Cascades of Emotion: The Emergence of Borderline Personality Disorder from Emotional and Behavioral Dysregulation

Abstract

Theories of borderline personality disorder (BPD) have often considered it a disorder involving both emotional and behavioral dysregulation (Linehan, 1993), yet the connection between these phenomena has been elusive. The following paper proposes the Emotional Cascade Model, a model that attempts to establish a clear relationship between emotional dysregulation and the wide array of dysregulated behaviors found in BPD. In this model, subsequent to an emotional stimulus, ruminative processes result in a positive feedback loop that increases emotional intensity, and this emotional intensity leads to ensuing behavioral dysregulation. These behaviors then provide negative feedback, in the form of distraction, which induces temporary reduction of negative emotion and thus relief. The model is presented in a framework in which BPD is considered an emergent phenomenon (Lewin, 1992), where the disorder arises from the total interactions of a network containing emotional cascades and other important factors. The model is then evaluated in light of various theories and therapeutic traditions, including both cognitive-behavioral and psychodynamic, indicating that it is a model that may transcend traditional theoretical and therapeutic doctrines. Keywordsborderline personality disorder; rumination; emotion dysregulation; non-suicidal self-injury; dialectical behavior therapy Linehan (1993) has proposed a comprehensive biopsychosocial theory of BPD in which she asserts that individuals who develop BPD are surrounded by an invalidating environment, one in which communication of emotional experience is met by erratic, inappropriate, and extreme responses by others. In combination with biological predispositions, individuals with BPD then develop an emotional vulnerability that results in: 1) heightened sensitivity to emotional stimuli, 2) experiencing emotions as extremely intense, and 3) a slow return to emotional baseline. Linehan also posits that this development of emotion dysregulation results in the development of subsequent behavioral dysregulation (defined here as behaviors that are difficult to control and result in impairment in the affected individual's functioning) because Cascades of Emotion: The Emergence of Borderline Personality Disorder from Emotional and Behavioral Dysregulation

Emotional Dysregulation and Nonsuicidal Self-Injury: A Meta-Analytic Review

“…It is thus impossible to know whether emotional dysregulation occurs before the engagement in NSSI or the reverse. Although most theoretical models suggest that individuals first experience emotional dysregulation and then engage in NSSI as an emotion regulation strategy [10,13,15,32], it is also likely that after the engagement in NSSI, individuals feel guilty or ashamed for doing so [7]. Feeling guilty or ashamed is an indicator of non-acceptance of emotional responses.…”

“…Additionally, Selby and Joiner proposed an emotional cascade model [32]. This model argues that when people are experiencing extreme negative emotions, some of them tend to ruminate intensely about the event that initiates these negative feelings.…”

La percepción de control de la ansiedad en el trastorno límite de la personalidad

“…(2016) quisieron medir la reactividad emocional y la regulación emocional volitiva en pacientes con tlp. Contrariamente a lo que se ha hipotetizado en teorías prominentes sobre el tlp (por ejemplo, Linehan, 1993;Selby y Joiner, 2009), los resultados mostraron que los individuos con tlp podían reducir su reactividad emocional a través de la regulación (siguiendo instrucciones para aplicar estrategias de regulación como el mindfulness o la distracción) tan satisfactoriamente como los sujetos del grupo control, aunque representaban una actividad basal psicofisiológica anormal. Así mismo, otros estudios han señalado que la reactividad emocional en el tlp puede que sea específica a ciertas emociones (Gratz y cols., 2010; Kuo y cols., 2013), por lo que quizá sea necesario que los estímulos provoquen las emociones clave en los individuos con tlp (Kuo y cols., 2016).…”

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“…(2016) quisieron medir la reactividad emocional y la regulación emocional volitiva en pacientes con tlp. Contrariamente a lo que se ha hipotetizado en teorías prominentes sobre el tlp (por ejemplo, Selby y Joiner, 2009), los resultados mostraron que los individuos con tlp podían reducir su reactividad emocional a través de la regulación (siguiendo instrucciones para aplicar estrategias de regulación como el mindfulness o la distracción) tan satisfactoriamente como los sujetos del grupo control, aunque representaban una actividad basal psicofisiológica anormal. Así mismo, otros estudios han señalado que la reactividad emocional en el tlp puede que sea específica a ciertas emociones (Gratz y cols., 2010; Kuo y cols., 2013), por lo que quizá sea necesario que los estímulos provoquen las emociones clave en los individuos con tlp (Kuo y cols., 2016).…”