A laboratory task to assess epistemic mistrust: behavioral evidence for mediation between childhood trauma and borderline personality features in young adults.

BackgroundChildhood trauma, including emotional neglect, emotional abuse, physical abuse, and sexual abuse, may contribute to borderline personality features like affective instability, identity problems, negative relationships, and self-harm. This study aims to explore how different types of childhood trauma affect these features in bipolar versus unipolar depressive disorders. MethodsWe included 839 participants of the Netherlands Study of Depression and Anxiety (NESDA) with a lifetime diagnosis of major depressive disorder single episode (MDDS; N = 443), recurrent major depressive disorder (MDD-R; N = 331), or bipolar disorder (BD; N = 65). Multivariate regression was used to analyze data from the Childhood Trauma Interview and borderline features (from the self-report Personality Assessment Inventory). ResultsOn average, participants were 48.6 years old (SD: 12.6), with 69.2 % being women, and 50.3 % of participants assessed positive for childhood trauma. Adjusted analyses revealed that participants diagnosed with BD, followed by MDD-R, exhibited the highest number of borderline personality features. Additionally, within the entire group, a strong association was found between childhood trauma, especially emotional neglect, and the presence of borderline personality features. ConclusionGiven the high prevalence of childhood trauma and borderline personality features, screening for these factors in individuals with mood disorders is crucial. Identifying these elements can inform and enhance the management of the often fluctuating and complex nature of these comorbid conditions, leading to more effective and tailored treatment strategies.

Difficulties in emotion regulation are one of the core features of borderline personality disorder (BPD). Individuals with BPD also report higher levels of experiential avoidance (EA) compared to controls. These constructs have never been studied concomitantly in adolescents. First, given the conceptual similarity of difficulties in emotion regulation and EA, the authors sought to determine whether EA provides incremental validity, above emotion dysregulation, in its association with borderline features. Second, EA was explored as a mediator in the relation between difficulties in emotion regulation and borderline features. The sample included 208 adolescents recruited from an inpatient psychiatric unit (M(age) = 15.96, SD = 1.39; females = 60.1%). Borderline personality features were assessed using the self-report Borderline Personality Features Scale for Children (Crick, Murray-Close, & Woods, 2005). EA was assessed using the Avoidance and Fusion Questionnaire for Youth (Greco, Lambert, & Baer, 2008), and difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (Gratz & Roemer, 2004). Greater borderline personality features were associated with significantly higher levels of EA and difficulties in emotion regulation. Hierarchical regression analyses showed that EA made a small, but significant, incremental and independent contribution to borderline features when added to a model already including difficulties in emotion regulation. In addition, EA partially mediated the relation between difficulties in emotion regulation and borderline features. EA and emotion regulation are both important targets of treatments aimed at decreasing borderline personality features in adolescents.

Both borderline personality features and dissociative symptoms have been associated with different types of childhood trauma. The aim of this investigation was to analyze to what extent emotional, physical, and sexual child maltreatment predict borderline personality features and dissociative symptoms. For this purpose, we analyzed data from 86 consecutively admitted patients who completed the Borderline Symptom List, the Childhood Trauma Questionnaire, and the German version of the Dissociative Experiences Scale for differential diagnosis of a borderline personality disorder. Hierarchical regression analyses revealed that borderline features were mainly predicted by emotional abuse, whereas pathological dissociation was best predicted by sexual and physical abuse. This evidence supports the hypothesis that different kinds of maltreatment may lead to different psychopathological symptoms in adulthood and should be taken into account in the therapy.

Numerous studies have demonstrated that the Alternative Model for Personality Disorders (AMPD) outperforms traditional categorical nosology (i.e., Section II) in predicting an array of salient clinical outcomes. However, despite the centrality of social-cognitive impairments in personality disorder, few studies have examined the superiority of the AMPD over Section II in predicting social-cognitive deficits. The current study addresses this gap by evaluating the incremental validity of AMPD-defined level of personality functioning (LPF) versus borderline personality features in predicting mentalizing - a social-cognitive construct proposed to underlie the development of personality disorder. Participants included 267 university students (Mage = 20.49, SD = 1.74) who completed self-report measures of LPF, borderline personality features, and two measures of mentalizing: the Reflective Functioning Questionnaire (RFQ) and the Mentalization Scale (MentS). Hierarchical regressions revealed that LPF explained additional variance in the RFQ beyond borderline features and internalizing psychopathology. Although borderline features also incremented LPF in predicting the RFQ, additional variance explained was less than half that contributed by the LPF over borderline features. LPF also incremented the variance explained in the MentS total score and subscales over and above borderline features and internalizing symptoms, whereas borderline features did not increment LPF in predicting any of the MentS variables. These results strengthen the evidence base for the superiority of the AMPD over Section II and suggest that mentalizing deficits are better captured by LPF than borderline personality disorder symptoms. Findings support the extension of mentalization-based treatment to AMPD-defined personality disorder, which should be explored in future research.

Crick, Murray-Close, and Woods (2005) encouraged the study of relational aggression as a developmental precursor to borderline personality features in children and adolescents. A longitudinal study is needed to more fully explore this association, to contrast potential associations with physical aggression, and to assess generalizability across various cultural contexts. In addition, parenting is of particular interest in the prediction of aggression or borderline personality disorder. Early aggression and parenting experiences may differ in their long-term prediction of aggression or borderline features, which may have important implications for early intervention. The currrent study incorporated a longitudinal sample of preschool children (84 boys, 84 girls) living in intact, two-parent biological households in Voronezh, Russia. Teachers provided ratings of children's relational and physical aggression in preschool. Mothers and fathers also self-reported their engagement in authoritative, authoritarian, permissive, and psychological controlling forms of parenting with their preschooler. A decade later, 70.8% of the original child participants consented to a follow-up study in which they completed self-reports of relational and physical aggression and borderline personality features. The multivariate results of this study showed that preschool relational aggression in girls predicted adolescent relational aggression. Preschool aversive parenting (i.e., authoritarian, permissive, and psychologically controlling forms) significantly predicted aggression and borderline features in adolescent females. For adolescent males, preschool authoritative parenting served as a protective factor against aggression and borderline features, whereas authoritarian parenting was a risk factor for later aggression.

Objective: The current study aimed to examine the relation between sleep disturbance, emotion dysregulation and borderline personality features in adolescent inpatients. Method: N = 217 adolescents (67.1% female; ages 12–17) with the following racial/ethnic breakdown: 67.4% White, 3.7% Hispanic, 2.8% Asian, 1.8% African American, and 6.4% multiracial) completed self-report measures of sleep disturbance, emotion dysregulation and borderline personality symptoms at admission to, discharge from, and at 6-months-post discharge from an inpatient psychiatric hospital. Group comparison and path analyses were conducted to examine differences in sleep disturbance between those with and without borderline personality disorder and the mediating role of emotion dysregulation in the relation between sleep disturbance and borderline personality features. Results: Borderline personality features and emotion dysregulation were significantly related to indices of sleep disturbance. Path models revealed that some sleep disturbance indices at admission directly predicted levels of borderline features at discharge and at 6-months-post-discharge. However, none of the indirect pathways between sleep disturbance at admission, emotion dysregulation at discharge, and borderline features at discharge or 6-months post-discharge were significant. Conclusions: Findings are consistent with prior literature which suggest that a unique relation exists between sleep disturbance and BPD, beyond comorbid depression symptoms. However, contrary to our hypotheses, the current study did not provide empirical support for the mediating role of emotion regulation in this relation. These findings have implications for existing personality disorder and sleep interventions and suggest further research into the mechanisms underlying the relation between sleep disturbance and borderline personality pathology is necessary.

ABSTRACTIndividuals with greater borderline personality features may be vulnerable to chronic pain. Because pain is an unpleasant sensory and emotional experience, affect dysregulation as the core personality feature may be linked to pain hypersensitivity. Studies have found that greater borderline features are associated with increased intensity in clinical and experimental pain, and that depression mediates this increase. The current study further examined the association between borderline features and heat pain sensitivity, the contribution of affect dysregulation and the other borderline personality factors (identity problems, negative relationships, self-harming/impulsivity) to the association, and depression as a mediator. Additionally, we examined whether blunted sympathetic responses mediate the association between borderline features and temporal summation of second pain (TSSP). Thermal pain threshold, thermal TSSP and aftersensations pain were assessed in 79 healthy individuals with varying degrees of borderline features. TSSP is a proxy measure for central sensitization and refers to the gradual increase in pain to repeated nociceptive stimuli. A regression analysis showed that greater borderline features predicted greater TSSP (β = .22, p = .050, R2 = .05). Borderline features were unrelated to pain threshold and TSSP decay. A stepwise regression showed greater TSSP in individuals with greater borderline features was accounted for by the negative relationships factor rather than the affect dysregulation factor. The results of mediational analyses showed depression and blunted sympathetic skin conductance responses mediated the positive association between TSSP and borderline features.

BackgroundCentral to most theories of borderline personality disorder (BPD) is the notion that the family environment interacts with genetically-based vulnerabilities to influence the development of BPD, with particular attention given to risk conferred by conflictual familial relations. However, the extent to which family conflict may relate to the development of BPD via related interpersonal beliefs is currently unknown. This study sought to test the hypothesis that the concurrent relation between conflictual family relations and borderline features in female college students is explained by beliefs associated with real or perceived unmet interpersonal needs (captured by Joiner’s [2005] Interpersonal Psychological Theory, specifically thwarted belongingness and perceived burdensomeness).MethodThe sample included 267 female undergraduates ages 18–25 years (M = 20.86; SD = 1.80). Level of borderline personality features, unmet interpersonal needs, and family conflict were assessed.ResultsBivariate analyses revealed significant relations between both thwarted belongingness and perceived burdensomeness, conflictual family relations, and borderline features. Multivariate analyses revealed that thwarted belongingness and perceived burdensomeness both mediated the relation between family conflict and borderline personality features, thus supporting a multiple mediation model.ConclusionsThis cross-sectional study is a preliminary step towards confirming the broad theoretical hypothesis that conflictual family relations relate to beliefs about thwarted belongingness and perceived burdensomeness, which, in turn, relate to borderline personality pathology. Limitations and areas of future research are discussed.

Examining the relation between borderline personality features and social support: The mediating role of rejection sensitivity

Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p = .038; adulthood: B = 2.92, t(91) = 3.04, p = .003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p = .004, was positively associated with depressive symptoms. Mixed-effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p = .013, and depressive symptoms, F(1, 87.2) = 4.88, p = .030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response.

ABSTRACTInsecure attachment is a well‐established risk factor for the emergence of borderline personality features (BPF), encompassing identity disturbance, affective instability, problematic interpersonal relationships and self‐harming behaviours. From a mentalizing‐based perspective, BPF may develop through the interplay of hypomentalizing, defined as a reduced capacity to understand and reflect on one's own and others' mental states, and epistemic mistrust (EM), the diminished capacity to trust communicated information. Both processes are shaped by attachment anxiety and avoidance. However, research investigating the mechanisms linking attachment to BPF remains limited. This study examined the parallel mediating roles of hypomentalizing and EM in the associations between attachment dimensions and BPF. Data were drawn from a large combined clinical and community sample of 1129 participants (291 men, 819 women, 17 transgender individuals and 2 categorized as ‘other’; mean age = 32.88 years, SD = 10.90). Participants completed the Experiences in Close Relationships—Revised (ECR‐R); the Reflective Functioning Questionnaire–54 (RFQ‐54); the Epistemic Trust, Mistrust and Credulity Questionnaire (ETMCQ); and the Borderline Features Scale of the Personality Assessment Inventory (PAI‐BOR). Parallel multiple mediation analyses indicated that both hypomentalizing and EM significantly mediated the relationships between (a) attachment anxiety and BPF and (b) attachment avoidance and BPF. Supplementary analyses showed that these pathways did not differ across diagnostic groups, but EM was expressed most strongly in those participants who met criteria for borderline personality disorder (BPD), where it differentiated the group from clinical (depression and anxiety disorders) and community comparisons. These findings support the theoretical basis for mentalization‐based interventions, highlighting the importance of improving mentalizing and reducing mistrust in communication to foster adaptive social learning. Nonetheless, the cross‐sectional design and reliance on self‐report measures limit causal inference and introduce potential bias. Future research should employ longitudinal designs to further evaluate the proposed model.

This study explored factors that might place women at risk for utilizing physical aggression in their relationships. Women (N = 103) court-referred to violence intervention programs completed measures of family of origin violence, relationship aggression, posttraumatic stress symptoms, and borderline personality features. Relationship aggression was correlated with reports of parent-to-child violence in the family of origin, borderline personality features, and the partner's use of violence. Regression analyses indicated that, controlling for partners' aggression, PTSD symptoms were negatively associated with physical aggression, and borderline features were positively associated with physical aggression. The relationship between family of origin violence and the use of physically aggressive conflict tactics was mediated by borderline features. Study limitations and implications for future research are discussed.

IntroductionAdolescence is a development stage that stands out by normative challenges that comprise the creation of representations about the self and the others, the definition of a sense of identity, and adaptation of emotional regulatory strategies and behaviors in social contexts, particularly within the group of peers. However, these developmental tasks can raise psychological difficulties that may facilitate the emergence of psychopathology in adolescents.ObjectivesAnalyze the role of self-disgust in the relationship between early memories of warmth and safeness with peers and borderline personality features in adolescents.MethodsSample was composed of 451 adolescents (260 females and 185 males), with a mean of 15.55 years of age (SD = 1.49), who completed self-report questionnaires to assess early memories of warmth and safeness with peers (EMWSSPeers-A), self-disgust (MSDS-A) and borderline features (BPFS-C). Pearson’s correlation coefficients and a path analysis were performed using SPSS and PROCESS Macro.ResultsGirls had higher values of self-disgust and borderline features than boys, as well as similar levels in early memories of warmth and safeness with peers. The mediation model was significant and explained 54% of the variance of the borderline traits, with early emotional positive memories with peers and self-disgust dimensions contributing significantly to the explanation model. Gender and exclusion (a specific dimension of the self-disgust scale) did not have predictive power in borderline features.ConclusionsOur results contribute to a better understanding of the psychological mechanisms involved in the development of borderline traits and consequently to clinical practices and research on adolescence.Disclosure of InterestNone Declared

The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating

Whereas some work links trauma exposure to poor subjective sleep quality, studies largely rely upon limited trauma measures and self-reported sleep at one time point. It is unknown whether trauma is related to persistent poor sleep, whether associations differ based on childhood versus adulthood trauma, and whether trauma exposure is related to poorer objectively assessed sleep. We tested whether childhood or adult trauma associated with persistent poor objectively and subjectively measured sleep at two time points in midlife women. One hundred sixty-seven women aged 40-60 at baseline were assessed twice 5 years apart. At baseline, women reported childhood trauma (Child Trauma Questionnaire), adult trauma (Brief Trauma Questionnaire), demographics, depressive symptoms, apnea symptoms, and medical history, and provided physical measures. At both visits, women completed 3 days of actigraphy (total sleep time [TST], wake after sleep onset [WASO]) and reported sleep quality (Pittsburgh Sleep Quality Index). Relations of childhood and adult trauma exposure, respectively, with persistent poor sleep at both baseline and follow-up visits (TST [<6 hours], WASO [>30 minutes], Pittsburgh Sleep Quality Index [>5]) were assessed in logistic regression models, adjusted for age, race/ethnicity, education, body mass index, sleep medications, nightshift work, apnea, depressive symptoms, vasomotor symptoms, and alcohol use. Childhood trauma was related to persistent high WASO (odds ratio [95% confidence interval] = 2.16 [1.04-4.50], P = 0.039, multivariable). Adult trauma was related to persistent poor sleep quality (odds ratio [95% confidence interval] = 2.29 [1.07-4.93], P = 0.034, multivariable). Trauma was unrelated to persistent short TST. Childhood and adult trauma, respectively, were related to persistent poor objective sleep continuity and subjective sleep quality in midlife women, independent of risk factors.