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Momentary interpersonal processes of suicidal surges in borderline personality disorder

Published online by Cambridge University Press:  10 December 2020

Aleksandra Kaurin Open the ORCID record for Aleksandra Kaurin [Opens in a new window] ,
Alexandre Y. Dombrovski ,
Michael N. Hallquist  and
Aidan G. C. Wright Open the ORCID record for Aidan G. C. Wright [Opens in a new window]
Aleksandra Kaurin*
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Alexandre Y. Dombrovski
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Michael N. Hallquist
Affiliation:
Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA
Aidan G. C. Wright
Affiliation:
Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
*
Author for correspondence: Aleksandra Kaurin, E-mail: [email protected]
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Abstract

Background

Suicide rates are high in borderline personality disorder (BPD) where interpersonal problems trigger intense affective dysregulation and impulses to act on suicidal thoughts. To date, however, no study has examined how interpersonal stressors contribute to momentary within-person links among affect and impulsivity with suicidal ideation (SI), and how those links vary over time in people's daily lives.

Methods

A total of 153 individuals diagnosed with BPD and 52 healthy controls completed a 21-day ecological momentary assessment protocol. Of these 153 individuals with BPD, 105 had a history of suicide attempts. Multilevel structural equation modeling was used to examine dynamic links among interpersonal perceptions, affect, state impulsivity, and suicidal intent.

Results

Aggregated across interactions, lower perceived warmth in others was associated with SI. This direct relationship, however, did not extend to momentary within-person associations. Instead, interpersonal conflicts were linked to SI indirectly via greater negative affect and lower positive affect. While a robust within-person link between interpersonal perceptions and impulsivity emerged, impulsivity did not account for the relationship between interpersonal perceptions and SI.

Conclusion

This intensive longitudinal study illustrates momentary interpersonal signatures of an emerging suicidal crisis. Among people with BPD at high risk for suicide, interpersonal triggers initiate a cascade of affective dysregulation, which in turn gives rise to SI.

Keywords

Affective dysregulationborderline personality disorderecological momentary assessmentimpulsivitymultilevel structural equation modellingsuicidal ideation
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 13 , October 2022 , pp. 2702 - 2712
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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