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Affect Regulation in Borderline Personality Disorder

Conklin, Carolyn Zittel PhD*; Bradley, Rebekah PhD†‡; Westen, Drew PhD†‡§

The Journal of Nervous and Mental Disease: February 2006 - Volume 194 - Issue 2 - p 69-77
doi: 10.1097/01.nmd.0000198138.41709.4f
Original Articles

Although difficulty with affect regulation is generally considered a core component of borderline personality disorder (BPD), surprisingly little research has focused on the nature of affect regulation and dysregulation in BPD. A random national sample of 117 experienced clinicians provided data on a randomly selected patient with BPD (N = 90) or dysthymic disorder (DD; N = 27). Clinicians described their patients using the Affect Regulation and Experience Q-sort-Questionnaire Version, a psychometric instrument designed for expert informants to assess affect and affect regulation. BPD and DD patients appear to differ in both the emotions they experience and the ways they regulate or fail to regulate them. Whereas DD patients are characterized by negative affect, BPD patients are characterized by both negative affect and affect dysregulation, which appear to be distinct constructs. BPD patients also show distinct patterns of affect regulation, and subtypes of BPD patients show distinct affect regulation profiles of potential relevance to treatment.

*Cambridge Hospital/Harvard Medical School, Cambridge, Massachusetts; and Departments of †Psychiatry, ‡Behavioral Sciences, and §Psychology, Emory University, Atlanta, Georgia.

Supported in part by NIMH MH59685 and MH60892 to the second author, NIMH MH62377 and MH62378 to the third author, and a grant from the Fund for Psychoanalytic Research of the American Psychoanalytic Association to the first author.

Portions of the present findings were presented as an invited paper given by the first author at the 2nd Annual Meeting of the National Institute of Mental Health and Borderline Personality Disorder Research Foundation, entitled “New Directions in Borderline Personality Disorder Research II,” in Minneapolis in May 2002.

Send reprint requests to Dr. Carolyn Zittel Conklin, Cambridge Hospital, Macht Building, 1493 Cambridge St., Cambridge, MA 02139; or Dr. Drew Westen, Departments of Psychology and Psychiatry and Behavioral Sciences, Emory University, 532 North Kilgo Circle, Atlanta, GA 30322.

© 2006 Lippincott Williams & Wilkins, Inc.