Researchers Home in on Emotion Regulation Difficulties Among Patients with Borderline Personality Disorder

Recent findings published in PLOS One shed light on the emotion regulation deficits that characterize borderline personality disorder (BPD). The findings suggest that people with BPD show deficits in adaptive emotion regulation, mindfulness, and self-compassion.

One of the key characteristics of borderline personality disorder is a difficulty processing and regulating emotions. Individuals with BPD undergo a range of strong negative emotions and often struggle to name these feelings. Moreover, BPD patients struggle to respond appropriately to their emotional states, often reacting with impulsivity and outbursts. Study authors Ella Salgó and colleagues proposed that this inability to regulate emotions may stem from dysfunctional emotion regulation strategies and deficits in mindfulness and self-compassion.

To explore this, the researchers gathered a sample of 59 adults with BPD and 70 healthy control participants who were matched by age, gender, and education. All participants filled out questionnaires that assessed the use of cognitive emotion regulation strategies following negative events. The surveys also included a measure of self-compassion and assessed five key aspects of mindfulness, which were, “observation, description, mindful actions, non-judgmental inner experience and non-reactivity.”

An analysis of the data revealed that the BPD group indeed presented with greater deficits in emotion regulation compared to the control group. Specifically, people with BPD scored higher in all four facets of the Difficulties in Emotion Regulation Scale. Further, they scored higher in use of maladaptive emotion regulation strategies (e.g., rumination, dramatization) and lower in use of adaptive emotion regulation strategies (e.g., putting into perspective, positive reappraisal) compared to the control group.

“Our results demonstrate that the inability to put an unpleasant event into perspective is characteristic of the BPD group . . . The incapability of considering and understanding different perspectives is a defining component of the “empathy” factor of the Levels of Personality Functioning Scale, and a proposed diagnostic criteria for BPD,” Salgó and colleagues observe.

Moreover, the patients with BPD scored lower in four out of five of the facets of mindfulness, with only “observation” showing no significant differences between the two groups. The researchers say that this finding supports the idea that practicing mindfulness might be a way to encourage the use of healthy emotion regulation strategies.

When it came to the Self-Compassion Scale, the BPD group scored higher in self-judgment, isolation, and over-identification, and lower in common humanity, mindfulness, and self-kindness.

One limitation noted by the authors was that the study relied on a self-report questionnaire, which is a less than ideal approach given that people with BPD tend to lack self-awareness and introspection. Nevertheless, Salgó and colleagues note that their study uncovered significant deficits in emotion regulation among people with BPD when compared to healthy controls. They suggest that a therapeutic approach that teaches skills related to emotion regulation, self-compassion, and mindfulness may be a key approach to treating individuals with BPD.



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