A Day in the Life of Borderline Personality Disorder: A Preliminary Analysis of Within-Day Emotion Generation and Regula
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A Day in the Life of Borderline Personality Disorder: A Preliminary Analysis of Within-Day Emotion Generation and Regulation Matthew W. Southward 1 Shannon Sauer-Zavala 1
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Stephen A. Semcho 1 & Nicole E. Stumpp 1 & Destiney L. MacLean 1 &
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract In Linehan’s (1993) biosocial theory, borderline personality disorder (BPD) results in part from frequent, intense, negative emotions and maladaptive behavioral responses to those emotions. We conducted a secondary data analysis of an intensive single-case experimental design to explore hourly relations among behavioral responses and emotions in BPD. Eight participants with BPD (Mage = 21.57, 63% female; 63% Asian-American) reported their emotions and behaviors hourly on two days. Participants reported a neutral-to-negative average emotional state with substantial variability each day. This emotional state was characterized most frequently by anxiety and joy. Participants tended to “dig into”, or savor, experiences of joy, but problemsolve around, push away, or accept anxiety. Acceptance predicted hour-by-hour increases in negative emotion intensity, and pushing emotions away predicted hour-by-hour increases in positive emotion intensity. These results suggest that anxiety dominates the emotional experiences of people with BPD and co-occurs with a variety of emotion regulation strategies, while joy co-occurs with strategies designed to prolong emotional experiences. Despite its general adaptiveness, acceptance may be less effective, and pushing emotions away may be more effective, than other emotion regulation strategies at improving momentary negative emotions for those with BPD. We discuss the preliminary nature of these findings and encourage future researchers to build on them in larger samples with more severe presentations of BPD. Keywords Borderline personality disorder . Ecological momentary assessment . Anxiety . Emotion regulation
Introduction Borderline Personality Disorder (BPD) is a severe psychiatric disorder characterized in part by affective instability, impulsive behaviors, and chronic suicidality (American Psychiatric Association [APA], 2013). This condition is estimated to affect approximately 1.6% of the general population (Torgersen 2009) and up to 20% of psychiatric inpatients (Gunderson and Links 2008). Although there may be no gender differences in the rates of BPD in the general population (Grant et al. 2008),
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10862-020-09836-1) contains supplementary material, which is available to authorized users. * Matthew W. Southward [email protected] 1
Department of Psychology, University of Kentucky, 343 Waller Ave., Suite 303, Lexington, KY 40504, USA
75% of people with BPD who present for treatment are women (Widiger and Trull 1993). Linehan’s (1993) biosocial theory, a leading conceptualization of BPD, posits that BPD “is primarily a disorder of the emotion regulation system” (Lineha
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