Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T09:07:42.706Z Has data issue: false hasContentIssue false

Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms

Published online by Cambridge University Press:  30 April 2015

Stephanie D. Stepp*
Affiliation:
University of Pittsburgh School of Medicine
Lori N. Scott
Affiliation:
University of Pittsburgh School of Medicine
Neil P. Jones
Affiliation:
University of Pittsburgh School of Medicine
Diana J. Whalen
Affiliation:
Washington University School of Medicine
Alison E. Hipwell
Affiliation:
University of Pittsburgh School of Medicine
*
Address correspondence and reprint requests to: Stephanie D. Stepp, Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213; E-mail: steppsd@upmc.edu.

Abstract

Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multimethod approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across 3 years (ages 16–18) in a diverse, at-risk sample of adolescent girls (N = 113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: self-report, emotion ratings to stressors from ecological assessments across 1 week, and observer-rated negative affectivity during a mother–daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. The results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. In addition, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M. (2006). As others see us: Clinical and research implications of cross-informant correlations for psychopathology. Current Directions in Psychological Science, 15, 9498.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.Google Scholar
Bagge, C. L., Nickell, A., Stepp, S. D., Durrett, C., Jackson, K., & Trull, T. J. (2004). Borderline personality disorder features predict negative outcomes 2 years later. Journal of Abnormal Psychology, 113, 279288.CrossRefGoogle ScholarPubMed
Bandelow, B., Krause, J., Wedekind, D., Broocks, A., Hajak, G., & Rüther, E. (2005). Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Research, 134, 169179.CrossRefGoogle ScholarPubMed
Barnard, K. E. (1994). Difficult Life Circumstances Scale. Seattle, WA: NCAST Publications.Google Scholar
Bateman, A. W., & Fonagy, P. (2003). The development of an attachment-based treatment program for borderline personality disorder. Bulletin of the Menninger Clinic, 67, 187211.Google Scholar
Battle, C. L., Shea, M. T., Johnson, D. M., Yen, S., Zlotnick, C., Zanarini, M. C., et al. (2004). Childhood maltreatment associated with adult personality disorders: Findings from the collaborative longitudinal personality disorders study. Journal of Personality Disorders, 18, 193211.Google Scholar
Beauchaine, T. P., Klein, D. N., Crowell, S. E., Derbidge, C., & Gatzke-Kopp, L. (2009). Multifinality in the development of personality disorders: A Biology × Sex × Environment interaction model of antisocial and borderline traits. Development and Psychopathology, 21, 735770.CrossRefGoogle ScholarPubMed
Bornovalova, M. A., Hicks, B. M., Iacono, W. G., & McGue, M. (2009). Stability, change, and heritability of borderline personality disorder traits from adolescence to adulthood: A longitudinal twin study. Development and Psychopathology, 21, 13351353.Google Scholar
Bornovalova, M. A., Huibregtse, B. M., Hicks, B., Iacono, W., & McGue, M. (2013). Tests of a direct effect of childhood abuse on adult borderline personality disorder traits: A longitudinal discordant twin design. Journal of Abnormal Psychology, 122, 180194.CrossRefGoogle ScholarPubMed
Bradley, R., Zittel Conklin, C., & Westen, D. (2005). The borderline personality disorder diagnosis in adolescents: Gender differences and subtypes. Journal of Child Psychology and Psychiatry, 46, 10061019.CrossRefGoogle ScholarPubMed
Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Erlbaum.Google Scholar
Carlson, E. A., Egeland, B., & Sroufe, L. A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 13111334.Google Scholar
Chanen, A. M., Jovev, M., Djaja, D., McDougall, E., Yuen, H. P., Rawlings, D., et al. (2008). Screening for borderline personality disorder in outpatient youth. Journal of Personality Disorders, 22, 353364.CrossRefGoogle ScholarPubMed
Clark, L. A., & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7, 309319.CrossRefGoogle Scholar
Clifton, A., & Pilkonis, P. A. (2007). Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Comprehensive Psychiatry, 48, 7078.Google Scholar
Coid, J., Yang, M., Tyrer, P., Roberts, A., & Ullrich, S. (2006). Prevalence and correlates of personality disorder among adults aged 16 to 74 in Great Britain. British Journal of Psychiatry, 188, 423431.Google Scholar
Conger, R. D., Conger, K. J., & Martin, M. J. (2010). Socioeconomic status, family processes, and individual development. Journal of Marriage and the Family, 72, 685704.CrossRefGoogle ScholarPubMed
Conger, R. D., Ge, X., Elder, G. H., Lorenz, F. O., & Simons, R. L. (1994). Economic stress, coercive family process, and developmental problems of adolescents. Child Development, 65, 541561.CrossRefGoogle ScholarPubMed
Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179193.Google Scholar
Crowell, S. E., Beauchaine, T. P., & Linehan, M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological Bulletin, 135, 495510.CrossRefGoogle ScholarPubMed
de Clercq, B., van Leeuwen, K., van den Noortgate, W., de Bolle, M., & de Fruyt, F. (2009). Childhood personality pathology: Dimensional stability and change. Development and Psychopathology, 21, 853869.Google Scholar
Duncan, T. E., Duncan, S. C., & Strycker, A. (2006). An introduction to latent variable growth curve modeling: Concepts, issues, and application (2nd ed.). Mahwah, NJ: Erlbaum.Google Scholar
Eppright, T. D., Kashani, J. H., Robinson, B. D., & Reid, J. C. (1993). Comorbidity of conduct disorder and personality disorders in an incarcerated juvenile population. American Journal of Psychiatry, 150, 12331236.Google Scholar
Evans, G. W. (2004). The environment of childhood poverty. American Psychologist, 59, 7792.CrossRefGoogle ScholarPubMed
Evans, G. W., & Cassells, R. C. (2013). Childhood poverty, cumulative risk exposure, and mental health in emerging adults. Clinical Psychological Science. Advance online publication.Google Scholar
Evans, G. W., & Kim, P. (2007). Childhood poverty and health: Cumulative risk exposure and stress dysregulation. Psychological Science, 18, 953957.Google Scholar
Evans, G. W., Li, D., & Whipple, S. S. (2013). Cumulative risk and child development. Psychological Bulletin, 139, 13421396.CrossRefGoogle ScholarPubMed
Fossati, A., Madeddu, F., & Maffei, C. (1999). Borderline personality disorder and childhood sexual abuse: A meta-analytic study. Journal of Personality Disorders, 13, 268280.CrossRefGoogle ScholarPubMed
Furman, W., & Shomaker, L. B. (2008). Patterns of interaction in adolescent romantic relationships: Distinct features and links to other close relationships. Journal of Adolescence, 31, 771788.Google Scholar
Glaser, J. P., van Os, J., Mengelers, R., & Myin-Germeys, I. (2008). A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorder. Psychological Medicine, 38, 12311239.Google Scholar
Glaser, J. P., van Os, J., Portegijs, P. J., & Myin-Germeys, I. (2006). Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. Journal of Psychosomatic Research, 61, 229236.CrossRefGoogle ScholarPubMed
Goodman, M., Patil, U., Triebwasser, J., Diamond, E., Hiller, A., Hoffman, P., et al. (2010). Parental viewpoints of trajectories to borderline personality disorder in female offspring. Journal of Personality Disorders, 24, 204216.CrossRefGoogle ScholarPubMed
Goodyer, I. M., Ashby, L., Altham, P. M., Vize, C., & Cooper, P. J. (1993). Temperament and major depression in 11- to 16-year-olds. Journal of Child Psychology and Psychiatry and Allied Disciplines, 34, 14091423.Google Scholar
Gottesman, I. I., & Gould, T. D. (2003). The endophenotype concept in psychiatry: Etymology and strategic intentions. American Journal of Psychiatry, 160, 636645.CrossRefGoogle ScholarPubMed
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., et al. (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, 533545.CrossRefGoogle ScholarPubMed
Grilo, C. M., Becker, D. F., Walker, M. L., Levy, K. N., Edell, W. S., & McGlashan, T. H. (1995). Psychiatric comorbidity in adolescent inpatients with substance use disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 10851091.Google Scholar
Hankin, B.L., Mermelstein, R., & Roesch, L. (2007). Sex differences in adolescent depression: Stress exposure and reactivity models. Child Development, 78, 279295.CrossRefGoogle ScholarPubMed
Hipwell, A. E., Loeber, R., Stouthamer-Loeber, M., Keenan, K., White, H. R., & Kroneman, L. (2002). Characteristics of girls with early onset disruptive and antisocial behaviour. Criminal Behaviour and Mental Health, 12, 99118.Google Scholar
Holm, A. L., & Severinsson, E. (2011). Struggling to recover by changing suicidal behaviour: Narratives from women with borderline personality disorder. International Journal of Mental Health Nursing, 20, 165173.Google Scholar
Holmbeck, G. N., Li, S. T., Schurman, J. V., Friedman, D., & Coakley, R. M. (2002). Collecting and managing multisource and multimethod data in studies of pediatric populations. Journal of Pediatric Psychology, 27, 518.Google Scholar
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155.CrossRefGoogle Scholar
Johnson, J. G., Smailes, E. M., Cohen, P., Brown, J., & Bernstein, D. P. (2000). Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: Findings of a community-based longitudinal study. Journal of Personality Disorders, 14, 171187.CrossRefGoogle ScholarPubMed
Jovev, M., & Jackson, H. J. (2006). The relationship of borderline personality disorder, life events and functioning in an Australian psychiatric sample. Journal of Personality Disorders, 20, 205217.CrossRefGoogle Scholar
Keenan, K., Hipwell, A., Chung, T., Stepp, S., Stouthamer-Loeber, M., Loeber, R., et al. (2010). The Pittsburgh Girls Study: Overview and initial findings. Journal of Clinical Child and Adolescent Psychology, 39, 506521.Google Scholar
Kernberg, O. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press.Google Scholar
Lataster, T., Wichers, M., Jacobs, N., Mengelers, R., Derom, C., Thiery, E., et al. (2009). Does reactivity to stress cosegregate with subclinical psychosis? A general population twin study. Acta Psychiatrica Scandinavica, 119, 4553.CrossRefGoogle ScholarPubMed
Lenzenweger, M. F., Lane, M., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV personality disorders in the national comorbidity replication (NCSR). Biological Psychiatry, 62, 553564.Google Scholar
Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Buchheim, P., Channabasavanna, S. M., et al. (1994). The International Personality Disorder Examination. Lutz, FL: Psychological Assessment Resources.Google Scholar
McDonald, R. P., & Ho, M. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7, 6482.Google Scholar
McMakin, D. L., Burkhouse, K. L., Olino, T. M., Siegle, G. J., Dahl, R. E., & Silk, J. S. (2011). Affective functioning among early adolescents at high and low familial risk for depression and their mothers: A focus on individual and transactional processes across contexts. Journal of Abnormal Child Psychology, 39, 12131225.Google Scholar
Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28, 969981.Google Scholar
Morey, L. C. (1991). Personality Assessment Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Muthén, B. O., & Muthén, L. K. (2012). Mplus user's guide (7th ed.). Los Angeles: Author.Google Scholar
Myers, W. C., Burkett, R. C., & Otto, T. A. (1993). Conduct disorder and personality disorders in hospitalized adolescents. Journal of Clinical Psychiatry, 54, 2126.Google Scholar
Myin-Germeys, I., & van Os, J. (2007). Stress-reactivity in psychosis: Evidence for an affective pathway to psychosis. Clinical Psychology Review, 27, 409424.CrossRefGoogle ScholarPubMed
Nunnally, J. C. (1978). Psychometric theory (2nd ed., pp. 229230). New York: McGraw–Hill.Google Scholar
O'Connor, T. G., Hetherington, E. M., Reiss, D., & Plomin, R. (1995). A twin-sibling study of observed parent-adolescent interactions. Child Development, 66, 812829.CrossRefGoogle ScholarPubMed
Pagano, M. E., Skodol, A. E., Stout, R. L., Shea, M. T. ,Yen, S., Grilo, C. M., et al. (2004). Stressful life events as predictors of functioning: Findings from the Collaborative Longitudinal Personality Disorders Study. Acta Psychiatrica Scandinavica, 110, 421429.Google Scholar
Pfohl, B., Blum, N., & Zimmerman, M. (1997). Structured Interview for DSM-IV Personality: SIDP-IV. Washington, DC: American Psychiatric Association.Google Scholar
Pietrek, C., Elbert, T., Weierstall, R., Müller, O., & Rockstroh, B (2013). Childhood adversities in relation to psychiatric disorders. Psychiatry Research, 206, 103110.CrossRefGoogle ScholarPubMed
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437448.Google Scholar
Rothbart, M. K. (2007). Temperament, development, and personality. Current Directions in Psychological Science, 16, 207212.CrossRefGoogle Scholar
Sansone, R. A., & Sansone, L. A. (2009). The families of borderline patients: The psychological environment revisited. Psychiatry, 6, 1924.Google Scholar
Shiner, R. L., Buss, K. A., McClowry, S. G., Putnam, S. P., Saudino, K. J., & Zentner, M. (2012). What is temperament now? Child Development Perspectives, 6, 436444.Google Scholar
Silk, J. S., Forbes, E. E., Whalen, D. J., Jakubcak, J. L., Thompson, W. K., Ryan, N. D., et al. (2010). Daily emotional dynamics in depressed youth: A cell phone ecological momentary assessment study. Journal of Experimental Child Psychology, 110, 214257.Google Scholar
Silk, J. S., Steinberg, L., & Morris, A. S. (2003). Adolescents’ emotion regulation in daily life: Links to depressive symptoms and problem behavior. Child Development, 74, 18691880.Google Scholar
Sinha, B. K., & Watson, D. C. (1997). Psychosocial predictors of personality disorder traits in a non-clinical sample. Personality and Individual Differences, 22, 527537.Google Scholar
Skodol, A. E., & Bender, D. S. (2003). Why are women diagnosed borderline more than men? Psychiatric Quarterly, 74, 349360.Google Scholar
Skodol, A. E., Pagano, M. E., Bender, D. S., Shea, M. T., Gunderson, J. G., Yen, S., et al. (2005). Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years. Psychological Medicine, 35, 443451.Google Scholar
Smith, D. J., Muir, W. J., & Blackwood, D. H. R. (2005). Borderline personality disorder characteristics in young adults with recurrent mood disorders: A comparison of bipolar and unipolar depression. Journal of Affective Disorders, 87, 1723.Google Scholar
Soloff, P. H., Lynch, K. G., & Kelly, T. M. (2002). Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. Journal of Personality Disorders, 16, 201214.Google Scholar
Stepp, S. D. (2012). Development of borderline personality disorder in adolescence and young adulthood: Introduction to the Special Section. Journal of Abnormal Child Psychology, 40, 15.Google Scholar
Stepp, S. D., Burke, J. D., Hipwell, A. E., & Loeber, R. (2012). Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. Journal of Abnormal Child Psychology, 40, 720.Google Scholar
Stepp, S. D., Keenan, K., Hipwell, A E., & Krueger, R. R. (2014). The impact of childhood temperament on the development of borderline personality disorder symptoms over the course of adolescence. Borderline Personality Disorder and Emotion Dysregulation, 1, 18.CrossRefGoogle ScholarPubMed
Stepp, S. D., Pilkonis, P. A., Hipwell, A. E., Loeber, R., & Stouthamer-Loeber, M. (2010). Stability of borderline personality disorder features in girls. Journal of Personality Disorders, 24, 460472.Google Scholar
Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Development and Psychopathology, 20, 118.Google Scholar
Stiglmayr, C. E., Grathwol, T., Linehan, M. M., Ihorst, G., Fahrenberg, J., & Bohus, M. (2005). Aversive tension in patients with borderline personality disorder: A computer-based controlled field study. Acta Psychiatrica Scandinavica, 111, 372379.CrossRefGoogle ScholarPubMed
Trull, T. J. (1995). Borderline personality disorder features in nonclinical young adults: I. Identification and validation. Psychological Assessment, 7, 3341. doi:10.1037/1040-3590.7.1.33 Google Scholar
Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010). Revised NESARC personality disorder diagnoses: Gender, prevalence, and comorbidity with substance dependence disorders. Journal of Personality Disorders, 24, 412426. doi:10.1521/pedi.2010.24.4.412 CrossRefGoogle ScholarPubMed
Trull, T. J., Useda, J. D., Conforti, K., & Doan, B. T. (1997). Borderline personality disorder features in nonclinical young adults: 2. Two-year outcome. Journal of Abnormal Psychology, 106, 307314.CrossRefGoogle ScholarPubMed
van Os, J., Kenis, G., & Rutten, B. P. (2010). The environment and schizophrenia. Nature, 468, 203212.CrossRefGoogle ScholarPubMed
Westen, D., & Chang, C. (2000) Personality pathology in adolescence: A review. Adolescent Psychiatry, 25, 61100.Google Scholar
Whalen, D. J., Scott, L. N., Jakubowski, K., McMakin, D., Hipwell, A. E., Silk, J., et al. (in press). Affective behavior during mother–daughter conflict and borderline personality disorder severity across adolescence. Personality Disorders: Theory, Research, and Treatment.Google Scholar
Wichers, M. C., Geschwind, N., Jacobs, N., Kenis, G., Peeters, F., Derom, C., et al. (2009). Transition from stress sensitivity to a depressive state: Longitudinal twin study. British Journal of Psychiatry, 195, 498503.Google Scholar
Wichers, M. C., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., et al. (2007). Evidence that moment-to-moment variation in positive emotions buffer genetic risk for depression: A momentary assessment twin study. Acta Psychiatrica Scandinavica, 115, 451457.Google Scholar
Winsper, C., Zanarini, M., & Wolke, D. (2012). Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a nonclinical population at 11 years. Psychological Medicine, 42, 24042420.Google Scholar
Zanarini, M., Williams, A., Lewis, R., Reich, R., Vera, S., Marino, M., et al. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154, 11011106.Google Scholar
Zweig-Frank, H., & Paris, J. (2002). Predictors of outcome in a 27-year follow-up of patients with borderline personality disorder. Comprehensive Psychiatry, 43, 103107.Google Scholar