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Is borderline personality disorder really an emotion dysregulation disorder and, if so, how? A comprehensive experimental paradigm

Published online by Cambridge University Press:  17 November 2020

Skye Fitzpatrick Open the ORCID record for Skye Fitzpatrick [Opens in a new window] ,
Sonya Varma  and
Janice R. Kuo
Skye Fitzpatrick*
Affiliation:
Department of Psychology, York University, Canada
Sonya Varma
Affiliation:
Department of Psychology, York University, Canada
Janice R. Kuo
Affiliation:
Department of Psychology, Palo Alto University, USA
*
Author for correspondence: Skye Fitzpatrick, E-mail: skyefitz@yorku.ca
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Abstract

Background

Leading theories suggest that borderline personality disorder (BPD) is an emotion dysregulation disorder involving lower basal vagal tone, higher baseline emotion, heightened emotional reactivity, delayed emotional recovery, and emotion regulation deficits. However, the literature to date lacks a unifying paradigm that tests all of the main emotion dysregulation components and comprehensively examines whether BPD is an emotion dysregulation disorder and, if so, in what ways. This study addresses the empirical gaps with a unified paradigm that assessed whether BPD is characterized by five leading emotion dysregulation components compared to generalized anxiety disorder (GAD) and healthy control (HC) groups.

Methods

Emotion was assessed across self-report, sympathetic, and parasympathetic indices. Participants with BPD, GAD, and HCs (N = 120) first underwent baseline periods assessing basal vagal tone and baseline emotional intensity, followed by rejection-themed stressors assessing emotional reactivity. Participants then either reacted normally to assess emotional recovery or attempted to decrease emotion using mindfulness or distraction to assess emotion regulation implementation deficits.

Results

Individuals with BPD and GAD exhibited higher self-reported and sympathetic baseline emotion compared to HCs. The BPD group also exhibited self-reported emotion regulation deficits using distraction only compared to the GAD group.

Conclusions

There is minimal support for several emotion dysregulation components in BPD, and some components that are present appear to be pervasive across high emotion dysregulation groups rather than specific to BPD. However, BPD may be characterized by problems disengaging from emotion using distraction.

Keywords

Borderline personality disorderemotion dysregulationemotion regulationvagal tone
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 12 , September 2022 , pp. 2319 - 2331
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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