Development of a Borderline Personality Disorder—Relevant Picture Stimulus Set

Abstract

Individuals with borderline personality disorder (BPD) report erratic and poorly regulated emotional behavior. However, these abnormalities have not been confirmed in laboratory studies. This may be because the emotional stimuli employed have not been sufficiently relevant or evocative of psychological themes germane to BPD (e.g., threats to attachment). The aim of this study was to develop a picture stimulus set relevant to BPD that could be employed in research to examine emotion dysregulation thought to be central to BPD. Ninety pictures were initially selected from the International Affective Picture System that had putative interpersonal and social content across a range of pleasantness and intensity. The set was then rated by 19 clinical BPD research experts on two dimensions: How self-referential the picture would be to someone with BPD and the extent to which the picture represented an ideal-other to a prototypic BPD case. Two sets of pictures were generated for future research with BPD participants.

Emotional processing in borderline personality disorder.

“…Our group recently developed a picture stimulus set intended to depict experiences (e.g., interpersonal violations) that are relevant to BPD patients (Sloan et al, 2010). The stimulus set was developed to use in investigations of emotional responding with BPD participants.…”

Toward validation of a borderline personality disorder–relevant picture set.

“…Each of their sets contained six images; none of which overlapped with the BPD-specific IAPS images selected by Sloan et al (2010) and used in the present investigation.…”

“…This procedure provided the basal physiology measures for the parent study. Following this, participants viewed 36 pictures from Sloan et al's (2010) BPD-specific IAPS picture set for a total of 6 min. During this task participants viewed each image for 5 s (order randomized), followed by 5 s of black screen at which time they verbally reported their subjective arousal to each image using the Self-Assessment Manikin (Bradley & Lang, 1994), a standardized 9-point Likert scale where 1 represents lowest arousal and 9 represents greatest arousal .…”

“…Sloan et al (2010) responded to the perceived need for a BPD-specific stimuli set by developing a picture subset from the IAPS designed to be pertinent to core themes frequently noted in clinical observations of BPD. To do this, Sloan and colleagues had 19 BPD experts rate 90 preselected IAPS images clearly depicting interpersonal and social content.…”

“…As such, it is not clear whether this picture set is more evocative to individuals with BPD than to people without BPD, or if this picture set is any more evocative than unpleasant, pleasant, or neutrally valenced subsets of IAPS images that are commonly used in cue reactivity studies, and not selected based on their relevance to BPD. As such, the present investigation had three aims: (a) to examine the extent to which a BPD-specific picture set based on Sloan et al's (2010) results evoked more subjective arousal in individuals with BPD compared to healthy controls and normative ratings for these images; (b) to investigate whether this BPD specific image set was more evocative to individuals with BPD than subsets of IAPS images with unpleasant, pleasant, or neutral valence that are not specific to BPD; and (c) to explore whether individual differences in BPD symptom severity and difficulties in emotion regulation were potential sources of heterogeneity in subjective reports of arousal to IAPS images.…”