Cognitive Reappraisal of Negative Emotional Images in Borderline Personality Disorder: Content Analysis, Perceived Effectiveness, and Diagnostic Specificity

Emotion regulation strategies among individuals with borderline personality disorder relative to other groups: A review

Borderline personality disorder (BPD) is associated with difficulties in emotion regulation (ER) abilities. Investigations of ER strategies in BPD have been less robust. This systematic review identified 55 studies comparing ER strategy use between individuals diagnosed with BPD versus psychiatric and non-psychiatric comparison groups. Individuals with BPD reported more frequent maladaptive and less frequent adaptive ER strategy use than non-psychiatric controls. Results were less consistent relative to psychiatric comparison groups, though individuals with BPD reported greater self-criticism and avoidance. Groups responded comparably to instructed use of adaptive (but not maladaptive) ER strategies. This body of research would benefit from further examination of the roles of psychiatric comorbidity and problematic behaviours in the relationship between BPD and ER strategies.

Attentional Tendencies That Impact Emotion Regulation Success Within a Borderline Personality Disorder Framework

Emotion regulation difficulties are key to borderline personality disorder (BPD) symptomatology. Literature indicates that attentional distraction, particularly within an interpersonal context, is common in BPD. Conversely, reappraisal tactics are less prevalent. The goal of the current study was to examine whether this discrepancy is observed when individuals reporting varying levels of BPD tendencies are given the choice of a preferred emotion regulation tactic when confronted with BPD-relevant stressors. Attentional engagement patterns, affective responses, and strategy success were also examined. Participants (N = 103) reported BPD tendencies as assessed by the Personality Assessment Inventory and were instructed to choose either to "distract" or to "reappraise" in response to affective images. Results revealed more instances of failing to implement distraction among individuals with higher BPD tendencies, which was also reflected in greater fixation biases to distressing content within those images. Results are discussed in terms of the malleability of emotion regulation in BPD contexts.

Acting against your own interests: The tension between emotion regulation preference and efficacy and its implications for individuals with depressive symptoms

The aim of this study was twofold: first, to compare individuals' strategy choices in low and high intensity conditions and the actual efficacy of these strategies; second, to assess whether and how perceived intensity levels of aversive situations moderate the relationship between depressive symptoms and a strategies' efficacy. In Experiment 1A (N = 58), we replicated previous results, showing that individuals prefer distraction in high- and reappraisal in low-intensity conditions, irrespective of depressive symptom levels. Experiment 1B (N = 50) assessed the efficacy of distraction and reappraisal strategies in aversive conditions with low and high intensity. Contrary to our prediction, reappraisal was more effective than distraction, independent of the intensity of the aversive conditions. In Experiment 2 (N = 113), we tested the interactive relationship between perceived intensity levels and depression on the relative effectiveness of reappraisal and distraction. We found that while in perceived low-intensity situations the advantage of distraction over reappraisal increased as depressive symptoms increased, no such relationship was found in high-intensity situations. The results suggest that while all individuals prefer to apply reappraisal in both low- and high-intensity conditions, for those with high level of depressive symptoms, such a preference acts against their own interests. The study highlights the need to distinguish between emotion regulation preferences and their actual efficacy, while illuminating possible implications for individuals with depressive symptoms.

Confirmatory factor analysis and psychometric properties of the Emotion Regulation Questionnaire in participants with personality disorders

Emotional dysregulation is a key symptom in participants with personality disorders. The Emotional Regulation Questionnaire (ERQ) has been studied with nonclinical samples; however, it is necessary to confirm the factorial structure of the ERQ in participants with personality disorders. The aims of the present study were to confirm the factorial structure of the Spanish version of the ERQ and analyse its psychometric properties as well as the association between the ERQ and the Borderline Symptoms List (BSL-23) and the Difficulties in Emotion Regulation Scale (DERS). The overall sample was composed of 250 patients with personality disorders, of whom 195 met the criteria for borderline personality disorder. Confirmatory factor analysis was conducted. The two-factor model showed an acceptable fit, similar to the original structure, in the participants with personality disorders and with borderline personality disorder. Cognitive reappraisal was negatively correlated with the DERS and BSL-23, and expressive suppression was positively correlated with the BSL-23. The ERQ is a reliable and valid instrument to evaluate emotional dysregulation in participants with personality disorders and participants with borderline personality disorder.

Clinical and Neurophysiological Correlates of Emotion and Food Craving Regulation in Patients with Anorexia Nervosa

Background: Difficulties in emotion regulation and craving regulation have been linked to eating symptomatology in patients with anorexia nervosa (AN), contributing to the maintenance of their eating disorder. Methods: To investigate clinical and electrophysiological correlates of these processes, 20 patients with AN and 20 healthy controls (HC) completed a computerized task during EEG recording, where they were instructed to down-regulate negative emotions or food craving. Participants also completed self-report measures of emotional regulation and food addiction. The P300 and Late Positive Potential (LPP) ERPs were analysed. Results: LPP amplitudes were significantly smaller during down-regulation of food craving among both groups. Independent of task condition, individuals with AN showed smaller P300 amplitudes compared to HC. Among HC, the self-reported use of re-appraisal strategies positively correlated with LPP amplitudes during emotional regulation task, while suppressive strategies negatively correlated with LPP amplitudes. The AN group, in comparison to the HC group, exhibited greater food addiction, greater use of maladaptive strategies, and emotional dysregulation. Conclusions: Despite the enhanced self-reported psychopathology among AN, both groups indicated neurophysiological evidence of food craving regulation as evidenced by blunted LPP amplitudes in the relevant task condition. Further research is required to delineate the mechanisms associated with reduced overall P300 amplitudes among individuals with AN.

Cognitive reappraisal during unpleasant picture processing: Subjective self-report and peripheral physiology

Increased attention among the research community in exploring underlying mechanisms of emotion regulation has prompted a growth of experimental works in this field. Empirical studies have mainly focused on self-reports, brain imaging, and electrophysiological measures, with only a few works exploring peripheral physiology. Additionally, most of such studies have not considered the specific stimuli content, even though prior literature has shown relevant differences in psychophysiological and subjective responses depending on picture categories. The current study assessed several peripheral correlates (startle amplitude, electrodermal changes, heart rate) of emotion regulation processes in a sample of 122 healthy participants. The task consisted of voluntary reappraisal of negative emotions prompted by unpleasant pictures (threat to others and victims), compared to a nonregulation control condition (looking at exemplars of the same categories and household objects). Results showed an effect of emotion regulation instructions in all psychophysiological and subjective measures. In peripheral physiology, greater responses were observed specifically when increasing negative emotions, concurring with previous research. Regarding specific content, our findings evidence a similar emotion regulation pattern, independently of the unpleasant category, suggesting a plausible effect of cognitive variables (such as cognitive effort) during voluntary reappraisal for both categories.