Components of emotion dysregulation in borderline personality disorder: A review of recent research

Abstract

Purpose: The aim of this paper is a synthetic presentation of the latest research results on the components of emotion dysregulation in borderline personality disorder (BPD). Views: Emotion dysregulation constitutes one of the most serious problems in BPD and manifests itself in numerous aspects of emotional functioning. Studies on BPD emotion dysregulation concern its various components, distinguished in different theoretical models. Based on a review of the empirical literature, we differentiate three main components of emotion dysregulation in BPD:(1) emotional sensitivity, (2) abnormal course of emotions in terms of: (a) emotional reactivity, (b) slow return to emotional baseline, (c) intensity of negative emotions, (d) lability of negative emotions, and (3) maladaptive aspects of applying emotion regulation strategies (described on the examples of the selected strategies: cognitive, interpersonal, and self-injury). Conclusions: Although a large number of issues pertaining to emotion dysregulation in BPD require further explanation, researchers agree that this phenomenon is characterized by a complex clinical presentation. A review of the recent studies on emotional sensitivity in BPD indicates mixed results when it comes to sensitivity to a certain kind of stimuli (i.e., facial expressions), but suggests consistently greater sensitivity in response to another (i.e., emotional scenes). The findings on reactivity and the speed of return to emotional baseline point to the significance of emotion-inducing stimuli in shaping these processes. Research results on the use of cognitive and interpersonal strategies of emotion regulation and on the predictors of self-injury are, however, not consistent. Future studies should therefore focus on identifying factors that might be affecting the differences in the outcomes of research on various components of emotion dysregulation. In order to be able to better adjust psychotherapy to the actual needs of patients with BPD, we suggest a need for combining two approaches in future research on emotion dysregulation in this disorder: within-group individual differences (considering differences within the group of patients with BPD) and a specific-transdiagnostic approach (directed at identifying differences between BPD and other mental disorders as well as their shared characteristics).

Emotion regulation strategies among individuals with borderline personality disorder relative to other groups: A review

“…With respect to habitual or preferred ER strategy use, participants with BPD typically reported lower use of adaptive (e.g., cognitive reappraisal and mindfulness) and greater use of maladaptive (e.g., experiential avoidance and self-criticism) ER strategies relative to HCs, consistent with previous reviews (e.g., Carpenter & Trull, 2013;Gratz et al, 2018;Grzegorzewski & Kucharska, 2018). However, some findings deviated from this trend, with differences in certain ER strategies garnering more support than others.…”

“…Several review articles on ER in BPD have included some studies of ER strategies, finding that BPD is associated with greater use of maladaptive strategies such as rumination, experiential avoidance, and thought suppression and less frequent use of adaptive strategies such as distraction and cognitive reappraisal (Carpenter & Trull, 2013; Cavicchioli et al, 2015; Chapman et al, 2011; Gratz et al, 2018; Grzegorzewski & Kucharska, 2018; Jazaieri et al, 2013). However, the majority of these were not systematic, comprehensive reviews of the literature on ER strategy use in BPD but rather included a nondescript sampling of ER strategy studies within a broader discussion of ER deficits in BPD (Carpenter & Trull, 2013; Gratz et al, 2018; Grzegorzewski & Kucharska, 2018; Jazaieri et al, 2013) or discussed the theorized role of one particular strategy (i.e., experiential avoidance) in BPD (Chapman et al, 2011). More recently, a meta‐analytic review (conducted in 2016) of 93 studies of ER strategies in relation to BPD symptoms showed that BPD symptoms were associated positively with the use of three maladaptive (i.e., rumination, suppression, and avoidance) and negatively with three adaptive (i.e., cognitive reappraisal, acceptance, and problem‐solving) ER strategies (Daros & Williams, 2019).…”

“…Compared to the considerable body of research supporting the hypothesis that ER abilities are impaired in BPD (see Gratz et al, 2018), research has less extensively examined the use of ER strategies among individuals diagnosed with BPD. Several review articles on ER in BPD have included some studies of ER strategies, finding that BPD is associated with greater use of maladaptive strategies such as rumination, experiential avoidance, and thought suppression and less frequent use of adaptive strategies such as distraction and cognitive reappraisal (Carpenter & Trull, 2013; Cavicchioli et al, 2015; Chapman et al, 2011; Gratz et al, 2018; Grzegorzewski & Kucharska, 2018; Jazaieri et al, 2013). However, the majority of these were not systematic, comprehensive reviews of the literature on ER strategy use in BPD but rather included a nondescript sampling of ER strategy studies within a broader discussion of ER deficits in BPD (Carpenter & Trull, 2013; Gratz et al, 2018; Grzegorzewski & Kucharska, 2018; Jazaieri et al, 2013) or discussed the theorized role of one particular strategy (i.e., experiential avoidance) in BPD (Chapman et al, 2011).…”

Emotion Dynamics and Emotion Regulation in Anorexia Nervosa: A Systematic Review of Ecological Momentary Assessment Studies

“…Therefore, components of emotion dynamics, such as emotional interdependency across time, emotional dialecticism (bipolarity), emodiversity and other subtypes of emotional lability, including the probability of acute change or emotional switching (for overviews, see [ 10 , 65 , 66 ]), as well as cognitive ER strategies, for example cognitive reappraisal or distraction, and behavioural ER strategies, such as social support seeking (for overviews, see [ 67 , 68 ]) should be examined. In addition, patients with AN need to be compared to patients with other mental disorders characterised by maladaptive emotion dynamics and ER, such as borderline personality disorder [ 69 ] or major depressive disorder [ 70 ], in order to identify disorder-specific and transdiagnostic patterns of these phenomena. Given disordered ER in men with AN see [ 71 ], this group should also be involved in further studies.…”

Self-Destructive Behaviors in People with Mood and Personality Disorders: Its Role and Implications for Future Functioning in the Light of Repression-Sensitization Variable

“…Many researchers underline the problem of inappropriate emotion regulation characteristic for people with personality disorders, especially in case of borderline personality disorder (Cavicchioli et al, 2021), but emotional crises are observed in other mental disorders as well (Santangelo et al 2016). Persons suffering from difficulties associated with personality disorders experience very complex emotional dysregulation resulting from biological and environmental causes (Grzegorzewski & Kucharska, 2018). They encounter a high level of emotional sensitivity, and a high level of emotional reactivity accompanied by a low level of agility of nervous processes.…”