Borderline personality disorder and adolescent suicide attempt: the mediating role of emotional dysregulation

Bojan Mirkovic,Marion Robin,Mario Speranza,Véronique Delvenne,Maurice Corcos,Alexandra Pham-Scottez

doi:10.1186/s12888-021-03377-x

Abstract

BackgroundEmotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). In addition, recent research in the adolescent population has shown that suicidal behaviours have been associated with maladaptive strategies of emotion regulation.MethodsThis study examined the relative contributions of emotional dysregulation to suicide attempt history in a clinical sample of borderline adolescents. Data were analyzed from 85 participants of the Collaborative European Research Network on Borderline Personality Disorder. Participants completed measures of BPD traits and symptoms, suicide behaviours, emotional dysregulation, attachment styles and lifetime depressive disorders.ResultsIn an SEM model, lifetime depressive disorders and insecure attachment styles have a significant direct effect on lifetime suicide attempt, but only lifetime depressive disorders have an indirect effect through emotion dysregulation. The results suggest that emotional dysregulation has a mediating role in suicide attempts among BPD adolescents.ConclusionsThese findings call for the development of interventions targeting the role of emotion dysregulation in effectively predicting and preventing suicidality in borderline adolescents.

Highlights

Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD)
The conflicting results reported in studies examining emotional dysregulation and suicidal behaviours (SB) suggest the notion that the nature of the relationship depends on the presence or absence of other variables such as mood depressive disorders (MDD) or interpersonal difficulties
Descriptive statistics and group differences Of the initial cohort, variables of interest were fully available for 75 adolescents (11 boys, 15%, 64 girls, 85%)

Summary

Introduction

Emotional dysregulation seems to be a core feature of Borderline Personality Disorders (BPD). Even in non-clinical populations, emotional regulation difficulties have been shown to be correlated with suicidality [25, 26]. Yen et al [23] showed that only the affective instability feature prospectively predicted suicide attempts (SAs) even when controlling for negative mood states such as major depression. In a sample of high-risk suicidal adolescents, Yen et al [11] found no difference in emotional regulation between BPDs and non-BPDs. On the other hand, the authors found that those with more BPD criteria had higher levels of negative affectivity, depression, anxiety and higher affective lability. The conflicting results reported in studies examining emotional dysregulation and SB suggest the notion that the nature of the relationship depends on the presence or absence of other variables such as mood depressive disorders (MDD) or interpersonal difficulties. Adult studies have shown that while there is significant overlap or co-morbidity between BPD and DD [12, 24], these are probably distinct clinical phenotypes

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Conclusion