Momentary assessment of everyday physical pain in outpatients with borderline personality disorder.

Abstract

Borderline personality disorder (BPD) is a severe psychiatric disorder associated with dysregulation in multiple domains of functioning. Physical health, and specifically pain, is one such domain that has gone understudied. Although evidence suggests that BPD is associated with chronic pain, few studies have examined nonchronic pain in the disorder. The current study used ambulatory assessment to examine momentary physical pain in everyday life in BPD outpatients (N = 26) and community comparisons (COM; N = 26) not in treatment for chronic pain (Nobservations = 5,458). We predicted and observed that BPD outpatients would report greater pain intensity and greater pain variability than COM comparisons. We also examined the relationship of pain and emotion dysregulation, a core feature of BPD, by testing the association between pain and negative affect concurrently and lagged over time. We predicted that momentary pain and negative affect would be associated in both groups, but that pain would predict negative affect more strongly in the BPD group. As predicted, concurrent pain and negative affect were associated in both groups, and groups differed significantly in terms of the association of lagged pain and next-assessment negative affect, with a negative association in the COM group. The current study represents a preliminary first step, finding that pain is relevant to the everyday experience of BPD individuals. This pain propensity may contribute to the elevated prevalence of BPD in chronic pain samples. Further, BPD individuals demonstrated emotional reactivity to pain, suggesting that pain may be a contributor to emotion dysregulation in this disorder. (PsycINFO Database Record (c) 2019 APA, all rights reserved).