A multi-method investigation of affective dysregulation in borderline personality disorder

A multi-method investigation of the affective dysregulation component of borderline personality disorder (BPD) investigated how information regarding arousal (calm-activated) and valence (pleasant-unpleasant) was incorporated into representations of emotions including physiological responding, conceptual representations of emotions, and use of emotion terms. Forty-six participants diagnosed with BPD and 51 control participants not endorsing significant BPD symptoms (2 or fewer) or any Axis I pathology completed a picture processing task. During the task participants viewed emotionally evocative images while a variety of psychophysiological measures were recorded (e.g., eye-blink startle response, heart rate, skin conductance, and facial muscle activity) and reported how the images made them feel. Valence and arousal levels of the images were systematically varied to simultaneously assess the impact on responding. To examine conceptual representations of emotion, multidimensional scaling was applied to similarity ratings of pairs of emotion terms to derive estimates of the degree to which participants emphasized valence and arousal when making rational judgments about emotions. To investigate the use of emotion labels the co-occurrence of 16 specific labels used by participants to describe their experience while viewing a subset of images was summarized to assess the degree to which participants emphasized valence and arousal when labeling their experience. Finally, to assess the impact of emotional activation on subsequent emotional functioning, prior to completing the picture processing procedure one-half of the participants from each group completed an interview designed to elicit feelings of anger/interpersonal violation, while the other half completed a neutral interview during which they described a typical day. Results indicated that participants with BPD exhibited a lower threshold for responding to increased arousal levels in an unpleasant manner than control participants, which manifested in self-reports of valence, heart rate acceleration, and increased eye-blink startle responses while viewing images under certain conditions. The results of the emotion labeling task indicated that participants with BPD emphasized arousal to a lesser degree than control participants. These findings suggest that the manner in which arousal affects emotional responding and how information about arousal is incorporated into representations of emotion may play an important role in the affective dysregulation component of BPD.