Using Negative Emotions to Trace the Experience of Borderline Personality Pathology: Interconnected Relationships Revealed in an Experience Sampling Study

Abstract

While emotional difficulties are highly implicated in borderline personality disorder (BPD), the dynamic relationships between emotions and BPD symptoms that occur in everyday life are unknown. The current paper examined the function of negative emotions as they relate to BPD symptoms in real time. Experience sampling methodology with 281 participants measured negative emotions and borderline symptoms, expressed as a spectrum of experiences, five times daily for two weeks. Overall, having a BDP diagnosis was associated with experiencing more negative emotions. Multilevel modeling supported positive concurrent relationships between negative emotions and BPD symptoms. Lagged models showed that even after three hours negative emotions and several symptoms continued to influence each other. Therefore, results indicated that negative emotions and BPD symptoms are intricately related; some evidenced long-lasting relationships. This research supports emotion-symptom contingencies within BPD and provides insight regarding the reactivity and functionality of negative emotions in borderline pathology.

A Contingency-Oriented Approach to Understanding Borderline Personality Disorder: Situational Triggers and Symptoms

“…Using ESM, studies have found that people with BPD experience more symptoms following negative emotional experiences (Law et al, in press), react with rage and devaluation to rejection (Berenson et al, 2011), react with impulsive and risky behavior to positive and negative affective and interpersonal experiences (Coifman et al, 2012), and react to others’ quarrelsome behavior with quarrelsomeness of their own (Sadikaj et al 2013). …”

“…For more information about the study see Hawkins et al (2014) and Law et al (in press). The method described focuses on the relevant measures and procedures for the current study.…”

“…These studies use experience-sampling methods (ESM) and multi-level modeling (MLM) to assess the frequency and magnitude with which certain symptoms are associated with certain triggers. Studies have demonstrated contingencies between negative emotions and BPD symptom experiences (Law, Fleeson, Arnold, & Furr, in press), rage and devaluation on rejection (Berenson, Downey, Rafaeli, Coifman, & Paquin, 2011), affective and interpersonal experiences on risky/impulsive behaviors (Coifman, Berenson, Rafaeli, & Downey, 2012), psychotic and dissociative symptoms on stress (Glaser, Van Os, Thewissen, & Myin-Germeys, 2010; Stiglmayr et al, 2008), self-esteem on stressful events (Zeigler-Hill & Abraham, 2006), quarrelsomeness on others’ quarrelsomeness (Sadikaj, Moskowitz, Russell, Zuroff, & Paris, 2013), and drinking on affective instability (Jahng et al, 2011). …”

“…By sticking closely to the DSM-IV-TR and DSM-5 wording of the symptoms, we are able to test whether occurrences of the defining symptoms of BPD are contingent. That is, we test whether BPD symptom occurrences are reactions associated with the presence of proximal triggers, and disappear when the triggers disappear (see Law et al, in press). By using a wide variety of theoretical triggers derived from a literature search, we are able to investigate which triggers are associated with which symptoms.…”

“…Reviewing several theoretical accounts of BPD led to our observation that many of the theories share the contingency model. After our review of the literature, we came to the following list of potential triggers (see Law et al, in press for negative emotions triggering BPD symptoms). Although this list is not exhaustive, it is inclusive of a variety of proposed triggers of BPD in the literature.…”