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Borderline personality disorder (BPD), a complex disorder linked to adverse behavioral outcomes and impaired functioning, is associated with difficulties in emotion regulation (ER)—including both ER abilities and use of ER strategies. BPD commonly co-occurs with other disorders that are themselves linked to emotion dysregulation. Thus, it is important to consider the potential role of these comorbidities when examining ER difficulties in BPD. The present study investigated relationships between ER abilities, ER strategies, and BPD, while considering key comorbidities, among a sample of participants: (a) diagnosed with BPD, (b) without BPD but matched to BPD group members on key classes of psychopathology (i.e., mood, anxiety, substance use, trauma-related, and other personality disorders; matched psychiatric control [MPC] group), or (c) free of assessed psychopathology (healthy control [HC] group). Results revealed few significant differences between the BPD and MPC groups, who both demonstrated greater impairments than the HC group across most ER abilities and strategies. Notable exceptions were greater impulse control difficulty (ability) and anger rumination (strategy) in the BPD relative to both other groups. Additionally, lower composite maladaptive ER strategies and higher composite adaptive strategies distinguished the HC from BPD group, with neither composite ER abilities nor strategies differentiating the MPC from BPD group, though this result is limited by statistical overlap between variables. By elucidating the potential role of psychiatric comorbidity in two key components of ER in BPD, this study contributes to a growing literature that may help inform therapeutic interventions targeting the severe emotional and behavioral dysregulation commonly seen in this complex disorder. / Psychology

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The World Health Organization has proposed for the ICD-11 a differentiation of symptoms to distinguish separate disorders of PTSD and complex PTSD (CPTSD), rather than one disorder of PTSD as in the current DSM-5. In addition, the accuracy and usefulness of the borderline personality disorder (BPD) diagnosis has been debated for years due to this history of trauma often associated with the diagnosis. New instruments have been developed to assess CPTSD, allowing needed research to expand our understanding of CPTSD and how it may differ from PTSD. The present study explored the relationships between the three different patterns of symptom expression associated with these disorders and various coping strategies in a sample of trauma survivors. A canonical correlation analysis (CCA) showed a significant relationship between trauma symptoms and coping strategies and suggested that individuals with higher borderline personality disorder symptoms, and subsequently complex PTSD and PTSD symptoms, were more likely to cope using avoidant coping strategies- behavioral disengagement, denial, and substance use. This finding was similar to previous research findings that suggested high rates of negative psychological outcomes for adults cognitive and behavioral avoidant coping strategies. Contributions from other coping techniques, such as restraint and venting, also showed significant, but not as strong relationships to higher psychological symptoms.

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Recent discussion of proposed changes to the 5th version of the Diagnostic and Statistical Manual of Mental Disorders highlighted the struggle to categorize and define the characteristics of persons who present with Borderline Personality Disorder (BPD). BPD has traditionally been defined as a personality disorder, assuming a distinct trajectory and prognosis that sets it apart from other mood disorder diagnoses. However, early discussion in the development of the DSM-V introduced the possibility of BPD as one of several disorders existing on a shared mood disorder or emotion-regulation disorder spectrum. The final, published DSM-V retained BPD as a personality disorder on a diagnostic spectrum apart from mood or emotion regulation disorders; however, does BPD represent a broader and persistent difficulty with emotion regulation, rather than a disorder of the personality? In the current study, 73 psychiatric inpatients in a state-operated forensic hospital and 428 undergraduate students from a local university were administered the Difficulties in Emotion Regulation Scale (DERS), as well as the BPD section of the Structured Interview for the Diagnosis of Personality Disorders, DSM-IV version (SIDP-IV). Total and subscale scores on the DERS were correlated with individual symptom ratings from the SIDP-IV Borderline. Results suggest many of the subscales representing different facets of emotion regulation evidenced low to moderate correlations with symptoms of BPD. The subscales of the DERS least associated with symptoms and diagnosis of BPD are those that emphasize cognitive regulation of emotional experiences. Thus, it is likely that BPD would fit well within a conceptualization of emotion regulation disorder. Results also suggest some differences between groups, where more overlap between constructs exist for college students rather than psychiatric inpatients, with the least associated constructs are those that emphasize both cognitive and behavioral components of emotional regulation.

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