Skip to main content
Top
Gepubliceerd in:

22-09-2020

A Day in the Life of Borderline Personality Disorder: A Preliminary Analysis of Within-Day Emotion Generation and Regulation

Auteurs: Matthew W. Southward, Stephen A. Semcho, Nicole E. Stumpp, Destiney L. MacLean, Shannon Sauer-Zavala

Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment | Uitgave 4/2020

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

In Linehan’s (1993) biosocial theory, borderline personality disorder (BPD) results in part from frequent, intense, negative emotions and maladaptive behavioral responses to those emotions. We conducted a secondary data analysis of an intensive single-case experimental design to explore hourly relations among behavioral responses and emotions in BPD. Eight participants with BPD (Mage = 21.57, 63% female; 63% Asian-American) reported their emotions and behaviors hourly on two days. Participants reported a neutral-to-negative average emotional state with substantial variability each day. This emotional state was characterized most frequently by anxiety and joy. Participants tended to “dig into”, or savor, experiences of joy, but problem-solve around, push away, or accept anxiety. Acceptance predicted hour-by-hour increases in negative emotion intensity, and pushing emotions away predicted hour-by-hour increases in positive emotion intensity. These results suggest that anxiety dominates the emotional experiences of people with BPD and co-occurs with a variety of emotion regulation strategies, while joy co-occurs with strategies designed to prolong emotional experiences. Despite its general adaptiveness, acceptance may be less effective, and pushing emotions away may be more effective, than other emotion regulation strategies at improving momentary negative emotions for those with BPD. We discuss the preliminary nature of these findings and encourage future researchers to build on them in larger samples with more severe presentations of BPD.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Voetnoten
1
Here, we use the phrases “likely” BPD and “likely” bipolar disorder because participants in these studies were not diagnosed with BPD or bipolar disorder but instead met thresholds on self-report questionnaires indicating the likely presence of these disorders.
 
2
Although we note that Ebner-Priemer et al. (2015) also included two independent datasets of 50 women with BPD from the US and 42 women with BPD from Germany.
 
Literatuur
go back to reference Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: Strategies for studying behavior change (3rd ed.). Pearson. Barlow, D. H., Nock, M. K., & Hersen, M. (2009). Single case experimental designs: Strategies for studying behavior change (3rd ed.). Pearson.
go back to reference Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Murray Latin, H., Ellard, K. E., Bullis, J. R., Bentley, K. H., Boettcher, H. T., & Cassiello-Robbins, C. (2018). Unified protocol for transdiagnostic treatment of emotional disorders (2nd Ed.). Guilford Press. Barlow, D. H., Farchione, T. J., Sauer-Zavala, S., Murray Latin, H., Ellard, K. E., Bullis, J. R., Bentley, K. H., Boettcher, H. T., & Cassiello-Robbins, C. (2018). Unified protocol for transdiagnostic treatment of emotional disorders (2nd Ed.). Guilford Press.
go back to reference Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5) – Adult version. Oxford University Press. Brown, T. A., & Barlow, D. H. (2014). Anxiety and related disorders interview schedule for DSM-5 (ADIS-5) – Adult version. Oxford University Press.
go back to reference Ebner-Priemer, U. W., Houben, M., Santangelo, P., Kleindienst, N., Tuerlinckx, F., Oravecz, Z., Verleysen, G., Van Deun, K., Bohus, M., & Kuppens, P. (2015). Unraveling affective dysregulation in borderline personality disorder: A theoretical model and empirical evidence. Journal of Abnormal Psychology, 124(1), 186–198. https://doi.org/10.1037/abn0000021.CrossRefPubMed Ebner-Priemer, U. W., Houben, M., Santangelo, P., Kleindienst, N., Tuerlinckx, F., Oravecz, Z., Verleysen, G., Van Deun, K., Bohus, M., & Kuppens, P. (2015). Unraveling affective dysregulation in borderline personality disorder: A theoretical model and empirical evidence. Journal of Abnormal Psychology, 124(1), 186–198. https://​doi.​org/​10.​1037/​abn0000021.CrossRefPubMed
go back to reference First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W., & Benjamin, L. S. (1997). Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). American Psychiatric Press. First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. W., & Benjamin, L. S. (1997). Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). American Psychiatric Press.
go back to reference Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. A., Pulay, A. J., Pickering, R. P., & Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(4), 533–545. https://doi.org/10.4088/jcp.v69n0404.CrossRefPubMed Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., Smith, S. M., Dawson, D. A., Pulay, A. J., Pickering, R. P., & Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69(4), 533–545. https://​doi.​org/​10.​4088/​jcp.​v69n0404.CrossRefPubMed
go back to reference Gunderson, J. G., & Links, P. S. (2008). Borderline personality disorder: A clinical guide (2nd ed.). American Psychiatric Publishing, Inc. Gunderson, J. G., & Links, P. S. (2008). Borderline personality disorder: A clinical guide (2nd ed.). American Psychiatric Publishing, Inc.
go back to reference Kockler, T. D., Santangelo, P. S., Limberger, M. F., Bohus, M., & Ebner-Priemer, U. W. (2019). Specific or transdiagnostic? The occurrence of emotions and their association with distress in the daily life of patients with borderline personality disorder compared to clinical and healthy controls. Psychiatry Research, 284, 112692. https://doi.org/10.1016/j.psychres.2019.112692.CrossRefPubMed Kockler, T. D., Santangelo, P. S., Limberger, M. F., Bohus, M., & Ebner-Priemer, U. W. (2019). Specific or transdiagnostic? The occurrence of emotions and their association with distress in the daily life of patients with borderline personality disorder compared to clinical and healthy controls. Psychiatry Research, 284, 112692. https://​doi.​org/​10.​1016/​j.​psychres.​2019.​112692.CrossRefPubMed
go back to reference Kring, A. M., & Sloan, D. M. (2010). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. Guilford Press. Kring, A. M., & Sloan, D. M. (2010). Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment. Guilford Press.
go back to reference Kuo, J. R., Neacsiu, A. D., Fitzpatrick, S., & MacDonald, D. E. (2014). A methodological examination of emotion inductions in borderline personality disorder: A comparison of standardized versus idiographic stimuli. Journal of Psychopathology and Behavioral Assessment, 36(1), 155–164. https://doi.org/10.1007/s10862-013-9378-x.CrossRef Kuo, J. R., Neacsiu, A. D., Fitzpatrick, S., & MacDonald, D. E. (2014). A methodological examination of emotion inductions in borderline personality disorder: A comparison of standardized versus idiographic stimuli. Journal of Psychopathology and Behavioral Assessment, 36(1), 155–164. https://​doi.​org/​10.​1007/​s10862-013-9378-x.CrossRef
go back to reference Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
go back to reference Neacsiu, A. D., Bohus, M., & Linehan, M. M. (2013). Dialectical behavior therapy skills: An intervention for emotion dysregulation. In J. J. Gross (Ed.), Vol. 2. Handbook of emotion regulation (pp. 491–508). Guilford Press. Neacsiu, A. D., Bohus, M., & Linehan, M. M. (2013). Dialectical behavior therapy skills: An intervention for emotion dysregulation. In J. J. Gross (Ed.), Vol. 2. Handbook of emotion regulation (pp. 491–508). Guilford Press.
go back to reference Santangelo, P., Mussgay, L., Sawitzki, G., Trull, T. J., Reinhard, I., Steil, R., Klein, C., Bohus, M., & Ebner-Priemer, U. W. (2014b). Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls. Journal of Abnormal Psychology, 123(1), 258–272. https://doi.org/10.1037/a0035619.CrossRefPubMedPubMedCentral Santangelo, P., Mussgay, L., Sawitzki, G., Trull, T. J., Reinhard, I., Steil, R., Klein, C., Bohus, M., & Ebner-Priemer, U. W. (2014b). Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls. Journal of Abnormal Psychology, 123(1), 258–272. https://​doi.​org/​10.​1037/​a0035619.CrossRefPubMedPubMedCentral
go back to reference Sauer-Zavala, S., Cassiello-Robbins, C., Woods, B. K., Curreri, A., Wilner, J. G., & Rassaby, M. (in press). Countering emotional behaviors in the treatment of borderline personalitydisorder. Theory, Research, and Treatment, 11(5), 328-338 Sauer-Zavala, S., Cassiello-Robbins, C., Woods, B. K., Curreri, A., Wilner, J. G., & Rassaby, M. (in press). Countering emotional behaviors in the treatment of borderline personalitydisorder. Theory, Research, and Treatment, 11(5), 328-338
go back to reference Southward, M. W., & Cheavens, J. S. (2020). Quality or quantity? A multistudy analysis of emotion regulation skills deficits associated with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 11(1), 24–35. https://doi.org/10.1037/per0000357.CrossRef Southward, M. W., & Cheavens, J. S. (2020). Quality or quantity? A multistudy analysis of emotion regulation skills deficits associated with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 11(1), 24–35. https://​doi.​org/​10.​1037/​per0000357.CrossRef
go back to reference Trull, T. J., Solhan, M. B., Tragesser, S. L., Jahng, S., Wood, P. K., Piasecki, T. M., & Watson, D. (2008). Affective instability: Measuring a core feature of borderline personality disorder with ecological momentary assessment. Journal of Abnormal Psychology, 117(3), 647–661. https://doi.org/10.1037/a0012532.CrossRefPubMed Trull, T. J., Solhan, M. B., Tragesser, S. L., Jahng, S., Wood, P. K., Piasecki, T. M., & Watson, D. (2008). Affective instability: Measuring a core feature of borderline personality disorder with ecological momentary assessment. Journal of Abnormal Psychology, 117(3), 647–661. https://​doi.​org/​10.​1037/​a0012532.CrossRefPubMed
go back to reference Yaroslavsky, I., Napolitano, S. C., & France, C. M. (2019). Ruminative responses to interpersonal precipitants mediate borderline personality disorder features’ effects on distress reactivity and recovery in daily life. Journal of Clinical Psychology, 75(12), 2188–2209. https://doi.org/10.1002/jclp.22839.CrossRefPubMed Yaroslavsky, I., Napolitano, S. C., & France, C. M. (2019). Ruminative responses to interpersonal precipitants mediate borderline personality disorder features’ effects on distress reactivity and recovery in daily life. Journal of Clinical Psychology, 75(12), 2188–2209. https://​doi.​org/​10.​1002/​jclp.​22839.CrossRefPubMed
Metagegevens
Titel
A Day in the Life of Borderline Personality Disorder: A Preliminary Analysis of Within-Day Emotion Generation and Regulation
Auteurs
Matthew W. Southward
Stephen A. Semcho
Nicole E. Stumpp
Destiney L. MacLean
Shannon Sauer-Zavala
Publicatiedatum
22-09-2020
Uitgeverij
Springer US
Gepubliceerd in
Journal of Psychopathology and Behavioral Assessment / Uitgave 4/2020
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505
DOI
https://doi.org/10.1007/s10862-020-09836-1