Borderline Personality Disorder and Emotion Dysregulation最新文献

Background: In a similar way to depression, the development of borderline personality traits seems closely linked to the experience of Stressful Life Events (SLEs). This study examined the extent to which emotion regulation and personality traits simultaneously mediate and significantly attenuate the direct path between SLEs and depressive symptoms.

Method: Parallel and serial multiple mediation models were employed to analyze a sample of 196 adolescents assessed twice over a 12-month period. A regression-based path analysis approach was employed to simultaneously estimate the specific indirect effects of emotion regulation and borderline traits on the direct relationship between SLEs and depression.

Results: In a parallel multiple mediation model, both borderline traits and emotion regulation fully mediated the direct relationship between SLEs and depressive symptoms. The serial multiple mediation model also showed complete mediation. In this model, the indirect pathway from SLEs to depressive symptoms, first through borderline traits and subsequently through emotion regulation, accounted for 70.8% of the total indirect effect. In contrast, the indirect effects via borderline traits and emotion regulation accounted for 24% and 5.3% of the total indirect effects, respectively.

Conclusion: To strengthen clinical practice, early identification of borderline personality traits combined with targeted interventions to address specific symptoms may enhance emotional regulation and reduce the risk of depressive symptoms in vulnerable adolescents.

Background: Nonsuicidal self-injury (NSSI) has been identified as one of the most important predictors of suicidal ideation and attempts. Nevertheless, previous research on NSSI has been limited, with different experimental designs leading to inconsistent findings regarding its underlying factors. This is especially true for time-related processes of NSSI. To address this, a standardized set of symptom-specific emotional stimuli was developed (Emotional Picture Set of Self-Injury Images, EPSI), depicting differing stages of NSSI. This study offers a first evaluation of the EPSI picture set as a measurement of emotional reactivity by using emotional self-reports and psychophysiological measures in a sample of healthy participants.

Method: The EPSI picture set, which includes images with neutral objects, self-injury objects, and self-injury scenes, was presented to N = 64 (age: 22.42 (1.4) years, sex: 18 m/ 46f) healthy participants. Emotional reactivity was assessed using emotional self-reports (Self-Assessment Manikin, SAM-Rating) for valence and arousal dimensions. Additionally, psychophysiological measures including skin conductance response, heart period, and the acoustic evoked startle response were recorded.

Results: Overall, the intraclass correlation coefficient and item-total correlation were sufficiently high, indicating good reliability at both the picture and category level. Participants rated self-injury pictures as significantly more unpleasant and arousing compared to pictures showing objects of self-injury and neutral objects. The skin conductance response to pictures with scenes of self-injury was significantly increased compared to pictures with neutral objects, as was heart period deceleration.

Conclusions: This initial evidence suggests that EPSI elicits distinct emotional responses and may serve as a valid measure for studying the process of NSSI. Future research could investigate the EPSI as a standardized measure, particularly in patients with NSSI and borderline personality disorder, to validate its clinical utility and gain insight into its psychophysiological mechanisms.

Background: Difficulties in emotion regulation are a key transdiagnostic factor in mental health disorders. While much research has focused on emotion regulation difficulties as stable, trait-like constructs, emotion regulation is inherently dynamic, unfolding over time. This highlights the need for state-like measures to capture these temporal dynamics in both laboratory and real-world contexts, such as the State Difficulties in Emotion Regulation Scale (S-DERS). The present study aimed to (a) translate the S-DERS into German, (b) validate its psychometric properties, and (c) provide novel examinations whether state-based emotion regulation difficulties share an underlying general factor or are interconnected but distinct sub-components, complemented with an exploratory network approach.

Methods: A sample of 214 participants, predominantly young females, completed the 21-item German version of the S-DERS following a negative mood induction procedure. Participants also completed a broader battery of psychological assessments. Factor structure, reliability, and construct validity were examined using confirmatory factor analysis and exploratory structural equation modeling (ESEM) with cross-loadings. These were compared to bi-factor, higher-order, and network models.

Results: The German S-DERS demonstrated a robust four-factor structure, high reliability, and strong construct validity, consistent with the original English version. ESEM indicated that extensive cross-loadings were necessary to achieve good model fit. A four-factor correlated model outperformed both bifactor and higher-order models, suggesting that emotion regulation difficulties are best conceptualized as four distinct but interrelated constructs without a shared general factor: (a) Non-acceptance of Current Emotions, (b) Limited Ability to Modulate Current Emotional and Behavioral Responses, (c) Lack of Awareness of Current Emotions, and (d) Lack of Clarity about Current Emotions.

Conclusions: The German version of the S-DERS is a reliable and valid tool for assessing state-like difficulties in emotion regulation. The extended factor models highlight the multidimensional nature of emotion regulation difficulties, with complex interrelations among distinct but related constructs. These insights can inform future research on emotion dysregulation and support efforts to validate the S-DERS in clinical populations.

Background: Social decision-making poses challenges for individuals with Borderline Personality Disorder (BPD), which can lead to maladaptive interpersonal functioning. Although previous research on cooperative decisions in BPD has produced mixed findings, studies examining different aspects of cooperative behavior suggest that individuals with BPD may specifically show reduced reactive cooperation, while their active cooperation appears similar to that of healthy individuals.

Methods: To address these mixed results, we used a comprehensive battery of economic tasks in this preregistered study to assess different aspects of cooperation in 35 women with BPD and 50 healthy women.

Results: Consistent with our expectations, there were no significant differences between groups in active cooperation within the Dictator Game. However, contrary to our hypotheses, neither BPD status nor dissociality scores were related to reactive cooperation in the Ultimatum Game. To synthesize findings across studies, a mini meta-analysis was conducted, revealing no significant overall effect of group membership on rejection rates in the Ultimatum Game. Additionally, women with BPD showed similar social preferences, fairness perceptions and inequality aversion as the control group.

Conclusion: These results suggest that in the context of anonymous, one-shot economic games, individuals with BPD may not differ from healthy individuals in terms of cooperative behavior. This highlights the importance of using baseline variants of standard economic tasks when considering contextual factors that affect social behavior in BPD.

Background: Childhood maltreatment (CM) is a potent predictor of lifelong emotional and psychological difficulties. We investigated how CM affects intra- and interpersonal emotion regulation (ER) processes and explored the impact of these ER difficulties on daily life mood.

Methods: We explored the CM-ER association in two studies. Data and code are available at https://osf.io/cbkyj/ . Study 1 tested pre-registered hypotheses ( https://osf.io/2kt35 ) on the association between CM and self-reported ER difficulties in a web-based sample (N = 553). Study 2 used ecological momentary assessment data (N = 103) to examine how trait-level intra- and interpersonal ER difficulties predict momentary negative mood in pseudo-randomized daily assessments over seven days (3,973 observations), particularly in the context of momentary interpersonal stressors.

Results: We replicated a positive association between CM severity and intrapersonal ER difficulties and revealed differential effects of abuse versus neglect. Additionally, CM was associated with lower use of and more difficulties in interpersonal ER. In exploratory analyses, we found that intrapersonal ER difficulties predicted increased negative mood during interpersonal stressors, while interpersonal ER use showed no significant effects on momentary mood.

Conclusions: Our findings highlight a critical treatment target: intrapersonal ER impairments, which uniquely predict daily mood fluctuations beyond the effect of CM severity. Reduced use of interpersonal ER was also observed in individuals with more severe CM, which could be adaptive in certain environments where social support is unavailable or inconsistent. We emphasize the need to prioritize ER-focused interventions in clinical settings to address the enduring consequences of CM.

Background: Emotional dysregulation, impulsivity, and interpersonal difficulties are some of the severe and debilitating symptoms of borderline personality disorder (BPD). Parenting while living with BPD is associated with high levels of parental distress, which may exacerbate symptoms of BPD and contribute to parental struggles navigating their relationship with their child/ren. This can in turn influence the child/ren's attachment and behavioural patterns, contributing to the intergenerational transmission of BPD and/or other mental health difficulties. To date, no previous research has systematically reviewed qualitative studies of the experiences of parents with BPD. The aim of this meta-ethnography is to holistically interpret the findings of existing qualitative research and thereby conceptually understand the experiences of parents with BPD and propose supports that would benefit them.

Methods: Following a systematic search of peer-reviewed research, independent eligibility screening and risk appraisal, nine relevant studies were selected for inclusion. The reviewers read and re-read these papers and identified key concepts for translation. Relationships between the key concepts were identified by the primary reviewer using NVivo, and a synthesis of the translation was performed.

Results: Six papers focused on the experiences of mothers with BPD, one on fathers, and two included both. The review identified some key challenges, including the pressure parents with BPD feel to adhere to their own and others' expectations, their struggle with managing difficult emotions such as shame and uncertainty, a lack of social support, and difficulties accessing adequate formal support. Three papers reported findings on the same intervention (Mother-Infant Dialectical Behaviour Therapy) describing benefits of the intervention, subsequent improvements, and the importance of peer support.

Conclusion: Taken together, we determined that shame is a key driver underpinning many of the challenges experienced by parents with BPD. Mothers and fathers with BPD shared similar experiences, however, their conceptualisations of being a 'good' parent were differentially shaped by societal norms. Our review confirmed gaps in current practice, including the paucity of evidence-based interventions available for parents with BPD. Parents with BPD may benefit from interventions that help them to set realistic expectations and address shame as a specific treatment objective.

Background: Individuals with a borderline personality disorder (BPD) show impairments in their ability to mentalize. Particularly in the parent-child relationship, mentalizing is an important foundation for sensitive parenting and the quality of interactive behavior. Previous studies of parental mentalizing in mothers with BPD are scarce and have focused primarily on one aspect of the multidimensional construct. In addition, there is currently no research comparing different mental disorders on different aspects of parental mentalizing, leaving disorder-specific differences unclear. Aim of this study is to examine disorder-specific differences in reflective functioning and mind-mindedness, two facets of parental mentalizing.

Methods: We compared mothers with BPD (n = 156) with a clinical control group of mothers with depressive or anxiety disorders (n = 65) and with healthy mothers (n = 91) using non-parametric inference for multivariate data. Mothers completed the Parental Reflective Functioning Questionnaire (PRFQ) and participated in a five-minute speech sample (FMSS) in which they reflected on their child and their relationship with their child. Verbal transcripts of the FMSS were rated using an adapted manual for coding mind-mindedness with the FMSS that incorporates the assessment of additional characteristics of mind-related speech.

Results: Mothers with BPD showed the highest impairments in parental mentalizing compared to both other groups, as evident in both operationalizations: They made more maladaptive attributions (PRFQ pre-mentalizing) than the other two groups and reported lower interest and curiosity and certainty in mental states than healthy mothers. In addition, mothers with BPD used more mental attributes with negative valence when asked to describe their child and the relationship compared to both other groups and more self-related mental attributes compared to healthy mothers. Additionally, Pearson correlational analyses revealed that only the use of mental attributes with negative valence was associated with all three subscales of the PRFQ in the anticipated directions. This supports the idea that the two operationalizations target different facets of parental mentalization.

Conclusions: Our findings revealed impaired parental mentalization in several domains for mothers with BPD. Disorder-specific differences were observed in the amount of maladaptive attributions and in the negativity of mental state references. These aspects should be considered in diagnostic and therapeutic processes when working with mothers with BPD. As a limitation, it should be noted that the group comparisons did not control for sociodemographic variables, which may have contributed to some of the observed group differences.