Rejection Sensitivity and Borderline Personality Disorder Features: The Mediating Roles of Attachment Anxiety, Need to Belong, and Self-Criticism

Anxious-depressive attack and rejection sensitivity-Toward a new approach to treatment-resistant depression

This paper aimed to find clues to treatment-resistant depression (TRD) solutions. Depression comorbid with anxiety is often treatment-resistant where anxious-depressive attack (ADA) often lurks. ADA is a recently proposed clinical idea for just a psychological version of a panic attack. It mostly begins with an abrupt surge of intense anxiety followed by uninterrupted intrusive thoughts; lasting ruminations about regret or worry produced by violent anxiety, agitation, and loneliness. Acting-out behaviors such as deliberate self-injury and over-dose may also be observed during the attack. As the basic psychopathology of ADA, rejection sensitivity (RS) was revealed by a structural equation model. It is said that the presence of RS in depressive disorders implies a poor prognosis. The following biological markers for RS were reviewed in the literature: first, the involvement of the μ-opioid receptor function in RS and, secondly, hypersensitivity of the dopamine D4 receptor (DRD4) in the medial prefrontal cortex. The latter has been suggested in fear-conditioned animal experiments. Manipulation of the μ-opioid receptor function together with the DRD4 function may culminate in a treatment for RS, which could contribute to the development of a treatment for TRD via the improvement of ADA.

Effectiveness of compassion-focused therapy for self-criticism in patients with personality disorders: a multiple baseline case series study

OBJECTIVE

Targeting self-criticism, the tendency to negatively evaluate and judge aspects of oneself, may improve treatment efficacy for personality disorders (PDs). This study aimed to test whether adding 12-week group compassion-focused therapy (CFT) that explicitly targets self-criticism to treatment as usual (TAU) would reduce self-criticism in patients with PDs.

METHOD

Twelve patients with PDs participated in a multiple baseline study, randomly allocated to different baseline lengths. The primary outcome was twice-weekly assessed self-critical beliefs during baseline, treatment, and follow-up phases. Secondary outcomes were self-criticism, self-compassion, and PD severity at the end of CFT and follow-up (trial registered: NL8131). Nine participants completed the intervention. No significant changes were observed during CFT, but at follow-up significant decrease in self-critical beliefs (Cohen's d = -0.43; 95% CI = -0.73 to -0.12) was reported compared to baseline. On secondary outcomes, most participants showed reliable improvement on self-reported criticism (66.7%) and self-compassion (55.6%), and a minority of patients showed reliable improvement in PD severity (33.3%).

CONCLUSIONS

This study seems to provide preliminary evidence for the effectiveness of 12-week CFT for self-critical beliefs in patients with PDs compared to TAU. CFT for self-criticism in PDs may complement treatment offerings and warrant further research.

"I'm fighting with BPD instead of my partner": A dyadic interpretative phenomenological analysis of the lived experience of couples navigating borderline personality disorder

Borderline personality disorder (BPD) is associated with romantic relationship distress and dissolution. The complex interaction between BPD and romantic relationships warrants further attention. Dyadic interviews (N = 10) were conducted to examine the experience and impact of BPD on couples' relationships. The results of interpretative phenomenological analysis consisted of two superordinate themes describing the couple experience of navigating BPD: (a) the shared experience of BPD as a relational stressor; and (b) adaptive dyadic coping in the context of BPD. Although BPD was experienced as a relational stressor, dyadic coping and shared externalization of BPD emerged as central components to adaptive couple functioning. Most couples reported that therapy was a critical external resource in their journey toward adaptively functioning in the context of BPD, both intrapersonally and interpersonally. The lived experiences of these couples provides therapists with an increased understanding of the resources that support adaptive dyadic coping with BPD.

Mother phubbing and adolescents' problematic SNS use: the mediating role of perceived burdensomeness and the moderating role of need to belong

There is a rapidly growing academic interest on parental phubbing, however, little research has explored the association between mother phubbing and adolescent problematic social networking sites use (PSNSU), the underlying mediating and moderating effects in this relationship are also in need to be uncovered. The present study examined whether mother phubbing would be positively related to adolescent PSNSU, whether perceived burdensomeness would mediate this relationship, and whether need to belong would moderate the associations between mother phubbing and adolescent PSNSU. The hypothesized research model was examined among 3,915 Chinese adolescents (47% of them were boys, mean age = 16.42 ± 0.77 years). The results showed that mother phubbing was positively associated with adolescent PSNSU and perceived burdensomeness mediated this association. Furthermore, need to belong moderated the relationship between perceived burdensomeness and PSNSU, the relationship between mother phubbing and perceived burdensomeness, and the relationship between mother phubbing and PSNSU.

Interpersonal Complementarity and Affect in Daily Life

The current study examines the associations between interpersonal complementarity and affective reactions during social interactions in daily life, as well as contextual moderators of these associations. This research aims to understand how satisfaction/frustration of interpersonal motives (operationalized as interpersonal complementarity) impacts affect, using Contemporary Integrative Interpersonal Theory as a guiding framework. Participants (N = 227) rated actor and partner agency and communion in interpersonal interactions in 6 prompted surveys per day for 21 days. Results suggested that communal and agentic complementarity was associated with more positive affect valence, though this association was stronger for communal complementarity. Additionally, agentic complementarity impacted affect in cold interactions, while communal complementarity impacted affect in warm interactions, indicating that there are potentially more agentic motives driving cold interactions and communal motives driving warm interactions. An increase in communal complementarity was associated with an increase in affect arousal, while an increase in agentic complementarity was associated with a decrease in affect arousal, indicating affect arousal may communicate something other than satisfaction/frustration of motives. The moderating role of type of interaction partner was also explored. Overall, the results of this study support fundamental assumptions of Contemporary Integrative Interpersonal Theory.

Antecedents of problematic social media use and cyberbullying among adolescents: attachment, the dark triad and rejection sensitivity

With the acceleration of internet use, problematic social media use (PSMU) is included in our lives. When looking at the antecedents of PSMU, being young has been found to be a risk factor for PSMU. In addition to the benefits of technological advances in education and training, rapid technological developments may also result in problematic behaviors, especially among children and young. Recently, possibilities brought by technology and more widespread use of technology by young people have created a new concept, namely, cyberbullying. The present study aims to examine the effects of attachment anxiety and avoidance on PSMU and cyberbullying as with the partial mediating effects of the Dark Triad personality traits, angry rejection sensitivity, and anxious rejection sensitivity among adolescents. In general, the findings supported the proposed theoretical model. The results are discussed in terms of theoretical and practical implications along with suggestions for future research.

Understanding a Mutually Destructive Relationship Between Individuals With Borderline Personality Disorder and Their Favorite Person

OBJECTIVE

Individuals with borderline personality disorder (BPD) commonly have a favorite person (FP), whom they are heavily emotionally attached to and dependent on. This study aims to identify and illustrate the patterns of destructive FP relationships based on actual experiences described by those with BPD.

METHODS

A data mining process was conducted using raw data collected from online communities, such as blogs and social networks. An in-depth review of the information to better understand the natural course of the FP relationship was also conducted.

RESULTS

Individuals with BPD form an intense and insecure attachment toward their FP, from which they enormously suffer. FPs can be their friends, romantic or life partners, or family members. As their feelings go beyond their control, being increasingly obsessed with their FP, they make their FP gradually lose hope in continuing the relationship and want to quit trying to fulfill their needs. The relationship finally ends when the FP stops being responsible for meeting their expectations and eventually drifts away.

CONCLUSION

This study suggests that certain FPs, distinctively named Teddy Bear Person, may behave in a particular manner to increase the likelihood of the FP relationship becoming more destructive. Moreover, the rejection sensitivity model should be discussed to understand their dysfunctional interaction.

Borderline Personality Disorder Symptoms and Its Clinical Correlates among Chinese University Students: A Cross-Sectional Study

Borderline personality disorder (BPD) is common among young adults. Related studies showed a wide range of prevalence among university students. Few studies regarding BPD symptoms and their correlations with different variables have been reported in the Chinese population. A cross-sectional, online survey was conducted on a sample of university students in China between November 2021 and January 2022. Sociodemographic questionnaires, the Screening Instrument for Borderline Personality Disorder (SI-Bord), the 18-item Experience in Close Relationships-Revised (ECR-R-18), the Meaning In Life Questionnaire (MLQ), the 10-item Perceived Stress Scale (PSS-10), the Patient Health Questionnaire (PHQ-9), the Rosenberg Self-Esteem Scale (RSES) and the Resilience Inventory (RI-9) were completed. Data were analyzed using Pearson’s correlation methods. Among 767 participants, mean age was 20.33 ± 1.495 years, and the majority were males (53.5%). According to the SI-Bord’s cut-off score >7, BPD symptoms were found in 17.5% of participants. Attachment anxiety, avoidance, depression, perceived stress, lack of meaning in life, resilience and self-esteem were significantly correlated with BPD symptoms with r’s of 0.473, 0.180, 0.451, 0.481, −0.148, −0.238 and −0.388, respectively (all p’s < 0.01). The prevalence of BPD symptoms is high among Chinese university students and significantly associated with mental health outcomes, suggesting that an early detection of BPD symptoms is necessary for this population.

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.

'No Man is an Island': Effects of social seclusion on social dream content and REM sleep

Based on the Social Simulation Theory of dreaming (SST), we studied the effects of voluntary social seclusion on dream content and sleep structure. Specifically, we studied the Compensation Hypothesis, which predicts social dream contents to increase during social seclusion, the Sociality Bias - a ratio between dream and wake interactions - and the Strengthening Hypothesis, which predicts an increase in familiar dream characters during seclusion. Additionally, we assessed changes in the proportion of REM sleep. Sleep data and dream reports from 18 participants were collected preceding (n = 94), during (n = 90) and after (n = 119) a seclusion retreat. Data were analysed using linear mixed-effects models. We failed to support the Compensation Hypothesis, with dreams evidencing fewer social interactions during seclusion. The Strengthening Hypothesis was supported, with more familiar characters present in seclusion dreams. Dream social interactions maintained the Sociality Bias even under seclusion. Additionally, REM sleep increased during seclusion, coinciding with previous literature and tentatively supporting the proposed attachment function for social REM sleep.

Interpersonal Relatedness and Non-suicidal Self-Injurious Behaviors in Female Adolescents With Borderline Personality Disorder

Background: Psychopathological models of adolescent borderline personality disorder (BPD) suggest that non-suicidal self-injuring (NSSI)-a particularly frequent symptom in girls-may constitute a way of coping with distress resulting from interpersonal concerns they typically experience as a developmental psychopathological feature. Objectives: Our objective was to investigate the relationship in BPD female adolescents between NSSI and the Sidney Blatt two-polarities model of personality development, which focuses on the psychological processes of interpersonal relatedness and self-definition. Methods: The study was conducted within the European Research Network on Borderline Personality Disorder in Adolescence, using the Depressive Experience Questionnaire (DEQ). Results: BPD patients (n = 59; mean age = 16.6 ± 1.3) scored significantly higher than healthy controls on the two DEQ sub-factors assessing the more immature forms of Interpersonal Relatedness (Neediness) and Self-definition (Self-criticism) and significantly lower on the more mature form of Self-definition (Efficacy). BPD adolescents with NSSI showed significantly higher scores on both mature and immature forms of Interpersonal Relatedness (Neediness and Connectedness) compared to BPD adolescents without NSSI. A logistic regression analysis showed that the subfactor Neediness of the DEQ was the only significant predictor of the presence of NSSI among BPD adolescents. Conclusions: The preliminary results of this study suggests that NSSI in adolescents with BPD is developmentally linked to high developmental concerns in the domain of interpersonal relatedness, which may be taken into consideration in clinical practice. More studies are necessary to better understand the relationships between NSSI and developmental psychopathology in borderline adolescents.

High Rejection Sensitivity in Patients With Somatoform Pain Disorder

Objective: Rejection sensitivity (RS) is often associated with mental disorders but as yet has not been investigated in patients with somatoform pain disorder (SPD). The aim of the study was to explore the degree of RS in patients with SPD compared to healthy controls. In addition, we examined factors associated with RS and the moderator effect of SPD. Methods: A total of 65 patients with SPD (confirmed by Structured Clinical Interview, SCID-I) and 65 age- and gender-matched healthy controls participated. Rejection Sensitivity Questionnaire (RSQ), Patient Health Questionnaire (PHQ-9, PHQ-15), Relationship Scale (ReSQ), Essen Trauma Inventory (ETI) and the Childhood Trauma Questionnaire (CTQ) were applied. Multiple linear regression analysis was performed. Results: The level of RS was significantly higher in patients with SPD compared to healthy controls (M = 10.30, SD = 5.64; M = 6.13, SD = 2.50; p < 0.001; d = 0.95). Higher levels of depressive symptoms (p < 0.001), childhood adversities (p < 0.001) and the insecure attachment style (p = 0.007) were related to higher levels of RS. No significant moderation effect was detected. Conclusions: Patients with SPD are highly sensitive to social rejection. In addition, insecure attachment styles as well as depressive symptoms and childhood adversities are strongly associated with RS. Further studies are needed to figure out how RS is connected to SPD over lifetime.

Unextracted plasma oxytocin levels decrease following in-laboratory social exclusion in young adults with a suicide attempt history

Social exclusion is associated with greater suicide risk and more needs to be known about the biological processes contributing to this association. Oxytocin, a neuropeptide that regulates social interactions, may protect against the negative effects of exclusion by motivating social engagement. Oxytocin levels and desire for social engagement increase when non-psychiatric controls experience acute social exclusion. However, among individuals with borderline personality disorder and chronic depression, oxytocin levels decrease following exclusion. Both of these psychiatric illnesses are associated with high rates of suicidal behavior. No research has examined changes in oxytocin following social exclusion among individuals at risk for suicide. This quasi-experimental study examined differences in oxytocin levels and perceptions of social connectedness following an in-laboratory, acute social exclusion task among (a) individuals with no depression or suicide attempt histories, (b) individuals with current depression symptoms, and (c) individuals with current depression symptoms and suicide attempt histories. Young adults (N = 100) completed self-report measures and provided blood samples before and after an acute social exclusion task (Cyberball). Oxytocin was quantified via enzyme-linked immunosorbent assay. Mixed-design ANCOVAs were used to evaluate changes in unextracted and extracted oxytocin levels, desire for emotional support, thwarted belongingness, and perceived burdensomeness. Among suicide attempters, unextracted oxytocin levels decreased and desire for emotional support did not significantly change following exclusion. Among depressed and healthy controls, desire for emotional support increased and unextracted oxytocin levels did not significantly change. No significant changes in extracted oxytocin levels, thwarted belongingness and perceived burdensomeness emerged. Further research is needed to determine if dysregulated oxytocin-related processes biologically predispose individuals with suicide attempt histories to greater social disconnection and suicide risk.