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Borderline personality disorder and emotion dysregulation

Published online by Cambridge University Press:  06 June 2019

Alexander L. Chapman
Alexander L. Chapman*
Affiliation:
Department of Psychology, Simon Fraser University, Vancouver, BC, Canada
*
Author for Correspondence: Alexander L. Chapman, Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC, CanadaV5A 1S6; E-mail: [email protected].
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Abstract

Borderline personality disorder (BPD) is a severe and complex disorder characterized by instability across many life domains, including interpersonal relations, behavior, and emotions. A core feature and contributor to BPD, emotion dysegulation (ED), consists of deficits in the ability to regulate emotions in a manner that allows the individual to pursue important goals or behave effectively in various contexts. Biosocial developmental models of BPD have emphasized a transaction of environmental conditions (e.g., invalidating environments and adverse childhood experiences) with key genetically linked vulnerabilities (e.g., impulsivity and emotional vulnerability) in the development of ED and BPD. Emerging evidence has begun to highlight the complex, heterotypic pathways to the development of BPD, with key heritable vulnerability factors possibly interacting with aspects of the rearing environment to produce worsening ED and an adolescent trajectory consisting of self-damaging behaviors and eventual BPD. Adults with BPD have shown evidence of a variety of cognitive, physiological, and behavioral characteristics of ED. As the precursors to the development of ED and BPD have become clearer, prevention and treatment efforts hold great promise for reducing the long-term suffering, functional impairment, and considerable societal costs associated with BPD.

Keywords

borderline personality disorderdevelopmentemotionemotion dysregulation
Type
Special Issue Articles
Information
Development and Psychopathology , Volume 31 , Special Issue 3: Emotion Dysregulation and Emerging Psychopathology , August 2019 , pp. 1143 - 1156
Copyright
Copyright © Cambridge University Press 2019 

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References

Abela, J. R. Z., Payne, A. V. L., & Moussaly, N. (2003) Cognitive vulnerability to depression in individuals with borderline personality disorder. Journal of Personality Disorders, 17, 319–329.Google Scholar
Ahmed, S. P., Bittencourt-Hewitt, A., & Sebastian, C. L. (2015) Neurocognitive bases of emotion regulation development in adolescence. Developmental Cognitive Neuroscience, 15, 11–25. doi:10.1016/j.dcn.2015.07.006Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
Amad, A., Ramoz, N., Thomas, P., Jardri, R., & Gorwood, P. (2014). Genetics of borderline personality disorder: Systematic review and proposal of an integrative model. Neuroscience & Biobehavioral Reviews, 40, 6–19.Google Scholar
Austin, M. A., Riniolo, T. C., & Porges, S. W. (2007). Borderline personality disorder and emotion regulation: Insights from the polyvagal theory. Brain and Cognition, 65, 69–76.Google Scholar
Baczkowski, B. M., van Zutphen, L., Siep, N., Jacob, G. A., Domes, G., Maier, S., … Arntz, A. (2017). Deficient amygdala–prefrontal intrinsic connectivity after effortful emotion regulation in borderline personality disorder. European Archives of Psychiatry and Clinical Neuroscience, 267, 551–565.Google Scholar
Baron, M., Gruen, R., Asnis, L., & Lord, S. (1985). Familial transmission of schizotypal and borderline personality disorders. American Journal of Psychiatry, 142, 927–934.Google Scholar
Bateman, A., & Fonagy, P. (2003). Health service utilization costs for borderline personality disorder patients treated with psychoanalytically oriented partial hospitalization versus general psychiatric care. American Journal of Psychiatry, 160, 169–171.Google Scholar
Bateman, A., & Fonagy, P. (2008). 8-year follow-up of patients treated for borderline personality disorder: Mentalization-based treatment versus treatment as usual. American Journal of Psychiatry, 165, 631–638.Google Scholar
Beauchaine, T. P. (2015). Future directions in emotion dysregulation and youth psychopathology. Journal of Clinical Child and Adolescent Psychology, 44, 875–896.Google Scholar
Beauchaine, T. P., Hinshaw, S. P., & Bridge, J. A. (2019). Nonsuicidal self-injury and suicidal behaviors in girls: The case for targeted prevention in preadolescence. Clinical Psychological Science. Advance online publication.Google Scholar
Beauchaine, T. P., Sauder, C. L., Derbidge, C. M., & Uyeji, L. L. (2019). Self-injuring adolescent girls exhibit insular cortex volumetric abnormalities that are similar to those observed in adults with borderline personality disorder. Development and Psychopathology. Advance online publication.Google Scholar
Beblo, T., Fernando, S., Kamper, P., Griepenstroh, J., Aschenbrenner, S., Pastuszak, A., … Driessen, M. (2013). Increased attempts to suppress negative and positive emotions in borderline personality disorder. Psychiatry Research, 210, 505–509. doi:10.1016/j.psychres.2013.06.036Google Scholar
Belsky, D. W., Caspi, A., Arseneault, L., Bleidorn, W., Fonagy, P., Goodman, M., … Moffitt, T. E. (2012). Etiological features of borderline personality related characteristics in a birth cohort of 12-year-old children. Development and Psychopathology, 24, 251–265.Google Scholar
Bevilacqua, L., & Goldman, D. (2013). Genetics of impulsive behaviour. Philosophical Transactions of the Royal Society B: Biological Sciences, 368.Google Scholar
Biskin, R. S. (2015). The lifetime course of borderline personality disorder. Canadian Journal of Psychiatry, 60, 303–308.Google Scholar
Black, D. W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, 226–239.Google Scholar
Blakemore, S.-J., & Robbins, T. W. (2012). Decision-making in the adolescent brain. Natural Neuroscience, 15, 1184–1191.Google Scholar
Bornovalova, M., Verhulst, B., Webber, T., McGue, M., Iacono, W. G., & Hicks, B. M. (2017). Genetic and environmental influences on the codevelopment among borderline personality disorder traits, major depression symptoms, and substance use disorder symptoms from adolescence to young adulthood. Development and Psychopathology, 30, 49–65.Google Scholar
Boucher, M., Pugliese, J., Allard-Chapais, C., Lecours, S., Ahoundova, A., Chouinard, R., & Gaham, S. (2017). Parent-child relationship associated with the development of borderline personality disorder: A systematic review. Personality and Mental Health, 11, 229–255.Google Scholar
Brown, M. Z., Comtois, K. A., & Linehan, M. M. (2002). Reasons for suicide attempts and non-suicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111, 198–202.Google Scholar
Brunner, R., Henze, R., Parzer, P., Kramer, J., Feigl, N., Lutz, K., & Stieltjes, B. (2010). Reduced prefrontal and orbitofrontal gray matter in female adolescents with borderline personality disorder: Is it disorder specific? NeuroImage, 49, 114–120.Google Scholar
Buckholdt, K. E., Parra, G. R., & Jobe-Shields, L. (2009). Emotion regulation as a mediator of the relation between emotion socialization and deliberate self-harm. American Journal of Orthopsychiatry, 79, 482–490.Google Scholar
Calkins, S. D., & Hill, A. (2007). Caregiver influences on emerging emotion regulation: Biological and environmental transactions in early development. In Gross, J. J. (Ed.), Handbook of emotion regulation (pp. 229–248). New York: Guilford Press.Google Scholar
Carpenter, R. W., & Trull, T. J. (2013). Components of emotion dysregulation in borderline personality disorder. Current Psychiatry Reports, 15, 335–342.Google Scholar
Casey, B. J., Jones, R. M., & Hare, T. A. (2008). The adolescent brain. Annals of the New York Academy of Science, 1124, 111–126.Google Scholar
Caspi, A., Henry, B., McGee, R. O., Moffitt, T. E., & Silva, P. A. (1995). Temperamental origin of child and adolescent behavior problems: From age three to age fifteen. Child Development, 66, 55–68.Google Scholar
Chapman, A. L., Dixon-Gordon, K. L., & Walters, K. N. (2013). Borderline personality features moderate emotional reactivity and emotion regulation in response to a laboratory stressor. Journal of Experimental Psychopathology, 4, 451–470.Google Scholar
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self- harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394.Google Scholar
Chapman, A. L., Hope, N., & Turner, B. J. (in press). Borderline personality disorder. In Lejuez, C. & Gratz, K. L. (Eds.), Handbook of personality disorders. New York: Cambridge University Press.Google Scholar
Chapman, A. L., Rosenthal, M. Z., Dixon-Gordon, K. L., Turner, B. J., & Kuppens, P. (2017). Borderline personality disorder and the effects of instructed emotional avoidance or acceptance in daily life. Journal of Personality Disorders, 31, 483–502.Google Scholar
Chapman, A. L., Specht, M. W., & Cellucci, T. (2005). Borderline personality disorder and deliberate self-harm: Does experiential avoidance play a role? Suicide and Life-Threatening Behavior, 35, 388–399.Google Scholar
Cicchetti, D. (2014). Illustrative developmental psychopathology perspectives on precursors and pathways to personality disorder: Commentary on the special issue. Journal of Personality Disorders, 28, 172–179.Google Scholar
Cloitre, M., Garvert, D. W., Weiss, B., Carlson, E. B., & Bryant, R. A. (2014). Distinguishing PTSD, complex PTSD, and borderline personality disorder: A latent class analysis. European Journal of Psychotraumatology, 5, 10.Google Scholar
Cohen, P., Crawford, T. N., Johnson, J. G., & Kasen, S. (2005). The children in the community study of developmental course of personality disorder. Journal of Personality Disorders, 19, 466–486.Google Scholar
Comtois, K. A., Elwood, L., Holdcraft, L. C., Smith, W. R., & Simpson, T. L. (2007). Effectiveness of dialectical behavior therapy in a community mental health center. Cognitive and Behavioral Practice, 14, 406–414.Google Scholar
Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological Bulletin, 135, 495–510.Google Scholar
Crowell, S. E., Kaufman, E. A., & Beauchaine, T .P. (2014). A biosocial model of BPD: Theory and empirical evidence. In Sharp, C. & Tackett, J. L. (Eds.), Handbook of borderline personality disorder in children and adolescents (pp. 143–157). New York: Springer.Google Scholar
Derbidge, C. M., & Beauchaine, T. P. (2014). A developmental model of self-inflicted injury, borderline personality, and suicide risk. In Lewis, M. & Rudolph, K. D. (Eds.), Handbook of developmental psychopathology (pp. 521–542). New York: Springer Science + Business Media.Google Scholar
Derks, Y., Westerhof, G., & Bohlmeijer, E. (2016). A meta-analysis on the association between emotional awareness and borderline personality pathology. Journal of Personality Disorders, 31, 1–23.Google Scholar
Diamond, A. (2018). Effects of early adverse experiences on the brain. Paper presented at Brain Talks. University of British Columbia, Vancouver, B.C., Canada.Google Scholar
Distel, M. A., Trull, T. J., Derom, C. A., Thiery, E. W., Grimmer, M. A., Martin, N. G., … Boomsma, D. I. (2008). Heritability of borderline personality disorder features is similar across three countries. Psychological Medicine, 38, 1219–1229.Google Scholar
Distel, M. A., Trull, T. J., Willemsen, G., Vink, J. M., Devon, C. A., Lynsey, N. G. M., & Boomsma, D. I. (2009). The five-factor model of personality and borderline personality disorder: A genetic analysis of comorbidity. Biological Psychiatry, 66, 1131–1138.Google Scholar
Dixon-Gordon, K. L., Haliczer, L. A., & Conkey, L. C. (in press). Emotion dysregulation and borderline personality disorder. In Beauchaine, T. P. & Crowell, S. E. (Eds.), The Oxford handbook of emotion dysregulation. Oxford: Oxford University Press.Google Scholar
Dixon-Gordon, K. L., Aldao, A., & De Los Reyes, A. (2015). Repertoires of emotion regulation: A person-centered approach to assessing emotion regulation strategies and links to psychopathology. Cognition and Emotion, 29, 1314–1325.Google Scholar
Dixon-Gordon, K. L., Chapman, A. L., Lovasz, N., & Walters, K. N. (2011). Too upset to think: The interplay of borderline personality features, negative emotions, and social problem solving in the laboratory. Personality Disorders: Theory, Research, and Treatment, 2, 243–260.Google Scholar
Dixon-Gordon, K. L., Hackel, L. M., Tull, M. T., & Gratz, K. L. (2018). The influence of emotional state on reinforcement learning in borderline personality disorder. Journal of Personality Disorders, 32, 433–446.Google Scholar
Donegan, N. H., Sanislow, C. A., Blumberg, H. P., Fullbright, R. K., Lacadie, C., Skudlarski, P., … Wexler, B. E. (2003). Amygdala hyperreactivity in borderline personality disorder: Implications for emotional dysregulation. Biological Psychiatry, 54, 116–123.Google Scholar
Ebner-Priemer, U. W., Badeck, S., Beckmann, C., Wagner, A., Feige, B., Weiss, I., … Bohus, M. (2005). Affective dysregulation and dissociative experience in female patients with borderline personality disorder: A startle response study. Journal of Psychiatric Research, 39, 85–92.Google Scholar
Eisenberg, N., Fabes, R. A., Shepard, S. A., Guthrie, I. K., Murphy, B. C., & Reiser, M. (1999). Parental reactions to children's negative emotions: Longitudinal relations to quality of children's social functioning. Child Development, 70, 513–534.Google Scholar
Fitzpatrick, S., & Kuo, J. R. (2015). A comprehensive examination of delayed emotional recovery in borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 47, 51–59.Google Scholar
Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 9, 1–9.Google Scholar
Fyer, M. R., Frances, A. J., Sullivan, T., Hurt, S. W., & Clarkin, J. (1988). Comorbidity of borderline personality disorder. Archives of General Psychiatry, 45, 348–352.Google Scholar
Glenn, C. R., & Klonsky, E. D. (2009). Emotion dysregulation as a core feature of borderline personality disorder. Journal of Personality Disorders, 23, 20–28.Google Scholar
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., … Ruan, W. J. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 533.Google Scholar
Gratz, K. L., & Roemer, L. (2004). Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, factor structure, and initial validation of the difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.Google Scholar
Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115, 850–855.Google Scholar
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271–299.Google Scholar
Gross, J. J. (2014). Emotion regulation: Conceptual and empirical foundations. In Gross, J. J. (Ed.), Handbook of emotion regulation (2nd ed.). New York: Guilford Press.Google Scholar
Guendelman, M. D., Owens, E. B., Galan, C., Gard, A., & Hinshaw, S. P. (2015). Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: Increased risk for internalizing symptoms and suicidality. Development and Psychopathology, 28, 1–14.Google Scholar
Gunderson, J. G. (2001). Borderline personality disorder: A clinical guide. Washington, DC: American Psychiatric Publishing.Google Scholar
Gunderson, J. G. (2007). Disturbed relationships as a phenotype for borderline personality disorder (commentary). American Journal of Psychiatry, 164, 1637–1640.Google Scholar
Hamza, C. A., Stewart, S. L., & Willoughby, T. (2012). Examining the link between nonsuicidal self-injury and suicidal behavior: A review of the literature and an integrated model. Clinical Psychology Review, 32, 482–495.Google Scholar
Hazlett, E. A., Zhang, J., New, A. S., Zelmanova, Y., Goldstein, K. E., Haznedar, M. M, … Chu, K. W. (2012). Potentiated amygdala response to repeated emotional pictures in borderline personality disorder. Biological Psychiatry, 72, 448–456.Google Scholar
Hecht, K. F., Cicchetti, D., Rogosch, F. A., & Crick, N. R. (2014). Borderline personality features in childhood: The role of subtype, developmental timing, and chronicity of child maltreatment. Development and Psychopathology, 26, 805–815.Google Scholar
Homan, K. J., Sim, L. A., Fargo, J. D., & Twohig, M .P. (2017). Five-year prospective investigation of self-harm/ suicide-related behaviors in the development of borderline personality disorder. Personality Disorders, 8, 183–188.Google Scholar
Hope, N. H., & Chapman, A. L. (in press). Difficulties regulating emotions mediates the associations of parental psychological control and emotion invalidation with borderline personality features. Personality Disorders: Theory, Research, and Treatment. Advance online publication.Google Scholar
Joiner, T. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.Google Scholar
Johnston, J. A. Y., Wang, F., Liu, J., Blond, B. N., & Wallace, A., Liu, J., … Blumberg, H. P. (2017). Multimodal neuroimaging of frontolimbic structure and function associated with suicide attempts in adolescents and young adults with bipolar disorder. American Journal of Psychiatry, 174, 667–675.Google Scholar
Jørgensen, C. R., Kjølbye, M., Freund, C., Bøye, R., Jordet, H., & Andersen, D. (2009). Level of functioning in patients with borderline personality disorder. The Risskov-I study. Nordic Psychology, 61, 42–60.Google Scholar
Kaiser, D., Jacob, G. A., Domes, G., & Arntz, A. (2017). Attentional bias for emotional stimuli in borderline personality disorder: A meta-analysis. Psychopathology, 49, 383–396.Google Scholar
Kaufman, E., Puzia, M. F., Mead, H. K., Crowell, S. E., & Beauchaine, T. P. (2017). Children's emotion regulation difficulties mediate the association between maternal borderline and antisocial symptoms and youth behavior problems over one year. Journal of Personality Disorders, 31, 170–192.Google Scholar
Kleindienst, N., Bohus, M., Ludaescher, P., Limberger, M. F., Kuenkele, K., Ebner-Priemer, U., … Schmahl, C. (2008). Motives for non-suicidal self-injury among women with borderline personality disorder. Journal of Nervous and Mental Disease, 196, 230–236.Google Scholar
Klonsky, E. D., & May, A. M. (2015). The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. International Journal of Cognitive Therapy, 8, 114–129.Google Scholar
Koenigsberg, H. W., Fan, J., Ochsner, K., Liu, X., Guise, K. G., Pizzarello, S., … Siever, L. J. (2010). Neural correlates of the use of psychological distancing to regulate responses to negative social cues: A study of patients with borderline personality disorder. Biological Psychiatry, 66, 854–877.Google Scholar
Koons, C. R., Chapman, A. L., Betts, B. B., O'Rourke, B., Morse, N., & Robins, C. J. (2006). Dialectical behavior therapy adapted for the vocational rehabilitation of significantly disabled mentally ill adults. Cognitive and Behavioral Practice, 13, 146–156.Google Scholar
Lancefield, K. S., Raudino, A., Downs, J. M., & Laurens, K. R. (2016). Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: A prospective population-based cohort study. Development and Psychopathology, 28, 527–536.Google Scholar
Lang, S., Katchoubey, B., Frick, C., Spitzer, C., Grabe, H. J., & Barnow, S. (2012). Cognitive reappraisal in trauma-exposed women with borderline personality disorder. Neuroimage, 59, 1727–1734.Google Scholar
Lazarus, R. S. (1991). Emotion and adaptation. Oxford: Oxford University Press.Google Scholar
Leible, T., & Snell, W. (2004). Borderline personality disorder and multiple aspects of emotional intelligence. Personality and Individual Differences, 37, 393–404.Google Scholar
Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV personality disorders in the National Comorbidity Survey replication. Biological Psychiatry, 62, 553–564.Google Scholar
Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. Lancet, 364, 453–461.Google Scholar
Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words: Affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18, 421–428.Google Scholar
Linehan, M. (1993a). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
Linehan, M. (1993b). Skills training manual for treating borderline personality disorder. New York: Guilford Press.Google Scholar
Linehan, M. M., Bohus, M., & Lynch, T. R. (2007). Dialectical behavior therapy for pervasive emotion dysregulation. In Gross, J. (Ed.), Handbook of emotion regulation (pp. 581–605). New York: The Guilford Press.Google Scholar
Linehan, M. (2015). DBT skills training manual. New York: Guilford Press.Google Scholar
Linehan, M. M., & Heard, H. L. (1999). Borderline personality disorder: Costs, course, and treatment outcomes. In Miller, N. & Magruder, K. (Eds.), The cost-effectiveness of psychotherapy: A guide for practitioners, researchers and policy makers (pp. 291–305). New York: Oxford University Press.Google Scholar
Links, P. S., Heslegrave, R., & van Reekum, R. (1999). Impulsivity: Core aspect of borderline personality disorder. Journal of Personality Disorders, 12, 1–9.Google Scholar
Links, P. S., Steiner, M., & Huxley, G. (1988). The occurrence of borderline personality disorder in the families of borderline patients. Journal of Personality Disorders, 2, 14.Google Scholar
Liston, C., McEwen, B. S., & Casey, B. J. (2009). Psychosocial stress reversibly disrupts prefrontal processing and attentional control. Proceedings of the National Academy of Sciences of the USA, 106, 912–917.Google Scholar
Mauss, I. B., Levinson, R. W., McCarter, L., Wilhelm, F. H., & Gross, J. J. (2005). The tie that binds? Coherence among emotional experience, behavior, and physiology. Emotion, 5, 175–190.Google Scholar
May, A. M., & Victor, S. E. (2018). From ideation to action: Recent advances in understanding suicide capability. Current Opinion in Psychology, 22, 1–6.Google Scholar
McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., … Linehan, M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry, 75, 777–785.Google Scholar
McCloskey, M. S., New, A. S., Siever, L. J., Goodman, M., Koenigsberg, H. W., Flory, J. D., & Coccaro, E. F. (2009). Evaluation of behavioral impulsivity and aggression tasks as endophenotypes for borderline personality disorder. Journal of Psychiatric Research, 43, 1036–1048.Google Scholar
Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., … Sund, A. M. (2014). Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: A randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 1082–1091.Google Scholar
Miller, A. B., & Prinstein, M. J. (2019). Adolescent suicide as a failure of acute stress-response systems. Annual Review of Clinical Psychology, 5, 21–26.Google Scholar
Musser, N., Zalewski, M., Stepp, S., & Lewis, J. (2018). A systematic review of negative parenting practices predicting borderline personality disorder: Are we measuring biosocial theory's “invalidating environment”? Clinical Psychology Review, 65, 1–16.Google Scholar
Niedtfeld, I., Kirsch, P., Schulze, L., Herpertz, S. C., Bohus, M., & Schmahl, C. (2012). Functional connectivity of pain-medicated affect regulation in borderline personality disorder. PLOS ONE, 7, 1–9.Google Scholar
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self- mutilative behavior. Journal of Consulting and Clinical Psychology, 72, 885–890.Google Scholar
Paris, J., & Zweig-Frank, H. (2001). A 27-year follow-up of patients with borderline personality disorder. Comprehensive Psychiatry, 42, 482–487.Google Scholar
Paris, J., Zweig-Frank, H., & Guzder, J. (1994). Psychological risk factors for borderline personality disorder in female patients. Comprehensive Psychiatry, 35, 301–305.Google Scholar
Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective on antisocial behavior. American Psychologist, 44, 329–335.Google Scholar
Patterson, C. M., & Newman, J. P. (1993). Reflectivity and learning from aversive events: Toward a psychological mechanism for syndromes of disinhibition. Psychological Review, 100, 716–736.Google Scholar
Perepletchikova, F., Nathanson, D., Aexlrod, S. R., Merrill, C., Walker, A., Grossman, M., … Walkup, J. (2017). Randomized clinical trial of dialectical behavior therapy for preadolescent children with disruptive mood dysregulation disorder: Feasibility and outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 56, 832–840.Google Scholar
Porges, S. W. (2001). The polyvagal theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123–146.Google Scholar
Power, R. A., & Pluess, M. (2015). Heritability estimates of the Big Five personality traits based on common genetic variants. Translational Psychiatry, 5. doi:10.1038/tp.2015.96Google Scholar
Reichborn-Kjennerud, T., Ystrom, E., Neale, M. C., Aggen, S. H., Mazzeo, S. E., Knudsen, G. P., … Kendler, K. S. (2013). Structure of genetic and environmental risk factors for symptoms of DSM-IV borderline personality disorder. JAMA Psychiatry, 70, 1206–1214.Google Scholar
Reitz, S., Kluetsch, R., Niedtfeld, I., Knorz, T., Lis, S., Paret, C., … Schmahl, C. (2015). Incision and stress regulation in borderline personality disorder: Neurobiological mechanisms of self-injurious behaviour. British Journal of Psychiatry, 207, 165–172.Google Scholar
Rosenthal, M. Z., Gratz, K. L., Kosson, D. S., Cheavens, J. S., Lejuez, C. W., & Lynch, T. R. (2008). Borderline personality disorder and emotional responding: A review of the research literature. Clinical Psychology Review, 28, 75–91.Google Scholar
Roth, R. H., Tam, S.-Y., Ida, Y., Yang, J.-X., & Deutch, A. Y. (1988) Stress and the mesocorticolimbic dopamine systems. Annals of the New York Academy of Science, 537, 138–147.Google Scholar
Ruocco, A. (2005). The neuropsychology of borderline personality disorder: A meta-analysis and review. Psychiatry Research, 137, 191–202.Google Scholar
Ruocco, A. S., Amirthavasagan, S., Choi-Kain, L. W., & McMain, S. F. (2013). Neural correlates of negative emotionality in borderline personality disorder: An activation-likelihood-estimation meta-analysis. Biological Psychiatry, 73, 153–160.Google Scholar
Salsman, N. L., & Linehan, M. M. (2012). An investigation of the relationships among negative affect, difficulties in emotion regulation, and features of borderline personality disorder. Journal of Psychopathology and Behavioral Assessment, 34, 260–267.Google Scholar
Sanchez, M. M., Young, L. J., Plotsky, P. M., & Insel, T. R. (2000). Distribution of corticosteroid receptors in the rhesus brain: Relative absence of glucocorticoid receptors in the hippocampal formation. Journal of Neuroscience, 20, 4657–4668.Google Scholar
Sauer, C., Sheppes, G., Lackner, H. K., Arens, E. A., Tarrasch, R., & Barnow, S. (2016). Emotion regulation choice in female patients with borderline personality disorder: Findings from self-reports and experimental measures. Psychiatry Research, 242, 375–384.Google Scholar
Scherer, K. R., Schorr, A., & Johstone, T. (2001). Appraisal processes in emotion: Theory, methods, research. New York: Oxford University Press.Google Scholar
Schulze, L., Schmahl, C., & Niedtfeld, I. (2016). Neural correlates of disturbed emotion processing in borderline personality disorder: A multimodal meta-analysis. Biological Psychiatry, 79, 97–106.Google Scholar
Selby, E. A., & Joiner, T. E. (2009). Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology, 13, 219–229.Google Scholar
Shaw, P., Kabani, N. J., Lerch, J. P., Eckstrand, K., Lenroot, R., Gogtay, N., …Wise, S. P. (2008). Neurodevelopmental trajectories of the human cerebral cortex. Journal of Neuroscience, 28, 3586–3594.Google Scholar
Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual Review of Clinical Psychology, 11, 379–405.Google Scholar
Skodol, A. E., Siever, L. J., Livesley, W. J., Gunderson, J. G., Pfohl, B., & Widiger, T. A. (2002). The borderline diagnosis: II. Biology, genetics and clinical course. Society of Biological Psychiatry, 51, 951–963.Google Scholar
Smith, J. M., Grandin, L. D., Alloy, L. B., & Abramson, L. Y. (2006) Cognitive vulnerability to depression and axis II personality dysfunction. Cognitive Therapy and Research, 30, 609–621.Google Scholar
Soloff, P. H., & Chiappetta, L. (2017). Suicidal behavior and psychosocial outcome in borderline personality disorder at 8-year follow-up. Journal of Personality Disorders, 31, 774–789.Google Scholar
Somerville, L. H. (2013). The teenage brain sensitivity to social evaluation. Current Directions in Psychological Science, 22, 121–127.Google Scholar
Stepp, S. D., Burke, J. D., Hipwell, A. E., & Loeber, R. (2012). Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. Journal of Abnormal Child Psychology, 40, 7–20.Google Scholar
Suvak, M. K., Litz, B. T., Sloan, D. M., Zanarini, M. C., Barrett, L. F., & Hofmann, S. G. (2011). Journal of Abnormal Psychology, 120, 414–426.Google Scholar
Swanson, E. N., Owens, E. B., & Hinshaw, S. P. (2014). Pathways to self-harmful behaviors in young women with and without ADHD: A longitudinal examination of mediating factors. Journal of Child Psychology and Psychiatry, 55, 505–515.Google Scholar
Takahashi, T., Chanen, A. M., Wood, S. J., Yücel, M., Tanino, R., Suzuki, M., … McGorry, P. D. (2009). Insular cortex volume and impulsivity in teenagers with first-presentation borderline personality disorder. Progress in Neuropsychopharmacology and Biological Psychiatry, 33, 1395–1400.Google Scholar
Taylor, S. E., Eisenberger, N. I., Saxbe, D., Lehman, B. J., & Lieberman, M. D. (2006). Neural responses to emotional stimuli are associated with childhood family stress. Biological Psychiatry, 60, 296–301.Google Scholar
Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. Monographs of the Society for Research in Child Development, 59, 25–52.Google Scholar
Torgersen, S., Lygren, S., Oien, P. A., Skyre, I., Onstad, S., Edvardsen, J., … Kringlen, E. (2000). A twin study of personality disorders. Comprehensive Psychiatry, 41, 416–425.Google Scholar
Trippany, R. L., Helm, H. M., & Simpson, L. (2006). Trauma reenactment: Rethinking borderline personality disorder when diagnosing sexual abuse survivors. Journal of Mental Health Counseling, 28, 95–110.Google Scholar
Unoka, Z., & Richman, J. M. (2016). Neuropsychological deficits in BPD patients and the moderator effects of co-occurring mental disorders: A meta-analysis. Clinical Psychology Review, 44, 1–12.Google Scholar
van der Kolk, B. A., Pelcovitz, D., Roth, S., & Mandel, F. S. (1996). Dissociation, somatization, and affect dysregulation: The complexity of adaption to trauma. American Journal of Psychiatry, 153, 83–93.Google Scholar
Vukasović, T., & Bratko, D. (2015). Heritability of personality: A meta-analysis of behavior genetic studies. Psychological Bulletin, 141, 769–785.Google Scholar
Weinberg, A., Klonsky, E. D., & Hajcak, G. (2009). Autonomic impairment in borderline personality disorder: A laboratory investigation. Brain and Cognition, 71, 279–286.Google Scholar
Westen, D., Ludolph, P., Misle, B., Ruffins, S., & Block, J. (1990). Physical and sexual abuse in adolescent girls with borderline personality disorder. American Journal of Orthopsychiatry, 60, 55–66.Google Scholar
Willoughby, T., Heffer, T., & Hamza, C. A. (2015). The Link between nonsuicidal self-injury and acquired capability for suicide: A longitudinal study. Journal of Abnormal Psychology, 124, 1110–1115.Google Scholar
Winograd, G., Cohen, P., & Chen, H. (2008). Adolescent borderline symptoms in the community: Prognosis for functioning over 20 years. Journal of Child Psychology & Psychiatry, 49, 933–941.Google Scholar
Witte, T. K., Gordon, K. H., Smith, P. N., & Van Orden, K. A. (2012). Stoicism and sensation seeking: Male vulnerabilities for the acquired capability for suicide. Journal of Research in Personality, 46, 384–392.Google Scholar
Wolff, S., Stiglmayr, C., Bretz, H. J., Lammers, C. H., & Auckenthaler, A. (2007). Emotion identification and tension in female patients with borderline personality disorder. British Journal of Clinical Psychology, 46, 347–360.Google Scholar
World Health Organization. (2016). ICD-10: International statistical classification of diseases and related health problems (2016 Version, 2nd ed.). Geneva: Author.Google Scholar
Yen, S., Shea, M. T., Battle, C. L., Johnson, D. M., Zlotnick, C., Dolan-Sewell, R., … Zanarini, M. C. (2002). Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: Findings from the collaborative longitudinal personality disorders study. Journal of Nervous and Mental Disease, 190, 510–518.Google Scholar
Zanarini, M. C., Frankenberg, F. R., Duo, E. D., Sickel, A. E., Trisha, A., Levin, A., & Reynolds, V. (1998). Axis I comorbidity of borderline personality disorder. American Journal of Psychiatry, 155, 1733–1739.Google Scholar
Zanarini, M., Frankenburg, F. R., Hennen, J., Reich, D. B., & Silk, K. R. (2004). Axis I comorbidity in patients with borderline personality disorder: 6-year follow-up and prediction of time to remission. American Journal of Psychiatry, 16, 2108–2114.Google Scholar
Zanarini, M. C., Frankenburg, F. R., Hennen, J., & Silk, K. R. (2003). The longitudinal course of borderline psychopathology: Six-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry, 160, 274–283.Google Scholar
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and Axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169, 476–483.Google Scholar
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Silk, K. R., Hudson, J. I., & McSweeney, L. B. (2007). The subsyndromal phenomenology of borderline personality disorder: A 10-year follow-up study. American Journal of Psychiatry, 164, 929–935.Google Scholar
Zanarini, M. C., Gunderson, J. G., Marino, M. F., Schwartz, E. O., & Frankenburg, F. R. (1988). DSM-III disorders in the families of borderline outpatients. Journal of Personality Disorders, 2, 292.Google Scholar
Zanarini, M. C., Jacoby, R. J., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2009). The 10-year course of social security disability income reported by patients with borderline personality disorder and axis II comparison subjects. Journal of Personality Disorders, 23, 346.Google Scholar
Zanarini, M. C., Williams, A. A., Lewis, R. E., Reich, R. B., Vera, S. C., Marino, M. F., … Frankenburg, F. R. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154, 1101–1106.Google Scholar
Zanarini, M. C., Yong, L., Frankenburg, F. R., Hennen, J., Reich, D. B., Marino, M. F., & Vujanovic, A. A. (2002). Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients. Journal of Nervous and Mental Disease, 190, 381–387.Google Scholar