Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study
- 27 July 2020
- journal article
- research article
- Published by Cambridge University Press (CUP) in Psychological Medicine
- Vol. 52 (6), 1014-1021
- https://doi.org/10.1017/s003329172000255x
Abstract
BackgroundIndividuals diagnosed with borderline personality disorder (BPD) often describe their lives as stressful and unpredictable. However, it is unclear whether the adversity faced by those with BPD is a product of stress reactivity or stress generation. Here, we examined the dynamic, prospective associations between BPD and stressful life events over 3 years. Given the heterogeneity present in BPD, we sought to understand which empirically derived dimensions of this heterogeneous disorder explain stress reactivity v. stress generation.MethodsParticipants included 355 individuals diagnosed with BPD and followed longitudinally at three annual assessments. Auto-regressive cross-lagged panel models were used to examine prospective associations between stressful life events and three latent dimensions implicated in BPD: negative affect, disinhibition, and antagonism.ResultsAntagonism and disinhibition, but not negative affect, prospectively predicted dependent stressful life events (events the individual may have some role in). Evidence for decompensation under stress was more tenuous, with independent stressful life events (those presumably outside the individual's control) predicting increases in negative affect.ConclusionsOur longitudinal study of a well-characterized clinical sample found more evidence for stress generation than for stress-induced decompensation in BPD. Stress generation in BPD is driven by externalizing dimensions: antagonism and disinhibition. These results highlight the utility of empirically derived dimensions for parsing heterogeneity present in BPD, leading to improvements in diagnostic evaluation, clinical prediction, and individualized approaches to treatment planning.This publication has 40 references indexed in Scilit:
- Symptoms of borderline personality disorder predict interpersonal (but not independent) stressful life events in a community sample of older adults.Journal of Abnormal Psychology, 2013
- Clarifying Interpersonal Heterogeneity in Borderline Personality Disorder Using Latent Mixture ModelingJournal of Personality Disorders, 2013
- Dependent Stressful Life Events and Prior Depressive Episodes in the Prediction of Major DepressionArchives of General Psychiatry, 2010
- Factorial Invariance Within Longitudinal Structural Equation Models: Measuring the Same Construct Across TimeChild Development Perspectives, 2010
- A meta-analytic review of the relationships between the five-factor model and DSM-IV-TR personality disorders: A facet level analysisClinical Psychology Review, 2008
- A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorderPsychological Medicine, 2007
- Stressful life events as predictors of functioning: findings from the Collaborative Longitudinal Personality Disorders StudyActa Psychiatrica Scandinavica, 2004
- Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternativesStructural Equation Modeling: A Multidisciplinary Journal, 1999
- The Revised Diagnostic Interview for Borderlines: Discriminating BPD from other Axis II DisordersJournal of Personality Disorders, 1989
- A RATING SCALE FOR DEPRESSIONJournal of Neurology, Neurosurgery & Psychiatry, 1960