Emotional cascades as prospective predictors of dysregulated behaviors in borderline personality disorder.

Abstract

People with borderline personality disorder (BPD) frequently engage in behaviors that may result in negative consequences. These behaviors can include binge eating, using substances, fighting, yelling, self-injuring, verbal aggression, or impulsive shopping. These behaviors frequently occur in the context of negative emotion, and they may serve to reduce it. The emotional cascade model (Selby & Joiner, 2009) asserts that people engage in these behaviors because the resulting physical sensations short-circuit emotional cascades, intense cycles of rumination, and negative emotion that are extremely painful. The purpose of the present study was to examine the potential for emotional cascades to prospectively predict the occurrence of dysregulated behaviors in daily life. Forty-seven behaviorally dysregulated participants completed 3,118 recordings of real-time emotions, thoughts, and behaviors on hand-held computers over 2 weeks. Results indicated that a 3-way interaction between elevated rumination, elevated negative emotion, and elevated BPD symptoms prospectively predicted the occurrence of a dysregulated behavior within the next 2 to 3 hr. In contrast, for those with elevated BPD symptoms, negative emotion at low levels of rumination was not predictive of a dysregulated behavior occurring, and neither was rumination at low levels of negative emotion. These findings suggest that the emotional cascade model may have important clinical implications, and future research should examine the specific facets of rumination and negative emotion involved in dysregulated behaviors.