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Borderline Personality Disorder and Emotion Dysregulation

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This video answers the question: Can I explain the relationship between negative and positive emotions and borderline personality disorder? First, let's take a look at the borderline personality disorder. It is a Cluster B personality disorder in the Diagnostic and Statistical Manual (DSM). This emotional, erratic, and dramatic cluster. It's in the same cluster as narcissistic, antisocial, and histrionic personality disorders. There are nine symptom criteria listed in the DSM for borderline personality disorder: frantic efforts to avoid abandonment, unstable pattern of relationships, identity disturbance, impulsivity in at least two areas where there's self damage, suicidal behavior, affective instability, chronic feelings of emptiness, inappropriate, intense anger or difficulty controlling anger, and paranoid ideation or dissociation. It's not surprising when looking at the definition of borderline personality disorder that there's some relationship to emotional reactivity. We know from prior research that there are a number of theories about how emotional regulation relates to borderline personality disorder. Under one theory, we see that borderline personality disorder is really a dysfunction of both positive and negative emotions and with this theory we would see a dampened emotional response to both positive and negative stimuli. Another similar theory is that both positive and negative emotions are involved, but it's mostly an expression of negative emotions and there's high variability with positive emotions, so on the positive emotion side we see large swings, but we see consistently negative emotions. A third theory is that borderline personality disorder is mostly a disorder involving negative emotions and it's really not any different in terms of positive emotions. We also see in studies of borderline personality disorder relating to the accuracy of recognizing facial expressions with individuals of borderline personality disorder, they tend to have low accuracy when looking at negative facial expressions and their accuracy is in the normal range for positive facial expressions. They tend to have higher emotional reactivity in response to negative emotions and the emotional reactivity isn't really any different for positive emotions. The results of the particular study reviewed here indicated that there was a strong association between borderline personality disorder symptoms and negative emotions, but only small deficits in positive emotions were observed. These findings were consistent across borderline personality disorder symptoms when looking at frequency, duration, and severity.
Chu C, Victor SE, Klonsky ED. Characterizing positive and negative emotional experiences in young adults with borderline personality disorder symptoms. Journal of Clinical Psychology. 2016;72(9):956-965. doi:10.1002/jclp.22299.

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