BORDERLINE PERSONALITY DISORDER TRAITS AND THE EFFECT OF A REJECTION EXPERIENCE ON ATTENTIONAL BIAS TOWARDS ALCOHOL

Abstract

This thesis comprises a literature review, “A systematic review of the relationship between borderline personality disorder or traits and alcohol use: active components, mediators and common risk factors”; an empirical paper, “Borderline personality disorder traits and the effect of a rejection experience on attentional bias towards alcohol” and relevant appendices. Borderline personality disorder is a controversial diagnosis which has been linked with alcohol use and misuse (Trull et al., 2000). A gap in the research was highlighted as no systematic review has explored the active components of borderline personality disorder (BPD) or borderline traits in predicting alcohol misuse, and the mechanisms by which these may influence alcohol misuse. The aim of the literature review was therefore to identify components and mechanisms through mediation, moderation or common-cause analysis. Ten studies were reviewed. Active components were affective instability and impulsivity, mechanisms were mediation through negative emotionality, anti-social personality disorder and social support, common risk factors were genetic factors, which had a stronger influence in later adolescence, shared and non-shared environmental influences, attachment and emotional clarity. This study concludes that traits of impulsivity and affective instability may create a vulnerability to using alcohol as a way of regulating emotions. It was proposed that causal influences can be better understood through longitudinal studies rather than cross-sectional studies. The literature review shows linkages between these variables, but does not explain how affective instability may cause drinking. The empirical paper argued that sensitivity to rejection may increase vulnerability to using alcohol as a way of regulating difficult emotions, and hence is a possible trigger for harmful alcohol (Gratz & Roemer, 2004). The empirical paper reported a study which aimed to explore whether borderline traits would interact with a social exclusion manipulation to predict an attentional bias towards alcohol in 111 students. This was studied using an experimental social exclusion experience and a dot probe task. Results did not show an interaction between borderline traits and exclusion in predicting attentional bias or any main effects. The failure to support the hypothesis may be attributable to the failure of the exclusion experience to elicit affective change and the insensitivity of the dot-probe task. Methodological refinements are suggested.