Referential Activity Differentially Mediates Expression of Positive and Negative Emotions in Borderline Personality Disorder.

Abstract

Borderline Personality Disorder (BPD) is a high risk and prevalent personality disorder that is associated with increased negative emotions, decreased positive emotions, and impairments in symbolization and impaired reflective functioning. These dimensions, while they may impact one another, have not been investigated concurrently from qualitative, linguistic narratives. We hypothesized a BPD group would have lower expression of positive emotions and greater expression of negative emotions and less reflective function than healthy controls. Additionally, we explored the role of referential activity (an index of symbolic capacity) between BPD and healthy controls in the context of valenced emotional expression. An adult, female BPD group (n = 13) and a demographically matched healthy control group (n = 14) were recruited and administered the Adult Attachment Interview and/or the Object Relations Inventory. Computerized text analyses were used to assess positive emotion and negative emotion, the Weighted Referential Activity Dictionaries to assess referential activity, and the Computerized Reflective Function dictionary. On the Object Relations Inventory, the BPD group expressed more frequent negative emotions and less frequent positive emotions; on the Adult Attachment Interview, the BPD group exhibited less expression of positive emotions. There were no differences between BPD and controls on referential activity or reflective functioning on either interview. However, BPD status fully mediated the significant relationship between referential activity and negative emotion expression. The BPD group utilized more referential activity when expressing negative emotions than controls. Conversely, the control group utilized more referential activity when expressing positive emotions than controls. Referential activity seems to play an important role in explaining the BPD versus control difference in valenced linguistic emotional expression. Furthermore, these results suggest the object relations inventory elicits more robust linguistic features relevant to BPD.