Borderline personality disorder and emotional responding: A review of the research literature

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Abstract

Although problems with emotional functioning are considered central to borderline personality disorder (BPD), it is only recently that studies have begun utilizing laboratory biobehavioral measures (including neuroimaging and psychophysiological measures) to examine emotional responding in BPD. The application of basic science methodologies used in a systematic program of research to investigate clinically relevant phenomena, often called translational research, holds much promise in advancing the assessment and treatment of BPD. In this paper, we begin with an overview of the research on self-reported emotional responding in BPD. Next, we outline the advantages that translational research has over traditional self-report methodology in furthering an understanding of emotional responding in BPD, and review the extant laboratory studies of emotional responding in BPD. Finally, problems commonly encountered when conducting translational research on emotion in BPD are outlined, and solutions to these problems are offered.

Section snippets

Self-report studies

One convenient and common approach to assessing emotional responding is the use of self-report measures, which use paper-and-pencil or electronic formats to ask respondents how they experience and/or express emotions. Most studies examining the role of emotional responding in BPD have relied exclusively on self-report measures. For example, studies investigating affective instability within BPD have generally used the Affective Lability Scale (ALS; Harvey, Greenberg, & Serper, 1989). Results of

Translational research: an overview

Translational research involves a systematic attempt to integrate the distinct perspectives of basic and clinical researchers. Whereas basic research often utilizes well-controlled laboratory methods to elucidate underlying processes, clinical research focuses on the more immediate, real-world implications of research findings and emphasizes the importance of ecological and external validity. The term “translational research” can be somewhat misleading, however, as it may be interpreted as

Translational research on emotional responding in BPD

Recent advances in laboratory technologies offer BPD researchers new opportunities to directly test hypotheses about emotional functioning using specific biobehavioral measures. Accordingly, for the purpose of this paper, we sought to identify published, laboratory-based studies in the area of BPD and emotional responding. To identify these studies, a literature search using the keywords ‘borderline personality disorder’ and either ‘affect’ or ‘emotion’ and limited to peer-reviewed journal

Behavioral studies

Whereas laboratory-based behavioral studies have been conducted with BPD participants to investigate clinically relevant phenomena associated with emotional responding (e.g., attention, executive functioning), far fewer studies have directly examined motoric/expressive indices of emotional responding in BPD. One exception is a recent study that investigated facial emotional expressivity in BPD (Renneberg, Heyn, Gebgard, & Bachmann, 2005). Frequency and intensity of facial emotional expressions

Psychophysiological studies

Psychophysiological methods for measuring emotional responding have been used for decades, and include measures such as skin conductance response (SCR; also frequently reported as galvanic skin response, electrodermal response, or skin resistance), facial electromyography, finger temperature, and heart rate (e.g., respiratory sinus arrhythmia and heart rate variability). Both skin conductance responses (SCRs) and heart rate (HR) are indices of autonomic nervous system activity, and both indices

Neuroimaging studies

Given evidence of the primary role of prefrontal and limbic areas in emotion regulation (see Davidson et al., 2000, LeDoux, 1996), researchers exploring the possible neurophysiology of emotional dysfunction in BPD have tended to focus on the prefrontal cortex, hippocampus, and amygdala. Dysfunction in any or all of these regions could underlie the disruptions in emotional functioning observed among individuals with BPD. As reviewed below, studies on the neurophysiology of emotional dysfunction

Common problems and possible solutions in translational research on emotion in BPD

There are inherent challenges associated with using controlled laboratory methods to study emotional responding in BPD. Although some are unique to specific studies, others are likely to be common when conducting translational research on emotion among individuals with BPD. In this section, we address several of the more common problems, along with a brief discussion of possible solutions. This list is not intended to be comprehensive but is offered as a primer for addressing some predictable

Conclusions and clinical implications

This paper reviewed the extant research examining emotional responding in BPD. Whereas studies using self-report methods consistently find that individuals with BPD report being more emotionally intense, having greater negative affective responses to emotionally evocative stimuli, and experiencing greater affective instability than controls, results are mixed across studies using behavioral and psychophysiological indices of emotional responding. Both subjective emotional ratings and HR

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