Theories Of Borderline Personality Disorder Research Articles

Validating the biosocial model of borderline personality disorder: Findings from a longitudinal study.

This longitudinal study aimed to validate the biosocial theory of borderline personality disorder (BPD) by examining the transactional relationship between individual vulnerabilities and parental invalidation, and their links to BPD symptoms. We recruited a sample of 332 adolescents (mean age = 14.18 years; 58.3% female) residing in Singapore and administered self-report measures across three time-points (six months apart). Results from our path analytic model indicated that parental invalidation, impulsivity, and emotional vulnerability exhibited unique predictive associations with emotion dysregulation six months later. There was also a reciprocal prospective relationship between emotion regulation difficulties and BPD symptoms. Using random-intercepts cross-lagged panel models, we found partial evidence for a within-individual reciprocal relationship between parental invalidation and emotional vulnerability, and a unidirectional relationship of within-individual changes in impulsivity positively predicting changes in parental invalidation six months later. Overall, the study provided partial empirical support for the biosocial model in a Singaporean context.

Alexithymia, Affective Lability, Impulsivity, and Childhood Adversity in Borderline Personality Disorder.

Long-standing theories of borderline personality disorder (BPD) suggest that symptoms develop at least in part from childhood adversity. Emotion dysregulation may meaningfully mediate these effects. The current study examined three factors related to emotion dysregulation-alexithymia, affective lability, and impulsivity-as potential mediators of the relation between childhood adversity and BPD diagnosis in 101 individuals with BPD and 95 healthy controls. Path analysis compared three distinct models informed by the literature. Results supported a complex mediation model wherein (a) alexithymia partially mediated the relation of childhood adversity to affective lability and impulsivity; (b) affective lability mediated the relation of childhood adversity to BPD diagnosis; and (c) affective lability and impulsivity mediated the relation of alexithymia to BPD diagnosis. Findings suggest that affective lability and alexithymia are key to understanding the relationship between childhood adversity and BPD. Interventions specifically targeting affective lability, impulsivity, and alexithymia may be particularly useful for this population.

Multimodal assessment of emotional reactivity and regulation in response to social rejection among self-harming adults with and without borderline personality disorder.

Theories of borderline personality disorder (BPD) highlight the central role of emotional dysfunction in this disorder, with a particular emphasis on emotional reactivity and emotion regulation (ER) difficulties. However, research on emotion-related difficulties in BPD has produced mixed results, often related to the particular indices of emotional responding used in the studies. As such, the specific nature of emotional dysfunction in BPD, as well as the extent to which subjective emotion-related difficulties map onto corresponding physiological deficits, remains unclear. This study examined both subjective and physiological indices of emotional reactivity and ER difficulties in response to a social rejection emotion induction (relative to a neutral emotion induction) across three groups of participants: self-harming young adults with BPD, self-harming young adults without BPD, and clinical controls with no self-harm history or BPD. Consistent with the hypotheses, results revealed a lack of convergence between subjective and physiological indices of emotional reactivity and ER difficulties among participants with BPD. Whereas participants with BPD reported both greater emotional reactivity and greater ER difficulties in response to the negative emotion induction than participants without self-harm or BPD, there were no significant differences in physiological indices of emotional reactivity or ER between participants with BPD and either of the control groups. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Difficulties regulating emotions mediates the associations of parental psychological control and emotion invalidation with borderline personality features.

Extant research has supported a connection between socialization in childhood and difficulties regulating emotions. The biosocial theory of borderline personality disorder (BPD; Crowell, Beauchaine, & Linehan, 2009; Linehan, 1993) suggests that emotion dysregulation is a core mechanism underlying the extreme behaviors, mood instability, identity disturbance, and relationship instability observed in BPD. The present study investigated the impact of socialization factors related to emotions, parental autonomy support, parental psychological control, and childhood trauma on BPD features in a nonclinical young adult sample (N = 357). Relationships between socialization factors and BPD features were evaluated using structural equation modeling, to test integrative hypotheses informed by biosocial theory and self-determination theory. We found that recalled experiences of childhood trauma, emotional magnification of negative emotions, neglect of negative emotions, and parental psychological control were positively associated with BPD features. Difficulties regulating emotions mediated the relationships of childhood emotion socialization factors and psychological control with BPD features. Implications for future research, resiliency, and intervention are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Emotion Vulnerability in the Context of Positively Valenced Stimuli: Associations with Borderline Personality Disorder Symptom Severity

Theories of borderline personality disorder (BPD) have posited that emotion vulnerability (including greater baseline emotion intensity, greater emotion reactivity to salient stimuli, and slower return to emotional baseline) is a key etiological factor in the development of the disorder. Despite evidence to suggest that baseline negative emotion is greater in individuals with BPD (and perhaps across psychopathology), less is known about potential patterns of positive emotion vulnerability that may be uniquely associated with BPD symptoms. In the current study, 120 undergraduate students enrolled in an introductory psychology course were shown three positively valenced video clips. Self-report and psychophysiological indices of emotion (i.e., respiratory sinus arrhythmia and galvanic skin response) were measured before, during, and after each clip. Analyses examined associations with BPD and depression symptom severity. Some evidence was found for a more attenuated subjective positive emotional response specific to BPD symptom severity, distinct from the effects of depression severity. Other patterns of associations with BPD severity, including greater baseline negative emotion and attenuated parasympathetic activity, were largely accounted for by depression severity. Results also suggested that positive emotion vulnerability in BPD may be somewhat context specific, and certain positively valenced stimuli (e.g., others expressing positive emotion) may contribute more to attenuated positive emotional responses. More broadly, this study highlights the value in examining how psychopathology may impact emotional responses to positive stimuli specifically.

Competing Theories of Borderline Personality Disorder.

The authors review four theories that propose different conceptualizations of borderline personality disorder's (BPD) core psychopathology: excess aggression, emotional dysregulation, failed mentalization, and interpersonal hypersensitivity. The theories are compared in their ability to explain BPD's coaggregation of four usually distinct sectors of psychopathology, their high overlap with other disorders, their ability to distinguish BPD from other disorders, their integration of heritability, and their clinical applicability. The aims of this review are to increase awareness of these theories, to stimulate improved theories, and to f ster testable hypotheses so that research can advance our knowledge about BPD's core.

Introduction to the Special Section on Theories of Borderline Personality Disorder.

Introduction to the Special Section on Theories of Borderline Personality Disorder.

The Five-Factor Model Is a Competing Theory of Borderline Personality Disorder: Commentary on Gunderson et al.

Gunderson, Fruzzetti, Unruh, and Choi-Kahn (2018) review four competing theories of borderline personality border (BPD). Regrettably, they did not acknowledge the theory that BPD is a maladaptive variant of Five-Factor Model general personality structure. This commentary indicates how the FFM of BPD addresses well, and does so empirically, the points of comparison, made by Gunderson et al.

Behaviour vs. perception: An investigation into the components of emotional invalidation.

The negative effects of emotionally invalidating environments are theorized by the biosocial theory of borderline personality disorder to be vast and severe. However, findings from studies on the impact of emotional invalidation (EI) vary, perhaps due to different operational definitions of EI. The current investigation seeks to explore the relationship between the objective behavioural observations of EI and recipient's subjective perceptions of experiencing these behaviours. First, 58 participants watched scripted interactions between a confederate and a mock participant and identified the presence of invalidating and/or neutral behaviours. Next, 92 participants engaged in one-on-one interactions with a confederate utilizing the same scripted interactions observed by the first set of participants. While the first set of participants identified invalidating behaviours accurately and consistently, the participants who experienced the behaviours demonstrated more variability in their perceptions of the behaviours as emotionally invalidating. These preliminary findings demonstrate that the objective existence of emotionally invalidating behaviours are likely not the same as the experienced perception of EI across individuals, highlighting the need to examine how EI is operationally defined and measured. Future research should examine what individual characteristics may play a role in perceiving behaviours as emotionally invalidating. Copyright © 2017 John Wiley & Sons, Ltd.

The mediating role of mentalizing capacity between parents and peer attachment and adolescent borderline personality disorder

BackgroundInsecure attachment is a precursor and correlate of borderline personality disorder. According to the mentalization-based theory of borderline personality disorder, the presence of insecure attachment derails the development of the capacity to mentalize, potentially resulting in borderline pathology. While one prior study found support for this notion in adolescents, it neglected a focus on peer attachment. Separation from primary caregivers and formation of stronger bonds to peers are key developmental achievements during adolescence and peer attachment warrants attention as a separate concept.FindingsIn a cross-sectional study, female outpatients (Mage 15.78=, SD = 1.04) who fulfilled DSM-5 criteria for BPD (N = 106) or met at least 4 BPD criteria (N = 4) completed self-reports on attachment to parents and peers, mentalizing capacity (reflective function) and borderline personality features. Our findings suggest that in a simple mediational model, mentalizing capacity mediated the relation between attachment to peers and borderline features. In the case of attachment to parents, the mediational model was not significant.ConclusionsThe current study is the first to evaluate this mediational model with parent and peer attachment as separate concepts and the first to do so in a sample of adolescents who meet full or sub-threshold criteria for borderline personality disorder. Findings incrementally support that mentalizing capacity and attachment insecurity, also in relation to peers, are important concepts in theoretical approaches to the development of borderline personality disorder in adolescence. Clinical implications are discussed.

Interpersonal problems and negative affect in Borderline Personality and Depressive Disorders in daily life.

Theories of Borderline Personality Disorder (BPD) suggest that interpersonal problems in BPD act as triggers for negative affect and, at the same time, are a possible result of affective dysregulation. Therefore, we assessed the relations between momentary negative affect (hostility, sadness, fear) and interpersonal problems (rejection, disagreement) in a sample of 80 BPD and 51 depressed outpatients at 6 time-points over 28 days. Data were analyzed using multivariate multi-level modeling to separate momentary-, day-, and person-level effects. Results revealed a mutually reinforcing relationship between disagreement and hostility, rejection and hostility, and between rejection and sadness in both groups, at the momentary and day level. The mutual reinforcement between hostility and rejection/disagreement was significantly stronger in the BPD group. Moreover, the link between rejection and sadness was present at all three levels of analysis for the BPD group, while it was localized to the momentary level in the depressed group.

Poor self-control and harsh punishment in childhood prospectively predict borderline personality symptoms in adolescent girls.

Developmental theories of borderline personality disorder (BPD) propose that harsh, invalidating parenting of a child with poor self-control and heightened negative emotionality often leads to a coercive cycle of parent-child transactions that increase risk for BPD symptoms such as emotion dysregulation. Although parenting practices and child temperament have previously been linked with BPD, less is known about the prospective influences of caregiver and child characteristics. Using annual longitudinal data from the Pittsburgh Girls Study (n = 2,450), our study examined how reciprocal influences among harsh parenting, self-control, and negative emotionality between ages 5 and 14 predicted the development of BPD symptoms in adolescent girls ages 14 to 17. Consistent with developmental theories, we found that harsh punishment, poor self-control, and negative emotionality predicted BPD symptom severity at age 14. Only worsening self-control between ages 12 and 14, however, predicted growth in BPD symptoms from 14 to 17. Furthermore, the effects of harsh punishment and poor self-control on age 14 BPD symptoms were partially mediated by their earlier reciprocal effects on each other between ages 5 and 14. Our findings underscore the need to address both child and parental contributions to dysfunctional transactions in order to stem the development of BPD symptoms. Moreover, problems with self-regulation in early adolescence may indicate heightened risk for subsequent BPD. Altogether, these results increase our understanding of developmental trajectories associated with BPD symptoms in adolescent girls.

Beliefs about unmet interpersonal needs mediate the relation between conflictual family relations and borderline personality features in young adult females.

BackgroundCentral to most theories of borderline personality disorder (BPD) is the notion that the family environment interacts with genetically-based vulnerabilities to influence the development of BPD, with particular attention given to risk conferred by conflictual familial relations. However, the extent to which family conflict may relate to the development of BPD via related interpersonal beliefs is currently unknown. This study sought to test the hypothesis that the concurrent relation between conflictual family relations and borderline features in female college students is explained by beliefs associated with real or perceived unmet interpersonal needs (captured by Joiner’s [2005] Interpersonal Psychological Theory, specifically thwarted belongingness and perceived burdensomeness).MethodThe sample included 267 female undergraduates ages 18–25 years (M = 20.86; SD = 1.80). Level of borderline personality features, unmet interpersonal needs, and family conflict were assessed.ResultsBivariate analyses revealed significant relations between both thwarted belongingness and perceived burdensomeness, conflictual family relations, and borderline features. Multivariate analyses revealed that thwarted belongingness and perceived burdensomeness both mediated the relation between family conflict and borderline personality features, thus supporting a multiple mediation model.ConclusionsThis cross-sectional study is a preliminary step towards confirming the broad theoretical hypothesis that conflictual family relations relate to beliefs about thwarted belongingness and perceived burdensomeness, which, in turn, relate to borderline personality pathology. Limitations and areas of future research are discussed.

An Investigation of the Biosocial Model of Borderline Personality Disorder

We sought to test the Biosocial Theory of borderline personality disorder (BPD) that posits that borderline traits are due to emotional dysregulation, caused by the interaction between childhood emotional vulnerability and invaliding parenting. A total of 250 adults (76% female, median age = 32.06 years) from a nonclinical population completed self-report measures assessing current levels of borderline traits and emotional dysregulation. They also completed retrospective measures of childhood emotional vulnerability and parental invalidation. Invalidating parenting and emotional vulnerability independently predicted emotion dysregulation, but an interaction effect was not found. Having experienced validating parenting was found to be a protective factor for developing borderline traits but was not significantly related to emotional dysregulation. Data in this sample did not support the underlying genesis of BPD proposed by the Biosocial Theory and a model that more parsimoniously explains the development of BPD is proposed.

Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls.

Theories of borderline personality disorder (BPD) postulate that high-risk transactions between caregiver and child are important for the development and maintenance of the disorder. Little empirical evidence exists regarding the reciprocal effects of parenting on the development of BPD symptoms in adolescence. The impact of child and caregiver characteristics on this reciprocal relationship is also unknown. Thus, the current study examines bidirectional effects of parenting, specifically harsh punishment practices and caregiver low warmth, and BPD symptoms in girls aged 14-17 years based on annual, longitudinal data from the Pittsburgh Girls Study (N = 2,451) in the context of child and caregiver characteristics. We examined these associations through the use of autoregressive latent trajectory models to differentiate time-specific variations in BPD symptoms and parenting from the stable processes that steadily influence repeated measures within an individual. The developmental trajectories of BPD symptoms and parenting were moderately associated, suggesting a reciprocal relationship. There was some support for time-specific elevations in BPD symptoms predicting subsequent increases in harsh punishment and caregiver low warmth. There was little support for increases in harsh punishment and caregiver low warmth predicting subsequent elevations in BPD symptoms. Child impulsivity and negative affectivity, and caregiver psychopathology were related to parenting trajectories, while only child characteristics predicted BPD trajectories. The results highlight the stability of the reciprocal associations between parenting and BPD trajectories in adolescent girls and add to our understanding of the longitudinal course of BPD in youth.

Affective behavior during mother–daughter conflict and borderline personality disorder severity across adolescence.

Developmental theories of borderline personality disorder (BPD) posit that transactions between child characteristics and adverse environments, especially those in the context of the parent-child relationship, shape and maintain symptoms of the disorder over time. However, very little empirical work has investigated the role of parenting and parent-child transactions that may predict BPD severity over time. We examined maternal and dyadic affective behaviors during a mother-adolescent conflict discussion task as predictors of the course of BPD severity scores across 3 years in a diverse, at-risk sample of girls (N = 74) oversampled for affective instability and their biological mothers. Adolescent girls completed a structured conflict discussion task with their mothers at age 16. Girls' self-reported BPD severity scores were assessed annually from ages 15 to 17. Mother-adolescent interactions were coded using a global rating system of maternal and dyadic affective behaviors. Results from multilevel linear mixed models indicated that positive maternal affective behavior (i.e., supportive/validating behavior, communication skills, autonomy-promoting behavior, and positive affect) and positive dyadic affective behaviors (i.e., satisfaction and positive escalation) were associated with decreases in girls' BPD severity scores over time. Dyadic negative escalation was associated with higher overall levels of BPD severity scores, but negative maternal affective behavior (i.e., negative affect, dominance, conflict, and denial) was not. These findings suggest that the mother-daughter context is an important protective factor in shaping the course of BPD severity scores during adolescence and may be valuable in assessment, intervention, and prevention efforts.

EPA-0900 – The role of attachment in the development of borderline personality disorder

Introduction Insecure attachment and the inability to identify emotions are seen as possible explanations for dysfunction of the emotional system in borderline personality disorder. There is a strong association between Borderline personality disorder and insecure attachment, and the attachment types that are most characteristic of these subjects are unresolved, preoccupied, and fearful. Previous studies have demonstrated that insecure attachment patterns, a trait disposition toward negative affect and impulsivity are associated with borderline personality disorder features. Aims This review aims to identify the relationship between attachment pattern during childhood and the development of borderline personality disorder in adulthood. Conclusion The high prevalence and severity of insecure attachments found in these subjects support the central role of disturbed interpersonal relationships in clinical theories of Borderline Personality disorder.

Perceived emotional invalidation and borderline personality disorder features: A test of theory

Contemporary theories of borderline personality disorder (BPD) have detailed the functional importance of emotional invalidation in meaningful relationships as an aetiological and perpetuating factor of its core disturbances. The purpose of our study was to test aspects of Linehan's (1993) biosocial and Fruzzetti (1996) and Fruzzetti, Shenk, and Hoffman's (2005) validation/invalidation family interactions transactional theories in a community sample of 186 participants. Results indicated that a multi-mediational path model of invalidation in meaningful relationships, emotion dysregulation, poor distress tolerance and BPD symptoms provided a perfect fit to the data and accounted for a substantial amount of variance in BPD (38%). The results provided support for these complimentary theories of BPD, which hold promise for clinical applications and future research.

Refining the phenotype of borderline personality disorder: Diagnostic criteria and beyond.

Borderline personality disorder (BPD) is a heterogeneous disorder, and previous analyses have parsed its phenotype in terms of subtypes or underlying traits. We refined the BPD construct by testing a range of latent variable models to ascertain whether BPD is composed of traits, latent classes, or both. We also tested whether subtypes of BPD could be distinguished by anger, aggressiveness, antisocial behavior, and mis-trustfulness, additional putative indicators drawn from Kernberg's (1967, 1975) theory of BPD. In a mixed clinical and nonclinical sample (N = 362), a factor mixture model consisting of two latent classes (symptomatic and asymptomatic) and a single severity dimension fit the BPD criteria, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), data better than latent class or factor analytic approaches. In the second analytic phase, finite mixture modeling of the symptomatic latent class (n = 100) revealed four BPD subtypes: angry/aggressive, angry/mistrustful, poor identity/low anger, and prototypical. Our results support a hybrid categorical-dimensional model of the BPD DSM-IV criteria. The BPD subtypes emerging from this model have important implications for treatment and etiological research.

Testing the biosocial model of borderline personality disorder: Results of a prospective 5‐year longitudinal study

AbstractSince its initial formulation, the biosocial theory of borderline personality disorder (BPD) still lacks robust empirical evidence, given there are no prospective longitudinal studies testing the main assumptions of the model. The current study examined longitudinally whether temperamental traits harm avoidance (HA) and novelty seeking (NS), internalizing and externalizing disorders, trauma and perceived invalidating parenting style, as measured during adolescence, contributed to the risk of BPD, diagnosed on the basis of standardized clinical interviews 5 years later. Individuals with BPD (n = 17) from a community sample of 416 young adults were compared to individuals with depressive disorders (n = 17) and psychiatrically healthy subjects (n = 34). Results indicated that adolescent internalizing disorders as well as the interaction of HA and perceived maternal overprotection predicted the risk of BPD 5 years later. NS was not shown to be a predisposing vulnerability. Results are interpreted as confirmation of the biosocial model. Gender‐specific etiological differences are discussed. Copyright © 2010 John Wiley & Sons, Ltd.