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Socada JL, Söderholm JJ, Rosenström T, Lahti J, Ekelund J, Isometsä ET. Affect dimensions and variability during major depressive episodes: Ecological momentary assessment of unipolar, bipolar, and borderline patients and healthy controls. J Psychiatr Res 2024; 170:408-416. [PMID: 38218014 DOI: 10.1016/j.jpsychires.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/21/2023] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Differentiating major depressive episodes (MDEs) of major depressive disorder (MDD), bipolar disorder (MDE/BD) and the MDEs comorbid with borderline personality disorder (MDE/BPD) is crucial for appropriate treatment, and knowledge of phenomenological differences may aid this. However, studies comparing affect experiences of these three patient groups and healthy subjects are scarce. In our study, participants (N = 114), including patients with MDD (n = 34), MDE/BD (n = 27), and MDE/BPD (n = 24), and healthy controls (HC, n = 29) responded to ecological momentary assessment (EMA) with ten circumplex model affect items ten times daily for seven days (7709 recordings). Explorative factor analysis resulted in two affect dimensions. The positive dimension included active, excited, cheerful (high arousal), and content (low arousal) affects, and the negative dimension irritated, angry, and nervous (high arousal) affects. Relative to HC, patients reported 3.5-fold negative affects (mean MDD 1.36 (SD 0.92), MDE/BD 1.43 (0.76), MDE/BPD 1.81 (0.95) vs. HC 0.44 (0.49) (p < 0.01)) but 0.5-fold positive affects (2.01 (0.90), 1.95 (0.89), 2.24 (1.03), vs. 3.2 (0.95), respectively (p < 0.01)). We used multilevel modelling. Negative-affect within-individual stability was lowest in MDE/BPD and highest in MDD. Negative affect predicted concurrent positive affect more in MDE/BPD than in MDD. Moderate size of subcohorts and no inpatients were limitations. Despite apparently similar MDEs, affective experiences may differ between BPD, BD, and MDD patients. Clinical subgroups of patients with depression may vary in affective instability and concurrent presence of negative and positive affects during depression.
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Affiliation(s)
- J Lumikukka Socada
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - John J Söderholm
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tom Rosenström
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Lahti
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Folkhälsan Research Centre, Helsinki, Finland
| | - Jesper Ekelund
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Erkki T Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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2
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O'Leary AM, Landers AL, Jackson JB. "I'm fighting with BPD instead of my partner": A dyadic interpretative phenomenological analysis of the lived experience of couples navigating borderline personality disorder. JOURNAL OF MARITAL AND FAMILY THERAPY 2024; 50:45-70. [PMID: 37811894 DOI: 10.1111/jmft.12669] [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: 04/04/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/10/2023]
Abstract
Borderline personality disorder (BPD) is associated with romantic relationship distress and dissolution. The complex interaction between BPD and romantic relationships warrants further attention. Dyadic interviews (N = 10) were conducted to examine the experience and impact of BPD on couples' relationships. The results of interpretative phenomenological analysis consisted of two superordinate themes describing the couple experience of navigating BPD: (a) the shared experience of BPD as a relational stressor; and (b) adaptive dyadic coping in the context of BPD. Although BPD was experienced as a relational stressor, dyadic coping and shared externalization of BPD emerged as central components to adaptive couple functioning. Most couples reported that therapy was a critical external resource in their journey toward adaptively functioning in the context of BPD, both intrapersonally and interpersonally. The lived experiences of these couples provides therapists with an increased understanding of the resources that support adaptive dyadic coping with BPD.
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Affiliation(s)
- Abigail M O'Leary
- Department of Human Development and Family Science, Virginia Tech, Falls Church, Virginia, USA
| | - Ashley L Landers
- Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA
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3
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Prusiński T. Personality disorder type only sometimes matters: An exploration of patient's personality disorder as a source of variance in early therapeutic alliance. Clin Psychol Psychother 2023. [PMID: 38149525 DOI: 10.1002/cpp.2943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The study aimed to analyse personality disorders among patients in the early phase of psychotherapy as a source of variance in the quality of the emerging alliance. METHODS The sample consisted of 131 individual psychotherapy patients with borderline (BPD), narcissistic (NPD), dependent (DPD) and obsessive-compulsive (OCPD) personality disorders and 131 psychotherapists. Different sources of alliance estimation were included. Therapeutic alliance was operationalized on several dimensions. The hypothesis was tested using an independent samples one-way analysis of variance. RESULTS The study revealed a significant effect of personality disorder type on early therapeutic alliance quality. BPD patients rated their early alliance the lowest compared to NPD, DPD and OCPD patients. This trend was dominant and replicated regardless of who rated the alliance and which dimension of alliance was estimated. CONCLUSIONS NPD, DPD and OCPD patients have better initial therapeutic alliances than BPD patients, and their alliances do not differ significantly. BPD patients build weaker alliances, and what poses a challenge for them is not only developing a strong and close bond but also conceptualizing goals and reaching agreement on tasks.
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Affiliation(s)
- Tomasz Prusiński
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
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4
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Yin Q, Hughes CD, Rizvi SL. Using GIMME to model the emotional context of suicidal ideation based on clinical data: From research to clinical practice. Behav Res Ther 2023; 171:104427. [PMID: 37980875 DOI: 10.1016/j.brat.2023.104427] [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: 01/31/2023] [Revised: 10/15/2023] [Accepted: 11/03/2023] [Indexed: 11/21/2023]
Abstract
Research and clinical experience highlight the variability of suicidal ideation (SI) within and between individuals. Although the idiographic emotional contexts in which SI occurs may offer explanations for its dynamic nature, most statistical methods focus on nomothetic patterns, making it difficult to advance our understanding of SI. Furthermore, the gap between nomothetic methods and a need for idiographic understanding of SI poses challenges to translating empirical knowledge into individualized clinical treatment. Group iterative multiple model estimation (GIMME) is a method that may bridge the idiographic-nomothetic divide by analyzing temporal relationships among a network of variables at both group- and individual-levels. This study explored the feasibility and clinical utility of GIMME applied to examine the relationships between various emotions and SI among individuals with borderline personality disorder who underwent Dialectical Behavior Therapy. We present graphic outputs that emerged throughout treatment and discuss how they could aid clinical assessment and case formulation (ClinicalTrials.gov Identifier: NCT03123198.).
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Affiliation(s)
- Qingqing Yin
- Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854, United States.
| | - Christopher D Hughes
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, United States; Department of Psychosocial Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States
| | - Shireen L Rizvi
- Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854, United States
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5
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Ringwald WR, Pilkonis PA, Wright AGC. Filling gaps in the nomological networks for dominance and affiliation by examining self-informant agreement on momentary interpersonal behavior. EUROPEAN JOURNAL OF PERSONALITY 2023. [DOI: 10.1177/08902070221145766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Interpersonal functioning involves an interplay of subjective perceptions and overt behavior. This study examines alignment between self and informant perceptions of momentary behavior to enrich the nomological networks for the domains of dominance and affiliation. We studied a sample of romantic couples ( N = 210 individuals) who rated their own and their partner’s interpersonal behavior during a 21-day ambulatory assessment (AA) protocol. We used multi-level structural equation modeling to estimate self-informant agreement on averages and variability of dominance and affiliation (between-person level) and on situational shifts in behavior (within-person level). We also examined convergence between self- and informant reported behavior measured by AA with cross-sectional self-report trait dominance, affiliation, and interpersonal problems. Results showed no self-informant agreement on dominance measured by AA, but moderate to strong agreement on affiliation at the between- and within-person levels. Self- and informant reported average affiliation measured by AA correlated with self-reports of trait affiliation, but only AA self-reports correlated with affiliation problems. Both self- and informant report dominance variability, and informant report affiliation variability, correlated with self-report interpersonal distress. Evidence for (mis)alignment in how dominance and affiliation are perceived by self and others have important implications for the role of these behaviors in everyday interpersonal functioning.
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Affiliation(s)
| | - Paul A Pilkonis
- Department of Psychiatry, University of Pittsburgh School of Medicine, PA, USA
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6
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Ringwald WR, Hallquist MN, Dombrovski AY, Wright AGC. Personality (Dys)Function and General Instability. Clin Psychol Sci 2023; 11:106-120. [PMID: 36844787 PMCID: PMC9949732 DOI: 10.1177/21677026221083859] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Humans adapt to a dynamic environment while maintaining psychological equilibrium. Systems theories of personality hold that generalized processes control stability by regulating how strongly a person reacts to various situations. Research shows there are higher-order traits of general personality function (Stability) and dysfunction (general personality pathology; GPP), but whether or not they capture individual differences in reactivity is largely theoretical. We tested this hypothesis by examining how general personality functioning manifests in everyday life in two samples (Ns=205; 342 participants and 24,920; 17,761 observations) that completed an ambulatory assessment protocol. Consistent with systems theories, we found (1) there is a general factor reflecting reactivity across major domains of functioning, and (2) reactivity is strongly associated with Stability and GPP. Results provide insight into how people fundamentally adapt (or not) to their environments, and lays the foundation for more practical, empirical models of human functioning.
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Affiliation(s)
| | - Michael N Hallquist
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill
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7
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Kaurin A, Dombrovski AY, Hallquist MN, Wright AG. Momentary interpersonal processes of suicidal surges in borderline personality disorder. Psychol Med 2022; 52:2702-2712. [PMID: 33298227 PMCID: PMC8190164 DOI: 10.1017/s0033291720004791] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide rates are high in borderline personality disorder (BPD) where interpersonal problems trigger intense affective dysregulation and impulses to act on suicidal thoughts. To date, however, no study has examined how interpersonal stressors contribute to momentary within-person links among affect and impulsivity with suicidal ideation (SI), and how those links vary over time in people's daily lives. METHODS A total of 153 individuals diagnosed with BPD and 52 healthy controls completed a 21-day ecological momentary assessment protocol. Of these 153 individuals with BPD, 105 had a history of suicide attempts. Multilevel structural equation modeling was used to examine dynamic links among interpersonal perceptions, affect, state impulsivity, and suicidal intent. RESULTS Aggregated across interactions, lower perceived warmth in others was associated with SI. This direct relationship, however, did not extend to momentary within-person associations. Instead, interpersonal conflicts were linked to SI indirectly via greater negative affect and lower positive affect. While a robust within-person link between interpersonal perceptions and impulsivity emerged, impulsivity did not account for the relationship between interpersonal perceptions and SI. CONCLUSION This intensive longitudinal study illustrates momentary interpersonal signatures of an emerging suicidal crisis. Among people with BPD at high risk for suicide, interpersonal triggers initiate a cascade of affective dysregulation, which in turn gives rise to SI.
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Affiliation(s)
| | | | - Michael N. Hallquist
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill
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8
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Rogers AH, Zvolensky MJ, Vujanovic AA, Ruggero CJ, Oltmanns J, Waszczuk MA, Luft BJ, Kotov R. Anxiety sensitivity and Pain Experience: a prospective investigation among World Trade Center Responders. J Behav Med 2022; 45:947-953. [PMID: 35715542 DOI: 10.1007/s10865-022-00336-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Chronic pain is a significant public health problem and is exacerbated by stress. The World Trade Center (WTC) Disaster represents a unique stressor, and responders to the WTC disaster are at increased risk for pain and other health complaints. Therefore, there is a significant need to identify vulnerability factors for exacerbated pain experience among this high-risk population. Anxiety sensitivity (AS), defined as fear of anxiety-related sensations, is one such vulnerability factor associated with pain intensity and disability. Yet, no work has tested the predictive effects of AS on pain, limiting conclusions regarding the predictive utility and direction of associations. Therefore, the current study examined the prospective associations of AS, pain intensity, and pain interference among 452 (Mage = 55.22, SD = 8.73, 89.4% male) responders to the WTC disaster completing a 2-week daily diary study. Using multi-level modeling, AS total score was positively associated with both pain intensity and pain interference, and that AS cognitive concerns, but not social or physical concerns, were associated with increased pain. These results highlight the importance of AS as a predictor of pain complaints among WTC responders and provide initial empirical evidence to support AS as a clinical target for treating pain complaints among WTC responders.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Joshua Oltmanns
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
| | - Monika A Waszczuk
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Benjamin J Luft
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
| | - Roman Kotov
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
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9
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Ringwald WR, Hallquist MN, Dombrovski AY, Wright AG. Transdiagnostic Associations With Interpersonal and Affective Variability in Borderline Personality Pathology. J Pers Disord 2022; 36:320-338. [PMID: 35647774 PMCID: PMC9830454 DOI: 10.1521/pedi.2022.36.3.320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Emotional and behavioral variability are unifying characteristics of borderline personality disorder (BPD). Ambulatory assessment (AA) has been used to quantify this variability in terms of the categorical BPD diagnosis, but evidence suggests that BPD instead reflects general personality pathology. This study aimed to clarify the conceptualization of BPD by mapping indices of variability in affect, interpersonal behavior, and perceptions of others onto general and specific dimensions of personality pathology. A sample of participants who met diagnostic criteria for BPD (n = 129) and healthy controls (n = 47) reported on their daily interactions during a 21-day AA protocol. Multilevel SEM was used to examine associations between shared and specific variance in maladaptive traits with dynamic patterns of functioning. The authors found that variability is an indicator of shared trait variance and Negative Affectivity, not any other specific traits, reinforcing the idea that BPD is best understood as general personality pathology.
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Affiliation(s)
| | - Michael N. Hallquist
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill
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10
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Houben M, Mestdagh M, Dejonckheere E, Obbels J, Sienaert P, van Roy J, Kuppens P. The Statistical Specificity of Emotion Dynamics in Borderline Personality Disorder. J Pers Disord 2021; 35:819-840. [PMID: 34124950 DOI: 10.1521/pedi_2021_35_509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Persons with borderline personality disorder (BPD) experience heightened emotional instability. Different components underlie instability, and the relation between instability and well-being could be confounded by average emotionality and within-person standard deviation across emotional states, reflecting variability. Therefore, the goal was to examine which pattern of emotion dynamics parsimoniously captures the emotional trajectories of persons with BPD. Forty persons with BPD, 38 clinical controls in a major depressive episode, and 40 healthy controls rated the intensity of their emotions 10 times a day for 1 week. After correction for differences in average emotionality, persons with BPD showed heightened emotional instability compared to both control groups. When additionally correcting for emotional variability, the authors found that instability indices did not differ between groups anymore. This shows that persons with BPD differ from control groups in the magnitude of emotional deviations from the emotional baseline, and not necessarily in the degree of abruptness of these deviations.
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Affiliation(s)
| | | | | | - Jasmien Obbels
- University Psychiatric Center KU Leuven, Leuven, Belgium
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11
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Kelley K, Walgren M, DeShong HL. Rumination as a transdiagnostic process: The role of rumination in relation to antisocial and borderline symptoms. J Affect Disord 2021; 295:865-872. [PMID: 34706457 DOI: 10.1016/j.jad.2021.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 07/20/2021] [Accepted: 08/21/2021] [Indexed: 12/25/2022]
Abstract
The present study examined the influence of several forms of repetitive negative thinking on antisocial and borderline symptoms to identify underlying mechanisms that may contribute to the presentation and cooccurrence of these symptoms. Participants (N = 403), completed the Personality Assessment Inventory, the Personality Diagnostic Questionnaire-4, and several measures of rumination/worry. Path analyses were conducted in which different forms of rumination/worry predicted antisocial and borderline symptoms across two personality disorder measures. Across both models tested, anger rumination emerged as the strongest predictor of both antisocial and borderline symptoms while worry negatively predicted antisocial symptoms. Rumination and worry explained substantially more variance in borderline symptoms compared to antisocial symptoms. This study is the first study to examine antisocial symptoms in relation to forms of rumination/worry and highlights the differential relations of rumination/worry to antisocial and borderline symptoms using a multi-measure approach. Further, this study highlights the importance of examining types of repetitive negative thinking, specifically rumination, as potential transdiagnostic processes.
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Affiliation(s)
- Karen Kelley
- Mississippi State University, Department of Psychology, P.O. Box 6161 Mississippi State, MS 39762, USA.
| | - Maggie Walgren
- Oklahoma State University, Department of Psychology, 116 North Murray Hall, Stillwater, OK 74078, USA
| | - Hilary L DeShong
- Mississippi State University, Department of Psychology, P.O. Box 6161 Mississippi State, MS 39762, USA
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12
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Barton BB, Goerigk S, Wüstenberg T, Dewald-Kaufmann J, Reinhard MA, Musil R, Ehring T, Jobst A, Padberg F. Altered immediate behavioral response to partial social exclusion: A cross-diagnostic study in patients with borderline personality disorder and persistent depressive disorder. J Psychiatr Res 2021; 144:177-183. [PMID: 34666281 DOI: 10.1016/j.jpsychires.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
Borderline personality disorder (BPD) and persistent depressive disorder (PDD) are related to interpersonal dysfunction which might become particularly apparent in situations of social exclusion (SE). While emotional responses to SE have been widely explored, behavioral data in clinical samples are lacking. In this cross-diagnostic study, we applied a variant of the Cyberball paradigm to investigate the dynamic behavioral response to partial SE in BPD and PDD. BPD patients (n = 36), PDD patients (n = 34) and age and gender matched healthy controls (HC) (total n = 70) played experimental (i.e. partial SE Cyberball) and control (i.e. inclusion only) conditions in randomized order. While all groups tended to increase ball tosses towards the excluder in response to SE, this behavioral turn was significantly lower in PDD (p = .03, d = -.30) and trendwise in BPD patients (p = .06, d = -.28). Thus, an altered immediate response to partial SE was observed in BPD and PDD, in addition to the emotional reactions. This study supports the hypothesis of a behavioral coping with SE in BPD and PDD that might be problematic in the long run and provides an experimental paradigm for future research on interpersonal dysfunction.
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Affiliation(s)
- Barbara B Barton
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany, Charles-de-Gaulle-Straße 2, 81737, Munich, Germany; Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University Munich, Germany, Leopoldstraße 13, 80802, Munich, Germany.
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Germany, Bonhoefferweg 3, 10117, Berlin, Germany; Department of Clinical Psychology and Psychotherapy, Ruprecht Karl University of Hauptstraße 47-51, 69117, Heidelberg, Germany.
| | - Julia Dewald-Kaufmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany, Charles-de-Gaulle-Straße 2, 81737, Munich, Germany.
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany, Leopoldstraße 13, 80802, Munich, Germany.
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany.
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany, Nussbaumstraße 7, 80336, Munich, Germany.
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Jin MJ, Lee HJ, Hwang KS, Lee JH, Yang CM, Jang SH, Lee SY. A Dimensional Understanding of Borderline Personality Disorder Using MMPI-2 PSY-5 Scales in Clinical Samples. Psychiatry Investig 2021; 18:1164-1170. [PMID: 34872242 PMCID: PMC8721292 DOI: 10.30773/pi.2021.0164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/07/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aims to understand borderline personality disorder (BPD) features by employing the Personality Psychopathology Five (PSY-5) scales from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS A total of 156 psychiatric patients completed PSY-5 scales of MMPI-2 and Personality Assessment Inventory-Borderline Subscale (PAI-BOR). Pearson's partial correlation analysis was conducted to control the impact of age and gender and to determine the relationship between PSY-5 scales and BOR. A hierarchical multiple regression analysis was implemented to examine whether PSY-5 scales predicted the BOR-total, and a path analysis was performed to determine whether PSY-5 scales predicted each PAI-BOR subscale. RESULTS The BOR-total score had a significant correlation with all PSY-5 scores, even after controlling for age and gender. However, only aggressiveness (AGGR), disconstraint (DISC), negative emotionality/neuroticism (NEGE), and introversion/low positive emotionality (INTR), excluding psychoticism (PSYC), significantly predicted BOR-total. The path analysis indicates that PSYC did not predict any BOR subscale, while NEGE predicted all BOR subscales. CONCLUSION The study findings indicate that NEGE best reflects BPD features, while PSYC is far from the core domain that describes BPD. In addition, the influence of age should be considered when understanding BPD, since age predicted the BOR-total and two BOR subscales.
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Affiliation(s)
- Min Jin Jin
- Faculty of Liberal Arts, Kongju National University, Gongju, Republic of Korea
| | - Hye-Jin Lee
- Department of Public Health, Wonkwang University Graduate School, Iksan, Republic of Korea
| | - Kyu-Sic Hwang
- Department of Psychiatry, School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea.,Wonkwang Brain-Behavior Mental Health Institute, Iksan, Republic of Korea
| | - Jae-Hee Lee
- Department of Nursing, Sehan University, Yeongam, Republic of Korea
| | - Chan-Mo Yang
- Department of Psychiatry, School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea.,Wonkwang Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.,Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Seung-Ho Jang
- Department of Psychiatry, School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea.,Wonkwang Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.,Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Sang-Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University Hospital, Iksan, Republic of Korea.,Wonkwang Brain-Behavior Mental Health Institute, Iksan, Republic of Korea.,Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Republic of Korea
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14
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Lekkas D, Gyorda JA, Price GD, Wortzman ZM, Jacobson NC. The Language of the Times: Using the COVID-19 Pandemic to Assess the Influence of News Affect on Online Mental Health-Related Search Behavior across the United States. J Med Internet Res 2021; 24:e32731. [PMID: 34932494 PMCID: PMC8805454 DOI: 10.2196/32731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022] Open
Abstract
Background The digital era has ushered in an unprecedented volume of readily accessible information, including news coverage of current events. Research has shown that the sentiment of news articles can evoke emotional responses from readers on a daily basis with specific evidence for increased anxiety and depression in response to coverage of the recent COVID-19 pandemic. Given the primacy and relevance of such information exposure, its daily impact on the mental health of the general population within this modality warrants further nuanced investigation. Objective Using the COVID-19 pandemic as a subject-specific example, this work aimed to profile and examine associations between the dynamics of semantic affect in online local news headlines and same-day online mental health term search behavior over time across the United States. Methods Using COVID-19–related news headlines from a database of online news stories in conjunction with mental health–related online search data from Google Trends, this paper first explored the statistical and qualitative affective properties of state-specific COVID-19 news coverage across the United States from January 23, 2020, to October 22, 2020. The resultant operationalizations and findings from the joint application of dictionary-based sentiment analysis and the circumplex theory of affect informed the construction of subsequent hypothesis-driven mixed effects models. Daily state-specific counts of mental health search queries were regressed on circumplex-derived features of semantic affect, time, and state (as a random effect) to model the associations between the dynamics of news affect and search behavior throughout the pandemic. Search terms were also grouped into depression symptoms, anxiety symptoms, and nonspecific depression and anxiety symptoms to model the broad impact of news coverage on mental health. Results Exploratory efforts revealed patterns in day-to-day news headline affect variation across the first 9 months of the pandemic. In addition, circumplex mapping of the most frequently used words in state-specific headlines uncovered time-agnostic similarities and differences across the United States, including the ubiquitous use of negatively valenced and strongly arousing language. Subsequent mixed effects modeling implicated increased consistency in affective tone (SpinVA β=–.207; P<.001) as predictive of increased depression-related search term activity, with emotional language patterns indicative of affective uncontrollability (FluxA β=.221; P<.001) contributing generally to an increase in online mental health search term frequency. Conclusions This study demonstrated promise in applying the circumplex model of affect to written content and provided a practical example for how circumplex theory can be integrated with sentiment analysis techniques to interrogate mental health–related associations. The findings from pandemic-specific news headlines highlighted arousal, flux, and spin as potentially significant affect-based foci for further study. Future efforts may also benefit from more expansive sentiment analysis approaches to more broadly test the practical application and theoretical capabilities of the circumplex model of affect on text-based data.
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Affiliation(s)
- Damien Lekkas
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra ParkwaySuite 300, Office #313S, Lebanon, US.,Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, US
| | - Joseph A Gyorda
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra ParkwaySuite 300, Office #313S, Lebanon, US
| | - George D Price
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra ParkwaySuite 300, Office #313S, Lebanon, US.,Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, US
| | - Zoe M Wortzman
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra ParkwaySuite 300, Office #313S, Lebanon, US
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra ParkwaySuite 300, Office #313S, Lebanon, US.,Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, US.,Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, US.,Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, US
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15
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Hopwood CJ, Bleidorn W, Wright AGC. Connecting Theory to Methods in Longitudinal Research. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 17:884-894. [PMID: 34739347 DOI: 10.1177/17456916211008407] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Advances in methods for longitudinal data collection and analysis have prompted a surge of research on psychological processes. However, decisions about how to time assessments are often not explicitly tethered to theories about psychological processes but are instead justified on methodological (e.g., power) or practical (e.g., feasibility) grounds. In many cases, methodological decisions are not explicitly justified at all. The disconnect between theories about processes and the timing of assessments in longitudinal research has contributed to misspecified models, interpretive errors, mixed findings, and nonspecific conclusions. In this article, we argue that higher demands should be placed on researchers to connect theories to methods in longitudinal research. We review instances of this disconnect and offer potential solutions as they pertain to four general questions for longitudinal researchers: how time should be scaled, how many assessments are needed, how frequently assessments should occur, and when assessments should happen.
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16
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Harp Th TSD, Hepp J, Trull TJ, Bateman AW, Kongerslev MT, Simonsen E. Positive Affect Is Associated With Decreased Symptom Severity in the Daily Lives of Individuals With Borderline Personality Disorder. J Pers Disord 2021; 35:355-372. [PMID: 31682195 DOI: 10.1521/pedi_2019_33_453] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Previous research has repeatedly demonstrated positive associations between negative affect (NA) and borderline personality disorder (BPD) symptoms in daily life, but studies have rarely addressed potential effects of positive affect (PA). Consequently, little is known about how PA in daily life covaries with symptoms of BPD. The authors assessed the effects of both PA and NA levels on BPD symptom severity in a sample of 81 treatment-seeking women diagnosed with BPD over a period of 21 days, employing a daily diary design. Using multivariate multilevel modeling, the authors obtained negative associations between PA levels and daily BPD severity in total and at the level of the individual symptoms inappropriate anger, affective instability, emptiness, identity disturbance, and paranoid ideation/dissociation. Moreover, the authors replicated previously reported positive associations between NA and BPD severity for all nine symptoms. Future research can address whether increasing PA in the treatment of BPD may potentially help reduce symptom burden.
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Affiliation(s)
- Tine S D Harp Th
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Johanna Hepp
- Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri
| | - Anthony W Bateman
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mickey T Kongerslev
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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17
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Edershile EA, Wright AGC. Fluctuations in grandiose and vulnerable narcissistic states: A momentary perspective. J Pers Soc Psychol 2021; 120:1386-1414. [PMID: 33090821 PMCID: PMC8060359 DOI: 10.1037/pspp0000370] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Theories of narcissism emphasize the dynamic processes within and between grandiosity and vulnerability. Research seeking to address this has either not studied grandiosity and vulnerability together or has used dispositional measures to assess what are considered to be momentary states. Emerging models of narcissism suggest grandiosity and vulnerability can further be differentiated into a three-factor structure-Exhibitionistic Grandiosity, Entitlement, and Vulnerability. Research in other areas of maladaptive personality (e.g., borderline personality disorder) has made headway in engaging data collection and analytic methods that are specifically meant to examine such questions. The present study took an exploratory approach to studying fluctuations within and between grandiose and vulnerable states. Fluctuations-operationalized as gross variability, instability, and lagged effects-were examined across three samples (two undergraduate and a community sample oversampled for narcissistic features; total person N = 862, total observation N = 36,631). Results suggest variability in narcissistic states from moment to moment is moderately associated with dispositional assessments of narcissism. Specifically, individuals who are dispositionally grandiose express both grandiosity and vulnerability, and vary in their overall levels of grandiosity and vulnerability over time. On the other hand, dispositionally vulnerable individuals tend to have high levels of vulnerability and low levels of grandiosity. Entitlement plays a key role in the processes that underlie narcissism and narcissistic processes appear unique to the construct and not reflective of broader psychological processes (e.g., self-esteem). Future research should consider using similar methods and statistical techniques on different timescales to study dynamics within narcissism. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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18
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Comparing Signal-Contingent and Event-Contingent Experience Sampling Ratings of Affect in a Sample of Psychotherapy Outpatients. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021; 42:13-24. [PMID: 33664551 DOI: 10.1007/s10862-019-09766-7] [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: 10/25/2022]
Abstract
Experience sampling methods are widely used in clinical psychology to study affective dynamics in psychopathology. The present study examined whether affect ratings (valence and arousal) differed as a function of assessment schedule (signal- versus event-contingent) in a clinical sample and considered various approaches to modeling these ratings. A total of 40 community mental health center outpatients completed ratings of their affective experiences over a 21-day period using both signal-contingent schedules (random prompts) and event-contingent schedules (ratings following social interactions). We tested whether assessment schedules impacted 1) the central tendency (mean) and variability (standard deviation) of valence or arousal considered individually, 2) the joint variability in valence and arousal via the entropy metric, and 3) the between-person differences in configuration of valence-arousal landscapes via the Earth Mover's Distance (EMD) metric. We found that event-contingent schedules, relative to signal-contingent schedules, captured higher average levels of pleasant valence and emotional arousal ratings. Moreover, signal-contingent schedules captured greater variability within and between individuals on arousal-valence landscapes compared to event-contingent schedules. Altogether, findings suggest that the two assessment schedules should not be treated interchangeably in the assessment of affect over time. Researchers must be cautious in generalizing results across studies utilizing different experience sampling assessment schedules.
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19
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Dixon-Gordon KL, Laws H. Emotional Variability and Inertia in Daily Life: Links to Borderline Personality and Depressive Symptoms. J Pers Disord 2021; 35:162-171. [PMID: 33650892 DOI: 10.1521/pedi_2021_35_504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Borderline personality disorder (BPD) and depression are characterized by negative emotionality, yet BPD is also theorized to be linked with emotional variability. The present study extends past work to a larger time scale and notes the degree to which stress-related emotional responses are variable or persistent across stressors using novel analytic models. Participants (N = 164) were undergraduate students who completed daily assessments of negative emotional responses to interpersonal stressors for 2 weeks. BPD and depression were associated with greater negative emotional intensity and greater emotional variability in response to nonsocial stressors. Only BPD features were associated with greater emotional variability in response to social stressors. This study is limited by its reliance on self-report in a nonclinical sample and limited within-person assessments. Data point to distinct constellations of emotional dysfunction in BPD and depression. Pending replication, these data may inform targeting of emotional dysfunction in treatment.
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Affiliation(s)
| | - Holly Laws
- University of Massachusetts Amherst, Amherst, Massachusetts
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20
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Clegg KA, Moskowitz D, Miners CT, Andrevski G, Sadikaj G. Person, situation, and spin: Examining the correlates of interpersonal spin with mobile application-based ECR. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Gulamani T, Rodrigo AH, Uliaszek AA, Ruocco AC. Facial Emotion Perception in Families Affected With Borderline Personality Disorder. J Pers Disord 2021; 35:132-148. [PMID: 33650891 DOI: 10.1521/pedi_2021_35_514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Emotion perception biases may precipitate problematic interpersonal interactions in families affected with borderline personality disorder (BPD) and lead to conflictual relationships. In the present study, the authors investigated the familial aggregation of facial emotion recognition biases for neutral, happy, sad, fearful, and angry expressions in probands with BPD (n = 89), first-degree biological relatives (n = 67), and healthy controls (n = 87). Relatives showed comparable accuracy and response times to controls in recognizing negative emotions in aggregate and most discrete emotions. For sad expressions, both probands and relatives displayed slower response latencies, and they were more likely than controls to perceive sad expressions as fearful. Nonpsychiatrically affected relatives were slower than controls in responding to negative emotional expressions in aggregate, and fearful and sad facial expressions more specifically. These findings uncover potential biases in perceiving sad and fearful facial expressions that may be transmitted in families affected with BPD.
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Affiliation(s)
| | | | | | - Anthony C Ruocco
- Department of Psychology, University of Toronto Scarborough, and the Department of Psychological Clinical Science, University of Toronto, Toronto, Canada
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22
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Moukhtarian TR, Reinhard I, Moran P, Ryckaert C, Skirrow C, Ebner-Priemer U, Asherson P. Comparable emotional dynamics in women with ADHD and borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:6. [PMID: 33579385 PMCID: PMC7879647 DOI: 10.1186/s40479-021-00144-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation (ED) is a core diagnostic symptom in borderline personality disorder (BPD) and an associated feature of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate differences in dynamical indices of ED in daily life in ADHD and BPD. METHODS We used experience sampling method (ESM) and multilevel modelling to assess momentary changes in reports of affective symptoms, and retrospective questionnaire measures of ED in a sample of 98 adult females with ADHD, BPD, comorbid ADHD+BPD and healthy controls. RESULTS We found marked differences between the clinical groups and healthy controls. However, the ESM assessments did not show differences in the intensity of feeling angry and irritable, and the instability of feeling sad, irritable and angry, findings paralleled by data from retrospective questionnaires. The heightened intensity in negative emotions in the clinical groups compared to controls was only partially explained by bad events at the time of reporting negative emotions, suggesting both reactive and endogenous influences on ED in both ADHD and BPD. CONCLUSIONS This study supports the view that ED is a valuable trans-diagnostic aspect of psychopathology in both ADHD and BPD, with similar levels of intensity and instability. These findings suggest that the presence or severity of ED should not be used in clinical practice to distinguish between the two disorders.
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Affiliation(s)
- Talar R Moukhtarian
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Iris Reinhard
- Central Institute of Mental Health, Division of Biostatistics, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Paul Moran
- Centre for Academic Mental Health, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Celine Ryckaert
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - Ulrich Ebner-Priemer
- Mental m-health lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany. .,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
| | - Philip Asherson
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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23
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Rappaport LM, Hunter MD, Russell JJ, Pinard G, Bleau P, Moskowitz DS. Emotional and interpersonal mechanisms in community SSRI treatment of social anxiety disorder. J Psychiatry Neurosci 2021; 46:E56-E64. [PMID: 33026311 PMCID: PMC7955850 DOI: 10.1503/jpn.190164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Affective and interpersonal behavioural patterns characteristic of social anxiety disorder show improvement during treatment with serotonin agonists (e.g., selective serotonin reuptake inhibitors), commonly used in the treatment of social anxiety disorder. The present study sought to establish whether, during community psychopharmacological treatment of social anxiety disorder, changes in positive or negative affect and agreeable or quarrelsome behaviour mediate improvement in social anxiety symptom severity or follow from it. METHODS Adults diagnosed with social anxiety disorder (n = 48) recorded their interpersonal behaviour and affect naturalistically in an event-contingent recording procedure for 1-week periods before and during the first 4 months of treatment with paroxetine. Participants and treating psychiatrists assessed the severity of social anxiety symptoms monthly. A multivariate latent change score framework examined temporally lagged associations of change in affect and interpersonal behaviour with change in social anxiety symptom severity. RESULTS Elevated agreeable behaviour and positive affect predicted greater subsequent reduction in social anxiety symptom severity over the following month of treatment. Elevated negative affect, but not quarrelsome behaviour, predicted less subsequent reduction in symptom severity. LIMITATIONS Limitations included limited assessment of extreme behaviour (e.g., violence) that may have precluded examining the efficacy of paroxetine because of the lack of a placebo control group. CONCLUSION The present study suggests that interpersonal behaviour and affect may be putative mechanisms of action for serotonergic treatment of social anxiety disorder. Prosocial behaviour and positive affect increase during serotonergic treatment of social anxiety disorder. Specifically, modulating agreeable behaviour, positive affect and negative affect in individuals' daily lives may partially explain and refine clinical intervention.
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Affiliation(s)
- Lance M Rappaport
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
| | - Michael D Hunter
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
| | - Jennifer J Russell
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
| | - Gilbert Pinard
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
| | - Pierre Bleau
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
| | - D S Moskowitz
- From the Department of Psychology, University of Windsor, Windsor, Ont., Canada (Rappaport); the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA (Rappaport); the Department of Psychology, McGill University, Montreal, Que., Canada (Rappaport, Russell, Moskowitz); the School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA (Hunter); and the Department of Psychiatry, McGill University, Montreal, Que., Canada (Russell, Pinard, Bleau)
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24
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Furr RM. The study of behaviour in personality psychology: Meaning, importance and measurement. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.726] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The target paper was intended to initiate dialogue about challenges to personality psychology's progress as a truly behavioural science, and the commentaries' diverse reactions underscore the fact that these issues do indeed merit serious discussion. This response addresses several broad questions raised in the commentaries—what is behaviour, is behaviour of primary importance yet understudied, and what are the strengths and weaknesses of core types of behavioural data? In addition, it addresses an issue raised in several commentaries, but only briefly mentioned in the target paper—the fact that behaviour can be conceptualized and measured at multiple levels of abstraction. These issues have implications for the nature of personality psychology and for the research conducted by personality psychologists. Copyright © 2009 John Wiley & Sons, Ltd.
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25
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Rost S, Crombez G, Sütterlin S, Vögele C, Veirman E, Van Ryckeghem DML. Altered regulation of negative affect in patients with fibromyalgia: A diary study. Eur J Pain 2020; 25:714-724. [PMID: 33259659 PMCID: PMC7984394 DOI: 10.1002/ejp.1706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 10/19/2020] [Accepted: 11/22/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Fibromyalgia is characterized by widespread musculoskeletal pain and often accompanied by cognitive and emotional problems. Adaptation to fibromyalgia may therefore also rely on one's ability to regulate emotional problems. In this study, we examined two indices of emotion regulation, that is, (a) affective instability, involving frequent large fluctuations in self-reported affect, and (b) resting heart rate variability (HRV). METHODS Participants were 46 patients with fibromyalgia (Mage = 45.4 years; 39 females) and 46 matched healthy controls (Mage = 44.9 years; 37 females). Heart rate was monitored under resting conditions to derive HRV. Subsequently, participants completed an electronic end-of-day diary for 14 consecutive days assessing daily levels of pain, disability, negative affect (NA) and positive affect (PA). Affective instability was operationalized as the mean square of successive differences in daily mood. RESULTS Results indicate increased levels of NA instability and reduced levels of HRV in patients with fibromyalgia in comparison with healthy controls. Furthermore, HRV and NA instability were inversely related. Finally, in patients, higher NA instability was related to increased pain disability. CONCLUSIONS Current findings support the idea that patients with fibromyalgia are confronted with fluctuating emotions. These results may have important implications for treatment as they provide support for the use of emotion regulation skills training in patients with fibromyalgia to impact upon NA instability. SIGNIFICANCE This study provides novel insight in the link between emotion regulation indices,that is, heart-rate variability and negative affective (NA) instability, in patients with fibromyalgia, and presents evidence for differences in both emotion regulation indices between patients with fibromyalgia and healthy people. Furthermore, results link increased NA instability with increased levels of daily disability in patients with fibromyalgia. Together, these findings offer support for a key role of emotion regulation in fibromyalgia outcomes, providing pathways for clinical practice.
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Affiliation(s)
- Silke Rost
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Stefan Sütterlin
- Faculty for Health and Welfare Sciences, Østfold University College, Halden, Norway.,Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Claus Vögele
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Research Group Health Psychology, University of Leuven, Belgium
| | - Elke Veirman
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Dimitri M L Van Ryckeghem
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.,Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
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26
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Akyunus M, Gençöz T, Karakose S. The Mediator Role of Negative Cognitive Emotion Regulation Strategies Between Interpersonal Problems and Borderline Personality Beliefs. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00373-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Clegg KA, Moskowitz DS, Miners CTH, Andrevski G, Sadikaj G, Zuroff DC. Interpersonal perception and interpersonal spin. J Pers 2020; 89:483-499. [PMID: 32976682 DOI: 10.1111/jopy.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Interpersonal spin is an indicator of intraindividual variability in social behavior. Spin is positively related to Neuroticism and is maladaptive, with well-documented deleterious effects on social functioning. The perceptual processes associated with spin and how spin emerges are less well-understood. The present research examines the interpersonal perception of individuals with higher spin and tests whether these perceptual processes explain the association of spin with Neuroticism. METHOD 267 students participated in a 20-day event contingent recording procedure, reporting on social interactions via mobile application. Participants' perceptions of others' behavior, their own affect, and their own behavior were measured within and across interactions. RESULTS We examined the affective and behavioral responses of individuals with higher spin to perceptions of others' behaviors. Individuals with higher spin showed greater affective and behavioral reactivity to perceptions of others' communal (agreeable-quarrelsome) behavior. Neuroticism predicted greater affective reactivity (i.e., steeper slopes between event-level perceived communion and negative affect), which in turn predicted higher spin. CONCLUSIONS Individuals with higher spin may have an interpersonal style characterized by greater reactivity to perceptions of others' communal behavior. These individuals' behavioral lability may reflect underlying emotional dysregulation. These processes may ultimately interfere with the formation and maintenance of social bonds.
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Affiliation(s)
| | - D S Moskowitz
- Department of Psychology, McGill University, Montreal, QC, Canada
| | | | - Goce Andrevski
- Smith School of Business, Queen's University, Kingston, ON, Canada
| | - Gentiana Sadikaj
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - David C Zuroff
- Department of Psychology, McGill University, Montreal, QC, Canada
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Ooi J, Michael J, Lemola S, Butterfill S, Siew CSQ, Walasek L. Interpersonal Functioning in Borderline Personality Disorder Traits: A Social Media Perspective. Sci Rep 2020; 10:1068. [PMID: 31974517 PMCID: PMC6978508 DOI: 10.1038/s41598-020-58001-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/06/2020] [Indexed: 12/15/2022] Open
Abstract
This is the first study to demonstrate interpersonal difficulties associated with borderline personality disorder (BPD) features in the domain of social media. Using crowdsourcing, we presented participants with a battery of questions about their recent social media use, and then assessed their BPD features using the short form of the Five-Factor Borderline Inventory. The results revealed that individuals with higher BPD trait scores reported posting more often on social media, as well as a higher incidence of experiencing regret after posting on social media, and of deleting or editing their posts. They also report a higher degree of importance of social media in their social behavior and daily routines. These results highlight the pervasiveness of interpersonal difficulties associated with BPD features even in the non-clinical population, and demonstrate that these difficulties are also observable in social media behavior. Our findings may provide a starting point for research using data from social media to illuminate the cognitive and emotional processes underpinning the interpersonal difficulties associated with BPD features, and to inform and assess therapeutic interventions.
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Affiliation(s)
- Jinnie Ooi
- Department of Philosophy, University of Warwick, Warwick, UK
| | - John Michael
- Department of Philosophy, University of Warwick, Warwick, UK.
- Department of Cognitive Science, Central European University Budapest, Budapest, Hungary.
| | - Sakari Lemola
- Department of Psychology, University of Warwick, Warwick, UK
| | - Stephen Butterfill
- Department of Cognitive Science, Central European University Budapest, Budapest, Hungary
| | - Cynthia S Q Siew
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Lukasz Walasek
- Department of Psychology, University of Warwick, Warwick, UK
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Wright AGC, Kaurin A. Integrating Structure and Function in Conceptualizing and Assessing Pathological Traits. Psychopathology 2020; 53:189-197. [PMID: 32375147 DOI: 10.1159/000507590] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/27/2020] [Indexed: 11/19/2022]
Abstract
The Diagnostic and Statistical Manual of Mental Disorders' (5th Edition) Alternative Model of Personality Disorders includes a dimensional trait model to describe individual differences in the manifestation of personality pathology. Empirically derived quantitative trait models of psychopathology address many of the structural problems of classical diagnostic schemes (e.g., nonbinary distributions, excessive comorbidity, and diagnostic heterogeneity). However, they are largely based on the structure of individual differences in the manifestation of psychopathology. In contrast, clinical theories of personality disorder, which are the foundation of intervention efforts, are based on the function of maladaptive behavior. This distinction is akin to the difference between morphology and physiology in the broader biological sciences. A structure-function divide in the focus of empirical and clinical work contributes to a lack of integration and difficulties with translation. Here we discuss this tension and argue for the need to bridge this divide and adopt research efforts that integrate structure and function of personality traits. Specifically, we suggest that between-person structure identifies the principal domains of functioning, but to understand dysfunction personality must be conceptualized and studied as an ensemble of contextualized dynamic processes.
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Affiliation(s)
- Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,
| | - Aleksandra Kaurin
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Bayes A, Parker G, Paris J. Differential Diagnosis of Bipolar II Disorder and Borderline Personality Disorder. Curr Psychiatry Rep 2019; 21:125. [PMID: 31749106 DOI: 10.1007/s11920-019-1120-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE OF REVIEW Differentiating bipolar (BP) disorders (in particular BP II) from borderline personality disorder (BPD) is a common diagnostic dilemma. We sought to critically examine recent studies that considered clinical differences between BP II and BPD, which might advance their delineation. RECENT FINDINGS Recent studies focused on differentiating biological parameters-genetics, epigenetics, diurnal rhythms, structural and functional neuroimaging-with indicative differences not yet sufficient to guide diagnosis. Key differentiating factors include family history, developmental antecedents, illness course, phenomenological differences in mood states, personality style and relationship factors. Less differentiating factors include impulsivity, neuropsychological profiles, gender distribution, comorbidity and treatment response. This review details parameters offering differentiation of BP II from BPD and should assist in resolving a frequent diagnostic dilemma. Future studies should specifically examine the BP II subtype directly with BPD, which would aid in sharpening the distinction between the disorders.
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Affiliation(s)
- Adam Bayes
- School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia. .,Black Dog Institute, Sydney, NSW, Australia.
| | - Gordon Parker
- School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia.,Black Dog Institute, Sydney, NSW, Australia
| | - Joel Paris
- Institute of Community and Family Psychiatry, SMBD-Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Smith M, South S. Romantic attachment style and borderline personality pathology: A meta-analysis. Clin Psychol Rev 2019; 75:101781. [PMID: 31918217 DOI: 10.1016/j.cpr.2019.101781] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 09/13/2019] [Accepted: 10/15/2019] [Indexed: 12/24/2022]
Abstract
Borderline Personality Disorder (BPD) implies profound impairment in interpersonal relationships, particularly romantic relationships (Daley, Burge, & Hammen, 2000). Insecure attachment bears striking resemblance to BPD traits in both empirical and theoretical work (Levy, Johnson, Clouthier, Scala, & Temes, 2015) and may be particularly suited for understanding the BPD-related deficits in romantic functioning. Despite several qualitative reviews concluding that secure attachment is disrupted in those with BPD traits, no consensus has emerged regarding the form of this disruption (Levy et al., 2015), with most reviews focusing on whether BPD is best captured as high levels of attachment anxiety or attachment avoidance. The purpose of the current review is to provide a quantitative synthesis of the strength and direction of the associations between attachment insecurity and BPD traits. Searches on PsycINFO and Pubmed resulted in 27 effect sizes that measured BPD and adult romantic attachment on the two primary dimensions of anxiety and avoidance (Fraley, Waller, & Brennan, 2000). Results demonstrated that attachment anxiety correlates most strongly with BPD traits (r = 0.48); however, attachment avoidance also evinced a significant effect (r = 0.30). Findings from regression analyses indicate that attachment anxiety and avoidance interact, suggesting a particularly strong relationship between attachment disorganization and BPD traits.
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Affiliation(s)
- Madison Smith
- Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, United States of America.
| | - Susan South
- Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, United States of America.
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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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Irwing P, Cook C, Pollet TV, Hughes DJ. Comedians' Trait Level and Stage Personalities: Evidence for Goal-Directed Personality Adaptation. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2019; 46:590-602. [PMID: 31409245 DOI: 10.1177/0146167219867963] [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] [Indexed: 11/17/2022]
Abstract
Recent findings have shown that both trait levels of personality and situational variability in its expression are of importance. So here, the Big Five personality traits of 77 professional and 125 amateur stand-up comedians were compared with two large matched samples (N > 100,000). The comedians were also observed while performing, which enabled a comparison of their stage personalities with situational requirements on 10 selected NEO-PIR facets. Both amateurs and professionals showed higher openness-to-experience, extraversion, and lower conscientiousness than their norm samples, while professionals also evidenced greater neuroticism. Irrespective of trait standing, with regard to most NEO-PIR facets, professionals expressed the appropriate on-stage persona and were better able to regulate their personality to conform to situational requirements than amateurs. This is consistent with research showing that individuals regulate their personality to conform to situational and goal requirements, and adds the finding that successful comedians demonstrate enhanced adaptability compared with amateurs.
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Affiliation(s)
| | - Clare Cook
- Northumbria University, Newcastle Upon Tyne, UK
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Abstract
Evolutionary models of psychopathology can shed light on gene-environment interactions. Differential susceptibility to the environment means that heritable traits can have positive or negative effects, depending on environmental context. Thus, traits that increase risk for mental disorders when the environment is negative can be adaptive when the environment is positive. This model can be applied to borderline personality disorder, with predictors such as emotional dysregulation and impulsivity seen as temperamental variations leading to negative effects in an unfavorable environment but to positive effects in a favorable environment. This model may also be useful in conceptualizing the mechanisms of effective therapy for borderline personality disorder.
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35
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Akyunus M, Gençöz T. The Distinctive Associations of Interpersonal Problems with Personality Beliefs Within the Framework of Cognitive Theory of Personality Disorders. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2019. [DOI: 10.1007/s10942-019-00322-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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36
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Nelis S, Bukowski WM. Daily Affect and Self-Esteem in Early Adolescence: Correlates of Mean Levels and Within-Person Variability. Psychol Belg 2019; 59:96-115. [PMID: 31328013 PMCID: PMC6625554 DOI: 10.5334/pb.467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 01/30/2019] [Indexed: 11/20/2022] Open
Abstract
Emotions and self-esteem are critical components of well-being and adaptation during adolescence. People differ in their average levels of affect and self-esteem, as well as in how much their affect and self-esteem fluctuate from moment to moment. Fluctuations in affect in particular have not been extensively examined in relation to adolescent-relevant variables. The present study investigates internalizing symptoms, social functioning, and overt and relational aggression as correlates of average levels and within-person variability in daily positive and negative affect (PA and NA) and self-esteem. Crucially, unique association were examined controlling for the other variables. Early adolescents (mean age 10.8 years, N = 94) completed daily diaries across four days on PA, NA, and self-esteem. They also completed general questionnaires, as did peers. Some key findings were that more internalizing symptoms were significantly associated with more variability in NA. The importance of peer relationships for adolescents' daily mean levels of PA and NA were shown. Peer-perceived social functioning was associated with less fluctuations in self-esteem. Some unexpected, non-significant, findings for aggression appeared. Finally, higher mean NA were associated with more NA fluctuations, whereas higher mean PA and self-esteem were associated with less fluctuations.
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37
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Fowler JC, Madan A, Allen JG, Oldham JM, Frueh BC. Differentiating bipolar disorder from borderline personality disorder: Diagnostic accuracy of the difficulty in emotion regulation scale and personality inventory for DSM-5. J Affect Disord 2019; 245:856-860. [PMID: 30699870 DOI: 10.1016/j.jad.2018.11.079] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/02/2018] [Accepted: 11/11/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Confusion abounds when differentiating the diagnoses of bipolar disorder (BD) from borderline personality disorder (BPD). This study explored the relative clinical utility of affective instability and self-report personality trait measures for accurate identification of BD and BPD. METHODS Receiver operator characteristics and diagnostic efficiency statistics were calculated to ascertain the relative diagnostic efficiency of self-report measures. Inpatients with research-confirmed diagnoses of BD (n = 341) or BPD (n = 381) completed the Difficulty in Emotion Regulation Scale (DERS) and Personality Inventory for DSM-5 (PID-5). RESULTS The total score for DERS evidenced relatively poor accuracy for differentiating the disorders (AUC = 0.72, SE = 0.02, p < .0001), while subscales of affective instability measures yielded fair discrimination (AUC range = 0.70-0.59). The PID-5 BPD algorithm (consisting of emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC = 0.83, SE = 0.04, p < .0001) with a good balance of specificity (SP = 0.79) and sensitivity (SN = 0.77). CONCLUSION Findings support the use of the PID-5 algorithm for differentiating BD from BPD. Furthermore, findings support the accuracy of the DSM-5 alternative model Criteria B trait constellation for differentiating these two disorders with overlapping features.
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Affiliation(s)
- J Christopher Fowler
- Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, United States.
| | - Alok Madan
- Houston Methodist Behavioral Health, 6550 Fannin St Houston, TX 77030, United States
| | - Jon G Allen
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States
| | - John M Oldham
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States
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38
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Hepp J, Störkel LM, Kieslich PJ, Schmahl C, Niedtfeld I. Negative evaluation of individuals with borderline personality disorder at zero acquaintance. Behav Res Ther 2018; 111:84-91. [DOI: 10.1016/j.brat.2018.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 09/12/2018] [Accepted: 09/29/2018] [Indexed: 12/14/2022]
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Meehan KB, Clarkin JF, Lenzenweger MF. Conceptual Models of Borderline Personality Disorder, Part 1: Overview of Prevailing and Emergent Models. Psychiatr Clin North Am 2018; 41:535-548. [PMID: 30447722 DOI: 10.1016/j.psc.2018.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Borderline personality disorder (BPD) is a debilitating condition with significant personal and societal costs. Throughout the history of the conceptualization of borderline pathology as a form of psychopathology, there has been debate concerning the essential attributes of this disorder, which has significant implications for its assessment and treatment. The first of this 2-part review evaluates the major approaches to conceptualizing BPD, from the traditional DSM diagnosis through the more recent Alternative Model in DSM-5, Section III, and the research domain criteria initiative of the National Institute of Mental Health that was articulated largely in response to limitations of the DSM.
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Affiliation(s)
- Kevin B Meehan
- Long Island University, Brooklyn Campus, 1 University Plaza, Brooklyn, NY 11201, USA; Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10065, USA.
| | - John F Clarkin
- Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10065, USA
| | - Mark F Lenzenweger
- Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10065, USA; State University of New York at Binghamton, Science IV, Binghamton, NY 13902, USA
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Conceptual Models of Borderline Personality Disorder, Part 2: A Process Approach and Its Implications. Psychiatr Clin North Am 2018; 41:549-559. [PMID: 30447723 DOI: 10.1016/j.psc.2018.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In part 2, the authors argue for a greater focus on a process approach to conceptualizing borderline personality disorder (BPD). The studies reviewed highlight contextual aspects of the pathology, specifically the affective and relational conditions under which BPD features become evident. The authors identify at what level in a complex social cognitive process the pathology may emerge. The implications of these findings for future model conceptualization are discussed, including the centrality of understanding BPD as an emergent phenomenon that cannot be reduced to single explanatory dimensions. The implications of these models for assessment, research, and treatment of BPD are discussed.
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Abstract
Borderline personality disorder (BPD) has a wide range of symptoms and clinical features that overlap with other diagnostic categories. Diagnosis is important because different disorders respond to different forms of treatment. Differential diagnosis is particularly relevant for distinguishing BPD from bipolar spectrum disorders, requiring a careful evaluation of affective instability and hypomania. BPD may also be confused with major depression, schizophrenia, attention-deficit/hyperactivity disorder, and posttraumatic stress disorder.
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Affiliation(s)
- Joel Paris
- McGill University, SMBD-Jewish General Hospital, 4333 Cote Ste Catherine, Montreal, Quebec H3A 1E4, Canada.
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42
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Everyday social interactions and intra-individual variability in affect: A systematic review and meta-analysis of ecological momentary assessment studies. MOTIVATION AND EMOTION 2018. [DOI: 10.1007/s11031-018-9735-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Van Liefferinge D, Sonuga-Barke E, Danckaerts M, Fayn K, Van Broeck N, van der Oord S. Measuring child and adolescent emotional lability: How do questionnaire-based ratings relate to experienced and observed emotion in everyday life and experimental settings? Int J Methods Psychiatr Res 2018; 27:e1720. [PMID: 29845690 PMCID: PMC6877123 DOI: 10.1002/mpr.1720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/12/2018] [Accepted: 04/09/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Emotional lability (EL) is an important trans-diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating-based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention-deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. METHODS In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N = 67). In Study 2, we examined the relationship between parental ratings and real-time measures of emotional experiences in daily life in adolescents (N = 65). RESULTS EL ratings were associated with different elements of real-time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. CONCLUSIONS These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD.
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Affiliation(s)
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,UK Institute for Disorders of Impulse and Attention, University of Southampton, Southampton, UK
| | - Marina Danckaerts
- Department of Neurosciences, Child and Adolescent Psychiatry, Leuven, Belgium.,University Psychiatric Centre, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Kirill Fayn
- Research Group Quantitative Psychology and Individual Differences, Leuven, Belgium
| | - Nady Van Broeck
- Research Group Clinical Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Saskia van der Oord
- Research Group Clinical Psychology, Katholieke Universiteit Leuven, Leuven, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Centre for Cognitive Science, University of Amsterdam, Amsterdam, The Netherlands
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Puri P, Kumar D, Muralidharan K, Kishore MT. Individuals with Borderline Personality Disorder manifest cognitive biases implicated in psychosis. Psychiatry Res 2018; 267:414-419. [PMID: 29960939 DOI: 10.1016/j.psychres.2018.06.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Abstract
Individuals with Borderline Personality Disorder (BPD) frequently manifest psychotic symptoms. Certain cognitive biases have been implicated in the genesis and maintenance of psychotic symptoms. The present study aimed at exploring whether individuals with BPD manifest these cognitive biases. Twenty-eight individuals with BPD and 28 healthy participants were assessed on four sub-domains of the Davos Assessment of Cognitive Biases Scale, viz. jumping to conclusions, belief inflexibility, attention for threat and external attribution. The BPD group had significantly higher scores on all the four cognitive biases in comparison to the healthy controls. Thus, the findings of the present study indicate that individuals with BPD manifest cognitive biases implicated in psychosis more prominently than healthy individuals. These findings can be used to improve the existing psychotherapeutic techniques for BPD.
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Affiliation(s)
- Priya Puri
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - Devvarta Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India.
| | - Kesavan Muralidharan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
| | - M Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
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45
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An interpersonal perspective on Criterion A of the DSM-5 Alternative Model for Personality Disorders. Curr Opin Psychol 2018; 21:11-17. [DOI: 10.1016/j.copsyc.2017.08.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/27/2017] [Accepted: 08/29/2017] [Indexed: 11/21/2022]
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46
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Carlson EN, Oltmanns TF. Is It Adaptive for People With Personality Problems to Know How Their Romantic Partner Perceives Them? The Effect of Meta-accuracy on Romantic Relationship Satisfaction. J Pers Disord 2018; 32:374-391. [PMID: 29847245 DOI: 10.1521/pedi.2018.32.3.374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
People with personality disorder (PD) symptoms tend to report and have partners who report lower quality relationships with them. Using a large community sample of romantic couples, the current research tested whether the established link between PD symptoms and partner-reported relationship quality was attenuated by meta-accuracy (insight into the impression one makes) as well as whether the link between PD symptoms and self-reported relationship quality was attenuated by positivity (assuming one makes a desirable impression). Results suggested that meta-accuracy for core personality traits moderated the link between PD symptoms and partner-reported relationship quality, such that high meta-accuracy attenuated whereas low meta-accuracy exacerbated the negative association between PD symptoms and quality. However, individuals with symptoms did not necessarily reap the same relational benefits of their meta-accuracy, and positivity did not moderate the link between their symptoms and relationship quality. Implications for assessment and whether meta-accuracy should be improved are discussed.
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47
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Lischke A, Herpertz SC, Berger C, Domes G, Gamer M. Divergent effects of oxytocin on (para-)limbic reactivity to emotional and neutral scenes in females with and without borderline personality disorder. Soc Cogn Affect Neurosci 2018; 12:1783-1792. [PMID: 29036358 PMCID: PMC5714167 DOI: 10.1093/scan/nsx107] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/11/2017] [Indexed: 12/31/2022] Open
Abstract
Borderline personality disorder (BPD) patients’ hypersensitivity for emotionally relevant stimuli has been suggested be due to abnormal activity and connectivity in (para-)limbic and prefrontal brain regions during stimulus processing. The neuropeptide oxytocin has been shown to modulate activity and functional connectivity in these brain regions, thereby optimizing the processing of emotional and neutral stimuli. To investigate whether oxytocin would be capable of attenuating BPD patients’ hypersensitivity for such stimuli, we recorded brain activity and gaze behavior during the processing of complex scenes in 51 females with and 48 without BPD after intranasal application of either oxytocin or placebo. We found divergent effects of oxytocin on BPD and healthy control (HC) participants’ (para-)limbic reactivity to emotional and neutral scenes: Oxytocin decreased amygdala and insula reactivity in BPD participants but increased it in HC participants, indicating an oxytocin-induced normalization of amygdala and insula activity during scene processing. In addition, oxytocin normalized the abnormal coupling between amygdala activity and gaze behavior across all scenes in BPD participants. Overall, these findings suggest that oxytocin may be capable of attenuating BPD patients’ hypersensitivity for complex scenes, irrespective of their valence.
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Affiliation(s)
- Alexander Lischke
- Department of Psychology, University of Greifswald, Greifswald, Germany.,Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Christoph Berger
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany.,Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University of Rostock, Rostock, Germany
| | - Gregor Domes
- Department of Psychology, University of Trier, Trier, Germany
| | - Matthias Gamer
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychology, University of Würzburg, Würzburg, Germany
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Wright AGC, Hallquist MN, Stepp SD, Scott LN, Beeney JE, Lazarus SA, Pilkonis PA. Modeling Heterogeneity in Momentary Interpersonal and Affective Dynamic Processes in Borderline Personality Disorder. Assessment 2018; 23:484-495. [PMID: 27317561 DOI: 10.1177/1073191116653829] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Borderline personality disorder (BPD) is a diagnosis defined by impairments in several dynamic processes (e.g., interpersonal relating, affect regulation, behavioral control). Theories of BPD emphasize that these impairments appear in specific contexts, and emerging results confirm this view. At the same time, BPD is a complex construct that encompasses individuals with heterogeneous pathology. These features-dynamic processes, situational specificity, and individual heterogeneity-pose significant assessment challenges. In the current study, we demonstrate assessment and analytic methods that capture both between-person differences and within-person changes over time. Twenty-five participants diagnosed with BPD completed event-contingent, ambulatory assessment protocols over 21 days. We used p-technique factor analyses to identify person-specific psychological structures consistent with clinical theories of personality. Five exemplar cases are selected and presented in detail to showcase the potential utility of these methods. The presented cases' factor structures reflect not only heterogeneity but also suggest points of convergence. The factors also demonstrated significant associations with important clinical targets (self-harm, interpersonal violence).
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Affiliation(s)
| | - Michael N Hallquist
- 2 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.,3 The Pennsylvania State University, University Park, PA, USA
| | | | - Lori N Scott
- 2 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Joseph E Beeney
- 2 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Sophie A Lazarus
- 2 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Paul A Pilkonis
- 2 University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
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Daros AR, Guevara MA, Uliaszek AA, McMain SF, Ruocco AC. Cognitive Emotion Regulation Strategies in Borderline Personality Disorder: Diagnostic Comparisons and Associations with Potentially Harmful Behaviors. Psychopathology 2018; 51:83-95. [PMID: 29566390 DOI: 10.1159/000487008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/13/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although difficulties in emotion regulation (ER) are considered a core feature of borderline personality disorder (BPD), the specific strategies that individuals with BPD most commonly use, their diagnostic specificity, and their associations with harmful behaviors have not been firmly established. SAMPLING AND METHODS Individuals with BPD (n = 30), mixed anxiety and/or depressive disorders (MAD; n = 30), and healthy controls (HC; n = 32) completed questionnaires assessing both cognitive ER strategies (e.g., cognitive reappraisal) and potentially harmful behaviors that individuals might use to regulate their emotions (e.g., self-injury). RESULTS BPD subjects endorsed more maladaptive cognitive ER strategies and fewer adaptive strategies compared to HC. Compared to MAD subjects, BPD individuals endorsed more maladaptive cognitive ER strategies, but only when those with subthreshold symptoms in the MAD group were excluded. BPD also endorsed engaging in potentially harmful behaviors more often than both HC and MAD. Discriminant analysis revealed that MAD endorsed lower rates of problem-solving and cognitive reappraisal compared to both HC and BPD. Higher maladaptive and lower adaptive ER strategies were associated with higher rates of potentially harmful behaviors, although the specific strategies differed for MAD versus BPD. CONCLUSIONS BPD and MAD endorse cognitive ER strategies with a comparable frequency, although BPD subjects engage in potentially harmful behaviors more often. Subthreshold BPD symptoms may also affect rates of ER strategy use in individuals with other mental disorders.
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Affiliation(s)
- Alexander R Daros
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Mylann A Guevara
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Amanda A Uliaszek
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Shelley F McMain
- Clinical Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anthony C Ruocco
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
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