability, and general and contextualized emotion goals. In Study 2, these measures were employed in a sample of 35 people with BPD and 35 matched controls who were also assessed on their current mood state and screened for Axis I and II disorders of the DSM-IV. RESULTS Study 1 showed that emotion dysregulation was positively predicted by borderline traits and contextualized emotion goals that impair goal attainment (i.e., greater preference for anger for collaboration and happiness for confrontation). Findings of Study 2 also showed that a higher preference for happiness for confrontation was linked to higher emotion dysregulation in both individuals with BPD and controls. Furthermore, individuals with BPD reported a lower preference for happiness for collaboration than controls. CONCLUSIONS These results support the importance of looking at emotion goals and its link with emotion dysregulation. Interventions targeting maladaptive contextualized goals may represent an important therapeutic window to enhance emotion regulation. PRACTITIONER POINTS Clinical implications BPD individuals' emotion regulation is linked to maladaptive emotion goals. Helping people at risk to manipulate their emotion goals to be more context sensitive may enhance well-being and serve as a therapeutic tool in practice. Limitations The present research only considered the context of collaboration and confrontation, but other contexts more relevant for individuals with BPD (i.e., self-harm situations) might provide valuable information about their difficulties in emotion regulation. To study contextualized emotion goals in clinical populations, longitudinal rather than cross-sectional designs should be considered.
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Affiliation(s)
| | - Jane McCagh
- Department of Psychology, Liverpool Hope University, UK
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Southward MW, Cheavens JS. Quality or quantity? A multistudy analysis of emotion regulation skills deficits associated with borderline personality disorder. Personal Disord 2019; 11:24-35. [PMID: 31464477 DOI: 10.1037/per0000357] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Linehan's (1993) biosocial theory posits that people with borderline personality disorder (BPD) have emotion regulation skills deficits characterized by (a) less frequent use of adaptive emotion regulation strategies, (b) more frequent use of maladaptive strategies, or (c) poorer quality strategy implementation (i.e., strategies implemented less skillfully). We tested these possibilities among participants with BPD, major depressive disorder (MDD), or no disorder (controls). Study 1 participants (N = 272) were recruited online; Study 2 participants (N = 90) completed in-person diagnostic assessments. The BPD groups reported greater use of maladaptive strategies than the MDD (d = .35) and control (d = 1.54) groups and lower quality implementation than the MDD (d = -.33) and control groups (d = -.97). BPD participants reported similar use of adaptive strategies as the MDD group (d = -.09) but less use than controls (d = -.47). BPD may be uniquely characterized by overuse of maladaptive strategies and poorer quality emotion regulation implementation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Abstract
AbstractBorderline personality disorder (BPD) is a severe and complex disorder characterized by instability across many life domains, including interpersonal relations, behavior, and emotions. A core feature and contributor to BPD, emotion dysegulation (ED), consists of deficits in the ability to regulate emotions in a manner that allows the individual to pursue important goals or behave effectively in various contexts. Biosocial developmental models of BPD have emphasized a transaction of environmental conditions (e.g., invalidating environments and adverse childhood experiences) with key genetically linked vulnerabilities (e.g., impulsivity and emotional vulnerability) in the development of ED and BPD. Emerging evidence has begun to highlight the complex, heterotypic pathways to the development of BPD, with key heritable vulnerability factors possibly interacting with aspects of the rearing environment to produce worsening ED and an adolescent trajectory consisting of self-damaging behaviors and eventual BPD. Adults with BPD have shown evidence of a variety of cognitive, physiological, and behavioral characteristics of ED. As the precursors to the development of ED and BPD have become clearer, prevention and treatment efforts hold great promise for reducing the long-term suffering, functional impairment, and considerable societal costs associated with BPD.
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Grzegorzewski P, Kulesza M, Pluta A, Iqbal Z, Kucharska K. Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder. Psychiatry Res 2019; 273:798-807. [PMID: 30819534 DOI: 10.1016/j.psychres.2018.12.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 11/29/2022]
Abstract
Self-report studies on empathy in adults with borderline personality disorder (BPD) have based upon the Interpersonal Reactivity Index (IRI) and generally identified deficits in perspective taking abilities in this group, but indicated less coherent results regarding empathic concern. These two constructs are considered subcomponents of cognitive (CE) and affective empathy (AE), respectively. However, the IRI does not enable for valid investigation of overall levels of these empathy types. Surprisingly, although some findings from the general population suggest that empathy types may be positively related to altruism, neither this link nor general altruism have been examined in BPD. Additionally, these constructs have not been sufficiently studied in this group in the context of alexithymia or potential clinical confounders. Hence, women with BPD (N = 30) and healthy women (N = 38) completed, i.a., the Questionnaire of Cognitive and Affective Empathy, Self-Report Altruism Scale, TAS-20, STAI, and CESD-R. Patients with BPD reported significantly decreased overall CE (including worse online simulation abilities - conceptually similar to perspective taking from the IRI), but a similar level of overall AE. They also demonstrated lower altruism. Taken together, these results suggest that BPD patients have difficulties with imagining what emotions others are feeling and with altruistic responding to their needs.
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Affiliation(s)
- Piotr Grzegorzewski
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland
| | - Maria Kulesza
- Laboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Zaffer Iqbal
- NAViGO Health Care and Social Care CIC, Grimsby, United Kingdom; Faculty of Health Sciences, University of Hull, Hull, United Kingdom
| | - Katarzyna Kucharska
- Department of Neuroses, Personality Disorders, and Eating Disorders, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland.
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Peter M, Arntz A, Klimstra TA, Faulborn M, Vingerhoets AJJM. Subjective emotional responses to IAPS pictures in patients with borderline personality disorder, cluster-C personality disorders, and non-patients. Psychiatry Res 2019; 273:712-718. [PMID: 31207857 DOI: 10.1016/j.psychres.2019.01.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/19/2018] [Accepted: 01/18/2019] [Indexed: 11/19/2022]
Abstract
According to Linehan (1993), emotion dysregulation is a central feature of borderline personality disorder (BPD). We hypothesized that patients with BPD are emotionally hyperresponsive. For BPD treatment, it is important to evaluate this hypothesis, because, if it is supported, therapeutic interventions could be designed to help patients to better manage hyperemotional reactions. We investigated the subjective reactions (in terms of valence and arousal) of patients with BPD to visual emotional stimuli of the International Affective Picture System (IAPS). We hypothesized that, compared to patients with Cluster-C personality disorders and non-patients, BPD patients would show higher scores on the arousal dimension and higher negative scores on the valence dimension when rating IAPS pictures with varying degrees of arousal and valence. Ratings of valence and arousal for 40 IAPS pictures were collected from 39 borderline personality disorder (BPD), 36 patients diagnosed with Cluster-C personality disorders (PD), and a group of 226 non-patients. Contrary to expectations, BPD patients did not differ from the non-patients. This indicates that their self-report scores do not reflect hypersensitivity. We found that patients with BPD showed lower scores on arousal than Cluster-C PD patients. The scores on valence suggested that Cluster-C PD patients also experienced more positive emotions than BPD patients.
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Affiliation(s)
- M Peter
- Department of Personality Disorders, GGz Breburg, Lage Witsiebaan 4, Tilburg, the Netherlands.
| | - A Arntz
- Department of Clinical Psychology, Faculty of Social and Behavioral Sciences, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam, the Netherlands
| | - T A Klimstra
- Developmental Psychology, Tilburg University, Warandalaan 2, Tilburg, the Netherlands
| | - M Faulborn
- Department of Forensic Psychiatry, GGz Breburg, Lage Witsiebaan 4, Tilburg, the Netherlands
| | - A J J M Vingerhoets
- Department of Medical and Clinical Psychology, Tilburg University, Warandalaan 2, Tilburg, the Netherlands
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Eldesouky L, English T. Regulating for a reason: Emotion regulation goals are linked to spontaneous strategy use. J Pers 2018; 87:948-961. [PMID: 30450549 DOI: 10.1111/jopy.12447] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE We investigated how individual differences in emotion regulation goals predict emotion regulation strategy use in daily life. METHOD Across three studies, we assessed two common types of emotion regulation goals (hedonic, social) and strategies spanning the entire process model of emotion regulation. We conducted two studies using global measures with undergraduates (N = 394; 18-25 years; 69% female; 56% European American) and community members (N = 302; 19-74 years; 50% female; 75% European American), and a nine-day daily diary study with another community sample (N = 272; 23-85 years; 50% female; 84% European American). RESULTS Globally and in daily life, pro-hedonic goals were positively associated with all antecedent-focused strategies (situation selection, situation modification, distraction, and reappraisal), pro-social goals were positively linked to reappraisal, and impression management goals positively predicted suppression. Contra-hedonic goals were negatively associated with reappraisal and positively associated with suppression in some studies. CONCLUSIONS The reasons why people regulate their emotions are predictive of the strategies they use in daily life. These links may be functional, such that people typically use strategies that are suitable for their goals. These findings demonstrate the value of an individual difference approach and highlight the motivational component of emotion regulation.
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Affiliation(s)
- Lameese Eldesouky
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, Missouri.,Department of Psychology, Stanford University, Stanford, California
| | - Tammy English
- Department of Psychological and Brain Sciences, Washington University in St. Louis, Saint Louis, Missouri
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Schnell K, Herpertz SC. Emotion Regulation and Social Cognition as Functional Targets of Mechanism-Based Psychotherapy in Major Depression With Comorbid Personality Pathology. J Pers Disord 2018; 32:12-35. [PMID: 29388896 DOI: 10.1521/pedi.2018.32.supp.12] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article characterizes functional systems as targets of integrated modular psychotherapy for episodes of major depression (MD) with a comorbid condition of borderline personality disorder (BPD) or chronic depression (CD). Both types of comorbidities to MD are conceptualized as a trait-like concept dominated by impairments in interpersonal functioning. Despite differences in psychopathology, existing data show significant similarities in impairments of emotion regulation and social cognition in BPD and CD, thought to reflect common disease mechanisms linked to early-life adversity. The preexistence of BPD and CD and related functional impairments inhibits the remission of episodic MD and calls for mechanism-based interventions that complement existing treatments of MD by targeting these dysfunctions. Contemporary methods of psychotherapy already provide interventions to address such complicated states of comorbidity by specifically improving dysfunctions of emotion regulation and social cognition. We suggest a layout of modular interventions that can address identified dysfunctions in comorbid MD.
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Affiliation(s)
- Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Asklepios Center for Psychiatry and Psychotherapy Göttingen, Göttingen, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University Hospital Heidelberg, Heidelberg, Germany
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Kuo JR, Fitzpatrick S, Krantz LH, Zeifman RJ. How do you choose and how well does it work?: the selection and effectiveness of emotion regulation strategies and their relationship with borderline personality disorder feature severity. Cogn Emot 2017; 32:632-640. [DOI: 10.1080/02699931.2017.1330254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Janice R. Kuo
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Skye Fitzpatrick
- Department of Psychology, Ryerson University, Toronto, ON, Canada
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Ibraheim M, Kalpakci A, Sharp C. The specificity of emotion dysregulation in adolescents with borderline personality disorder: comparison with psychiatric and healthy controls. Borderline Personal Disord Emot Dysregul 2017; 4:1. [PMID: 28078089 PMCID: PMC5223469 DOI: 10.1186/s40479-017-0052-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research has supported the notion that emotion dysregulation is a core feature of BPD. However, given that this feature is typical of healthy adolescents as well as adolescents with other psychiatric disorders, the specificity of emotion dysregulation to BPD in this age group has not yet been determined. The overall aim of this study was to examine emotion dysregulation in adolescent inpatients with BPD compared with non-BPD inpatient adolescents and healthy non-clinical adolescents, taking into account both global emotion dysregulation deficits and more specific impairments. METHOD The sample included 185 adolescent inpatients with BPD (M = 15.23, SD = 1.52), 367 non-BPD psychiatric inpatient adolescents (M = 15.37, SD = 1.40), and 146 healthy adolescents (M = 15.23, SD = 1.22), all of whom were between the ages of 12 and 17. Borderline personality features were assessed, along with emotion dysregulation and psychiatric severity. RESULTS After controlling for age, gender, and psychiatric severity, results revealed that adolescents with BPD had higher overall emotional dysregulation compared with non-BPD psychiatric controls and healthy controls. These differences were apparent in only two domains of emotion dysregulation including limited access to emotion regulation strategies perceived as effective and impulse control difficulties when experiencing negative emotions. CONCLUSIONS Findings suggest BPD-specific elevations on emotion dysregulation generally, and subscales related to behavioral regulation specifically.
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Affiliation(s)
- Marina Ibraheim
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204 USA
| | - Allison Kalpakci
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204 USA
| | - Carla Sharp
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204 USA
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