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

BackgroundLeading 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...

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Bibliographic Details
Published in:Psychological medicine 2022-09, Vol.52 (12), p.2319-2331
Main Authors: Fitzpatrick, Skye, Varma, Sonya, Kuo, Janice R.
Format: Article
Language:English
Subjects:
Anxiety disorders
Borderline personality disorder
Components
Delayed
Distraction
Emotional regulation
Emotions
Generalized anxiety disorder
Heart rate
Mindfulness
Original Article
Paradigms
Parasympathetic nervous system
Personality
Personality disorders
Physiology
Reactivity
Recovery
Self report
Vagus nerve
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Summary:BackgroundLeading 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.MethodsEmotion 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.ResultsIndividuals 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.ConclusionsThere 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.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291720004225