Skip to main content

A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorder

  • J.-P. Glaser (a1), J. Van Os (a1) (a2), R. Mengelers (a1) and I. Myin-Germeys (a1) (a3) (a4)

Stress is postulated to play an essential role in the expression of core borderline symptoms. However, the phenomenology of stress reactivity in borderline personality disorder remains unclear. The current study investigated the phenomenology of stress sensitivity in borderline personality disorder in the flow of daily life and compared this with stress sensitivity in patients suffering from psychotic disorders, a group so far known to report the largest reactivity to stress.


A total of 44 borderline patients, 42 patients with psychotic disorder and 49 healthy controls were studied with the Experience Sampling Method (a structured diary technique assessing current context and mood in daily life) to assess: (1) appraised subjective stress related to daily events and activities; and (2) emotional reactivity conceptualized as changes in positive and negative affect.


Multilevel regression analysis revealed that subjects with borderline personality disorder experienced significantly more emotional reactivity to daily life stress compared with both patients with psychosis and healthy controls, as evidenced by a larger increase in negative affect and a larger decrease in positive affect following stress.


These results are the first to ecologically validate the incorporation of stress reactive symptoms in the diagnosis of borderline personality disorder. Borderline patients continually react stronger than patients with psychosis and healthy controls to small disturbances that continually happen in the natural flow of everyday life. Altered emotional stress reactivity may define borderline personality disorder.

Corresponding author
*Address for correspondence: I. Myin-Germeys, Ph.D, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616 (VIJV), 6200MD Maastricht, The Netherlands. (Email:
Hide All
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. APA: Washington, DC.
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates: Hillsdale, NY.
Cowdry, RW, Gardner, DL, O'Leary, KM, Leibenluft, E, Rubinow, DR (1991). Mood variability: a study of four groups. American Journal of Psychiatry 148, 15051511.
Daley, SE, Hammen, C, Davila, J, Burge, D (1998). Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood. Journal of Consulting and Clinical Psychology 66, 595603.
Delespaul, PAEG (1995). Assessing Schizophrenia in Daily Life. Universitaire Pers Maastricht: Maastricht, The Netherlands.
Ebner-Priemer, UW, Kuo, J, Kleindienst, N, Welch, SS, Reisch, T, Reinhard, I, Lieb, K, Linehan, MM, Bohus, M (2007). State affective instability in borderline personality disorder assessed by ambulatory monitoring. Psychological Medicine 37, 961970.
First, MB, Gibbon, M, Spitzer, RL, Williams, JBW, Benjamin, LS (1997). User's Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Press: Washington, DC.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV Axis I Disorders – Patient Edition (SCID-I/P), 11–2002 revision. Biometrics Research Department, New York State Psychiatric Institute: New York.
Green, AS, Rafaeli, E, Bolger, N, Shrout, PE, Reis, HT (2006). Paper or plastic? Data equivalence in paper and electronic diaries. Psychological Methods 11, 87105.
Gunderson, JG, Phillips, KA (1991). A current view of the interface between borderline personality disorder and depression. American Journal of Psychiatry 148, 967975.
Jacobs, N, Nicolson, NA, Derom, C, Delespaul, P, van Os, J, Myin-Germeys, I (2005). Electronic monitoring of salivary cortisol sampling compliance in daily life. Life Sciences 76, 24312443.
Jovev, M, Jackson, HJ (2006). The relationship of borderline personality disorder, life events and functioning in an Australian psychiatric sample. Journal of Personality Disorders 20, 205217.
Kanner, AD, Coyne, JC, Schaefer, C, Lazarus, RS (1981). Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. Journal of Behavioral Medicine 4, 139.
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261276.
Koenigsberg, HW, Harvey, PD, Mitropoulou, V, Schmeidler, J, New, AS, Goodman, M, Silverman, JM, Serby, M, Schopick, F, Siever, LJ (2002). Characterizing affective instability in borderline personality disorder. American Journal of Psychiatry 159, 784788.
McGuffin, P, Farmer, A, Harvey, I (1991). A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry 48, 764770.
Monroe, SM (1983). Major and minor life events as predictors of psychological distress: further issues and findings. Journal of Behavioral Medicine 6, 189205.
Myin-Germeys, I, Krabbendam, L, Delespaul, PA, van Os, J (2004). Sex differences in emotional reactivity to daily life stress in psychosis. Journal of Clinical Psychiatry 65, 805809.
Myin-Germeys, I, Krabbendam, L, Jolles, J, Delespaul, PA, van Os, J (2002). Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study. American Journal of Psychiatry 159, 443449.
Myin-Germeys, I, Peeters, F, Havermans, R, Nicolson, NA, DeVries, MW, Delespaul, P, Van Os, J (2003). Emotional reactivity to daily life stress in psychosis and affective disorder: an experience sampling study. Acta Psychiatrica Scandinavica 107, 124131.
Myin-Germeys, I, van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry 58, 11371144.
Norman, RM, Malla, AK (1991). Subjective stress in schizophrenic patients. Social Psychiatry and Psychiatric Epidemiology 26, 212216.
Pagano, ME, Skodol, AE, Stout, RL, Shea, MT, Yen, S, Grilo, CM, Sanislow, CA, Bender, DS, McGlashan, TH, Zanarini, MC, Gunderson, JG (2004). Stressful life events as predictors of functioning: findings from the collaborative longitudinal personality disorders study. Acta Psychiatrica Scandinavica 110, 421429.
Paris, J (2005). Borderline personality disorder. Canadian Medical Association Journal 172, 15791583.
Paris, J, Gunderson, J, Weinberg, I (2007). The interface between borderline personality disorder and bipolar spectrum disorders. Comprehensive Psychiatry 48, 145154.
Peeters, F, Nicolson, NA, Berkhof, J, Delespaul, P, deVries, M (2003). Effects of daily events on mood states in major depressive disorder. Journal of Abnormal Psychology 112, 203211.
Perry, JC, Lavori, PW, Pagano, CJ, Hoke, L, O'Conell, ME (1992). Life events and recurrent depression in borderline and antisocial personality disorders. Journal of Personality Disorders 6, 394407.
Pompili, M, Girardi, P, Ruberto, A, Tatarelli, R (2005). Suicide in borderline personality disorder: a meta-analysis. Nordic Journal of Psychiatry 59, 319324.
Samuels, J, Eaton, WW, Bienvenu, OJ 3rd, Brown, CH, Costa, PT Jr., Nestadt, G (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry 180, 536542.
Schwartz, JE, Stone, AA (1998). Strategies for analyzing ecological momentary assessment data. Health Psychology 17, 616.
Sinha, BK, Watson, DC (1997). Psychosocial predictors of personality disorder traits in a non-clinical sample. Personality and Individual Differences 22, 527537.
Stein, KF (1996). Affect instability in adults with a borderline personality disorder. Archives of Psychiatric Nursing 10, 3240.
Stiglmayr, CE, Grathwol, T, Linehan, MM, Ihorst, G, Fahrenberg, J, Bohus, M (2005). Aversive tension in patients with borderline personality disorder: a computer-based controlled field study. Acta Psychiatrica Scandinavica 111, 372379.
Stone, AA, Shiffman, S, Schwartz, JE, Broderick, JE, Hufford, MR (2002). Patient non-compliance with paper diaries. British Medical Journal 324, 11931194.
Stone, AA, Shiffman, S, Schwartz, JE, Broderick, JE, Hufford, MR (2003). Patient compliance with paper and electronic diaries. Controlled Clinical Trials 24, 182199.
Strauss, JS (1994). The person with schizophrenia as a person. II: Approaches to the subjective and complex. British Journal of Psychiatry (Suppl.), 103107.
Tolpin, LH, Gunthert, KC, Cohen, LH, O'Neill, SC (2004). Borderline personality features and instability of daily negative affect and self-esteem. Journal of Personality 72, 111137.
Torgersen, S, Kringlen, E, Cramer, V (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry 58, 590596.
Trull, TJ (1995). Borderline personality disorder features in nonclinical young adults: 1. Identification and validation. Psychological Assessment 7, 3341.
van Eck, MM, Nicolson, NA, Berkhof, H, Sulon, J (1996). Individual differences in cortisol responses to a laboratory speech task and their relationship to responses to stressful daily events. Biological Psychology 43, 6984.
Ventura, J, Green, MF, Shaner, A, Liberman, RP (1993). Training and quality assurance with the Brief Psychiatric Rating Scale: ‘The Drift Busters’. International Journal of Methods in Psychiatric Research 3, 221244.
Zanarini, MC, Frankenburg, FR, Dubo, ED, Sickel, AE, Trikha, A, Levin, A, Reynolds, V (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry 155, 17331739.
Zanarini, MC, Frankenburg, FR, Hennen, J, Reich, DB, Silk, KR (2004). Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. American Journal of Psychiatry 161, 21082114.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed