Boredom in Borderline Personality Disorder: A Lost Criterion Reconsidered

Abstract

Difficulty with boredom was eliminated from the formal diagnostic criteria for borderline personality disorder (BPD) in 1994 based on significantly limited, unpublished data. However, it is apparent in clinical practice that boredom remains relevant to BPD. This review synthesizes empirical research, with consideration of theoretical accounts, to critically examine the relevance of boredom to BPD. We first briefly review issues in defining and measuring boredom and offer an expanded conceptualization for BPD, which includes the notion of boredom reactivity, before turning to boredom’s differentiation from and overlap with feelings of emptiness, with which it was paired prior to its removal from the DSM. We then discuss perspectives on boredom’s significance in BPD, briefly touching on its relevance in other personality disorders. We propose a Boredom Cascade Model that articulates how boredom and boredom reactivity interact with identity disturbance and chronic emptiness to create escalating patterns of behavioral dysregulation and make recommendations for research and treatment.

Boredom Makes Me Sick: Adolescents’ Boredom Trajectories and Their Health-Related Quality of Life

“…If students repeatedly experience such lessons across the semester and their boredom levels increase over time, they then may withdraw from classes and start to engage in maladaptive escape behaviors. Based on the above-mentioned boredom cascade model, the experience of boredom can then lead to such maladaptive escapes, prompting issues regarding individuals’ mental and physical health [ 35 ]. More specifically, repeated and increasingly intense experiences of boredom in mathematics, a subject typically judged as highly important by relevant others (e.g., parents, teachers, society), are likely to increase the use of avoidant and anger-related or acting-out strategies of emotion regulation [ 50 ].…”

“…Similarly, in the context of work, there is evidence that boring, monotonous working conditions are associated with emotional health complaints [ 20 ] and physical health problems, such as visual and musculoskeletal complaints, asthma, bronchitis, and hand tremors [ 20 , 21 ], as well as stress-related health issues such as cardiovascular diseases [ 22 ]. Furthermore, there is ample empirical evidence that general boredom proneness and leisure boredom are linked with depression [ 23 , 24 , 25 , 26 , 27 ], somatic complaints [ 26 ], substance abuse [ 28 , 29 , 30 , 31 ], obesity, eating disorders [ 32 , 33 ], and borderline personality disorder diagnosis [ 34 , 35 ].…”

“…It is therefore conceivable that boredom and health are linked through reciprocal effects. Furthermore, the boredom cascade model suggests that boredom results in frustration and maladaptive escape behaviors (such as impulsive behavior induced by identity disturbance) that fuel chronic feelings of emptiness, which, in turn, generate boredom [ 35 ].…”

Boredom Makes Me Sick: Adolescents’ Boredom Trajectories and Their Health-Related Quality of Life

“…They then may withdraw from classes and start to engage in maladaptive escape behaviors. Based on the above-mentioned boredom cascade model, the experience of boredom can then lead to such maladaptive escapes, prompting issues regarding individuals' mental and physical health (Masland et al, 2020). More specifically, repeated and increasingly intense experiences of boredom in mathematics, a subject typically judged as highly important by relevant others (e.g.…”

“…It is therefore conceivable that boredom and health are linked through reciprocal effects. Furthermore, the boredom cascade model suggests that boredom results in frustration and maladaptive escape behaviors (such as impulsive behavior induced by identity disturbance) that fuel chronic feelings of emptiness, which, in turn, generate boredom (Masland et al, 2020).…”