Change of Emotional Experience in Major Depression and Borderline Personality Disorder During Psychotherapy: Associations With Depression Severity and Personality Functioning

2019 ◽  
pp. 1-20 ◽  
Author(s):  
Ulrike Dinger ◽  
Magdalena Fuchs ◽  
Johanna Köhling ◽  
Henning Schauenburg ◽  
Johannes C. Ehrenthal
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Emotional Experience ◽  
Negative Emotions ◽  
Borderline Personality ◽  
Depression Severity ◽  
Personality Functioning ◽  
Before And After ◽  
Patient Groups

This study examines emotional experience in major depressive disorder (MDD) with and without comorbid borderline personality disorder (BPD). It investigates if depression severity or personality functioning mediates group differences and which aspects of emotional experience change during psychotherapy. The emotional experience of MDD-BPD patients (n = 44) was compared to MDD-only patients (n = 35) before and after multimodal short-term psychotherapy. Emotions were classified based on valence and an active/passive polarity. MDD-BPD patients exhibited more active-negative emotions. This group difference was mediated by the level of personality functioning, but not by depression severity. Although passive-negative emotions decreased and positive emotions increased during therapy, there was no significant change in active-negative emotions. The two patient groups did not significantly differ in the change of emotional experience. Lower levels of personality functioning in depressed patients with BPD are associated with a broader spectrum of negative emotions, specifically more active-negative emotions.

Positive Emotion in Borderline Personality Disorder

2019 ◽  
pp. 332-352
Author(s):  
Jill M. Hooley ◽  
Sara R. Masland
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Negative Mood ◽  
Severe Form ◽  
Borderline Personality ◽  
Negative Emotionality ◽  
Personality Pathology ◽  
Emotional Experiences

Borderline personality disorder (BPD) is a severe form of personality pathology characterized by high levels of negative emotionality. Because negative emotions are so central to the clinical presentation of BPD, the issue of how people with this disorder process and experience positive emotional experiences is relatively unexplored. This chapter provides an overview of what is currently known about positive emotions and BPD. Although the literature is characterized by many inconsistencies, our review suggests that people with BPD do indeed experience positive emotions. However, their recall of positive emotional experiences appears to be reduced, perhaps because such experiences are more transient, less stable, and more likely to be quickly replaced by negative emotions. Problems with the identification and accurate differentiation of positive emotions may also play a role. Such difficulties may conspire to create a psychological world for people with BPD that is characterized by a focus on negative mood and negative emotional experiences. In addition to focusing on negative affect, we suggest that it might also be clinically beneficial to make problems with positive affect a specific clinical target.

scholarly journals Don't Make Me Angry: Frustration-Induced Anger and Its Link to Aggression in Women With Borderline Personality Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Katja Bertsch ◽  
Sarah Back ◽  
Aleya Flechsenhar ◽  
Corinne Neukel ◽  
Marlene Krauch ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Negative Emotion ◽  
Negative Emotions ◽  
Borderline Personality ◽  
Current Data ◽  
Healthy Women ◽  
Interpersonal Dysfunction ◽  
Before And After

Aggression is a prominent interpersonal dysfunction of individuals with borderline personality disorder (BPD). In BPD aggression is predominantly reactive in nature, often triggered by frustration, provocation, or social threat and is associated with intense anger and an inability to regulate this strong, negative emotion. Building on previous research, we were interested in investigating negative emotionality in general and anger in particular in women with BPD before and after frustration induction. To achieve this, 60 medication-free women with BPD and 32 healthy women rated the intensity of negative emotions (angry, frustrated, upset, embarrassed, nervous) before and after performing a Titrated Mirror Tracing Task, which reliably induces frustration and distress. As expected, women with BPD reported significantly greater intensity of negative emotions before and after frustration than healthy women. Specifically, they showed a significantly stronger frustration-induced increase in anger, while other negative emotions remained unaffected by frustration induction. This anger increase was significantly related to aggressive behavior reported in the 2 weeks prior to the experiment, as well as to the level of frustration experienced in the experiment itself, but not with emotion dysregulation. The current data confirm the important role of frustration-induced anger independent of emotion dysregulation in BPD, in particular with regard to aggression, a prominent interpersonal dysfunction of this disorder. These findings underline the importance of interventions with particular focus on anger.

scholarly journals Dyadic Emotion Regulation in Women with Borderline Personality Disorder

2021 ◽  
Author(s):  
Annemarie Miano ◽  
Sven Barnow ◽  
Stina Wagner ◽  
Stefan Roepke ◽  
Isabel Dziobek
Keyword(s):  
Emotion Regulation ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Male Partner ◽  
Borderline Personality ◽  
Self Report ◽  
Negative Behaviors ◽  
Support Seeking ◽  
Threatening Situation

Abstract Background Emotion regulation (ER) and interpersonal dysfunction constitute key features of borderline personality disorder (BPD). Here, we tested if females with BPD show impairments in dyadic ER, that is in their support seeking and creation of closeness. We investigated if women with BPD might over-rely on their male partner by excessive support seeking and establishing of closeness, during conversations with personally and relationship-threatening topics. Methods Thirty couples in which the women were diagnosed with BPD and 34 healthy control (HC) couples were videotaped while discussing neutral, personally threatening, and relationship-threatening topics. Support seeking was rated by three independent raters, using a naïve observer method. The creation of closeness was rated using a continuous video-rating. Perceived emotions were assessed using self-report after each conversation. Results Women with BPD engaged in more support seeking than HC women, especially in more negative behaviors to elicit support, they created less closeness to their partner than HCs and reported a greater decline of positive emotions in both threatening conditions. Women with BPD displayed more fluctuations than controls between creating closeness and distance in the personally-threatening situation. They reported a larger increase in negative emotions after the relationship threatening conversation compared to female HC. Conclusions The present study indicates an increased demand of dyadic ER in BPD. Increased negative support seeking and less creation of closeness to the partner might reflect ineffective strategies to actually receive support from the partner.

Economic Evaluation of a Mobile Diary App versus Paper-based Diary Cards for Patients with Borderline Personality Disorder (Preprint)

2021 ◽  
Author(s):  
Sidsel Lund Laursen ◽  
Astrid Langergaard ◽  
Jesper Søndergaard ◽  
Sabrina Storgaard Sørensen ◽  
Stig Helweg-Jørgensen ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Data Collection ◽  
Suicidal Behaviour ◽  
Borderline Personality ◽  
Healthcare Sector ◽  
Qaly Gain ◽  
Depression Severity ◽  
Advantages And Disadvantages ◽  
Psychiatric Outpatient

BACKGROUND The use of mobile diary applications (apps) in dialectical behaviour therapy (DBT) could entail several positive consequences, such as allowing therapists to follow their patients during treatment. OBJECTIVE The objective of this study was to examine the costs and consequences of using a mobile diary app compared to paper-based diary cards in DBT treatment for patients with borderline personality disorder (BPD) in a psychiatric outpatient facility to develop the current knowledge. METHODS The study was conducted alongside a pragmatic, multicentre randomized controlled trial. Participants were recruited at five Danish psychiatric outpatient facilities and were randomized to register emotions, urges, and skills use in a mobile diary app or on paper-based diary cards. Participants in both groups received DBT delivered by therapists. A cost-consequence analysis with a time horizon of 12 months was undertaken. Consequences included quality-adjusted life years (QALY), depression severity, borderline severity, suicidal behaviour, healthcare use, and treatment compliance. Moreover, advantages and disadvantages of using a mobile diary app were studied. All relevant costs were included. RESULTS In total, 78 participants were included in the analysis. Participants in both groups had a QALY gain, and a decrease in depression severity, borderline severity, and suicidal behaviour. Significant differences were found between the app group and the paper group for both QALY gain (adjusted difference -0.054, SE 0.03) and depression severity (adjusted difference -1.11, SE 1.57). The use of services in the healthcare sector was similar across both time points and groups (difference: psychiatric hospitalization <5 and <5, general practice -1.32, SE 3.68 and 2.02, SE 3.19). An insignificantly higher number of participants in the paper group dropped out before treatment start (P value .07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and registered an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. The mobile diary app was considered timesaving as it was expected to be 1 minute faster to complete. Advantages of the app were the opportunity to choose between different methods of registering; comparative ease of use; increased self-insight; and a new type of data collection. Disadvantages were a negative influence on the therapist-patient interaction; worries about performance goals; reduced flexibility in data collection; and implementation issues. The between-group difference in total costs ranged from £78.15-234.44 per participant during the 12-months. CONCLUSIONS A mobile diary app can potentially entail several positive consequences for patients suffering from BPD although at a higher cost than paper-based diary cards. A mobile diary app might contribute with new information on the patients, which is not available from the paper diary. Further research is encouraged, as this is still a new field. CLINICALTRIAL ClinicalTrials.gov NCT03191565 INTERNATIONAL REGISTERED REPORT RR2-

Staff attitudes towards patients with borderline personality disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1010-1010
Author(s):  
E. Bodner ◽  
S. Cohen-Fridel ◽  
I. Ianco
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental Health Professionals ◽  
Negative Emotions ◽  
Borderline Personality ◽  
List Type ◽  
Staff Attitudes ◽  
Community Settings ◽  
Common Diagnosis ◽  
Level Of Agreement

IntroductionBDP is a common diagnosis in hospitals and community settings, estimated at 20% and 11%, respectively. Nevertheless, the attitudes and skills of all mental health professionals regarding the treatment of these patients had hardly been studied.ObjectivesDevelop tools and use them to understand staff attitudes towards BDP patients.Aims(1)To develop two inventories for the measurement of cognitive and emotional attitudes towards borderline personality disorder (BPD) patients and their treatment;(2)To use these tools to understand and compare attitudes of psychiatrists, psychologists and nurses toward BPD patients.MethodTwo lists of items referring to cognitive and emotional attitudes towards BPD patients were formulated. Nurses, psychologists and psychiatrist (n = 57), working in public psychiatric institutions rated their level of agreement with each item. Both lists of attitudes yielded three factors (cognitive: required treatment, suicidal tendencies, and antagonistic judgment, and emotional: negative emotions, experienced difficulties in treatment, and empathy, respectively).ResultsPsychologists scored lower than psychiatrists and nurses on antagonistic judgments. Nurses scored lower than psychiatrists and psychologists on empathy. Regression stepwise analyses on the three emotional attitudes separately showed that suicidal tendencies of BPD patients mainly explained negative emotions and difficulties in treating these patients. All groups were interested in learning more about the treatment of these patients.ConclusionsSuicidal tendencies of BPD patients provoke antagonistic judgments among the three professions. Psychiatrists, psychologists and nurses hold distinctive cognitive and emotional attitudes towards these patients. Staff training programs regarding BDP patients should consider these differences and concerns.

scholarly journals Sleep recordings in individuals with borderline personality disorder before and after trauma therapy

2016 ◽  
Vol 124 (S1) ◽  
pp. 99-107 ◽  
Author(s):  
Sara Lena Weinhold ◽  
Robert Göder ◽  
Astrid Pabst ◽  
Anna-Lena Scharff ◽  
Maggie Schauer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Trauma Therapy ◽  
Before And After

scholarly journals Nonacceptance of negative emotions in women with borderline personality disorder: association with neuroactivity of the dorsal striatum

2019 ◽  
Vol 44 (5) ◽  
pp. 303-312 ◽  
Author(s):  
Agnes Lamers ◽  
Max Toepper ◽  
Silvia Carvalho Fernando ◽  
Nicole Schlosser ◽  
Eva Bauer ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Negative Emotions ◽  
Dorsal Striatum ◽  
Borderline Personality

scholarly journals Comparable emotional dynamics in women with ADHD and borderline personality disorder

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Talar R. Moukhtarian ◽  
Iris Reinhard ◽  
Paul Moran ◽  
Celine Ryckaert ◽  
Caroline Skirrow ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Negative Emotions ◽  
Multilevel Modelling ◽  
Borderline Personality ◽  
Emotional Dysregulation ◽  
Healthy Controls ◽  
Hyperactivity Disorder ◽  
Affective Symptoms ◽  
Comorbid Adhd

Abstract Background Emotional dysregulation (ED) is a core diagnostic symptom in borderline personality disorder (BPD) and an associated feature of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate differences in dynamical indices of ED in daily life in ADHD and BPD. Methods We used experience sampling method (ESM) and multilevel modelling to assess momentary changes in reports of affective symptoms, and retrospective questionnaire measures of ED in a sample of 98 adult females with ADHD, BPD, comorbid ADHD+BPD and healthy controls. Results We found marked differences between the clinical groups and healthy controls. However, the ESM assessments did not show differences in the intensity of feeling angry and irritable, and the instability of feeling sad, irritable and angry, findings paralleled by data from retrospective questionnaires. The heightened intensity in negative emotions in the clinical groups compared to controls was only partially explained by bad events at the time of reporting negative emotions, suggesting both reactive and endogenous influences on ED in both ADHD and BPD. Conclusions This study supports the view that ED is a valuable trans-diagnostic aspect of psychopathology in both ADHD and BPD, with similar levels of intensity and instability. These findings suggest that the presence or severity of ED should not be used in clinical practice to distinguish between the two disorders.

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