scholarly journals Within- and Between-Persons Effects of Self-Esteem and Affective State as Antecedents and Consequences of Dysfunctional Behaviors in the Everyday Lives of Patients With Borderline Personality Disorder

2020 ◽  
Vol 8 (3) ◽  
pp. 428-449 ◽  
Author(s):  
Philip S. Santangelo ◽  
Jana Holtmann ◽  
Georg Hosoya ◽  
Martin Bohus ◽  
Tobias D. Kockler ◽  
...  

Dysfunctional behaviors are conceptualized as maladaptive affective coping attempts in borderline personality disorder (BPD). The recent benefits-and-barriers model extended the affective function assumption by adding self-esteem as a barrier to engaging in dysfunctional behaviors. Patients with BPD ( N = 119) carried e-diaries to report their current self-esteem, emotional valence, tense arousal, and whether they engaged in dysfunctional behaviors 12 times a day for 4 days. Dynamic structural equation modeling revealed that on the within-person level, high momentary negative affect predicted dysfunctional behaviors, and on the between-person level, low trait self-esteem predicted dysfunctional behaviors. We also found an association between engaging in dysfunctional behaviors and momentary self-esteem and trait levels of valence and tense arousal. Moreover, our results indicate a deterioration of, rather than relief from, negative affective state after dysfunctional behaviors. These findings highlight the importance of emotion-regulation skills and reestablishing a positive self-view as important treatment targets to reduce dysfunctional behaviors in BPD.

2020 ◽  
Author(s):  
Timothy Allen ◽  
Michael Hallquist ◽  
Aidan G.C. Wright ◽  
Alexandre Dombrovski

Importance: Clinicians treating borderline personality disorder (BPD) are often faced with the difficult challenge of assessing when, and for whom, risk for suicide is greatest. Addressing this dilemma requires longitudinal, prospective data from high-risk samples with an elevated base rate of suicide attempts.Objective: To test whether dispositional characteristics modulate the pathway from interpersonal dysfunction to suicide in BPD. Design: This longitudinal, observational study was conducted between 1990 and 2020. Data were analyzed between April and July 2020. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Setting: Participants were recruited from inpatient, outpatient, and community referral sources.Participants: 458 individuals (Mean age = 28.59, 77% female) diagnosed with BPD.Main Outcomes and Measures: Presence or absence of a suicide attempt within one year of each follow-up assessment. Multilevel structural equation modeling was used to 1) examine longitudinal, within-person transitions from interpersonal dysfunction to suicidal ideation to suicide attempts (i.e., the [I]nterpersonal-[I]deation-[A]ttempt pathway); and 2) evaluate whether two maladaptive personality dimensions, negative affect and disinhibition, moderated these transitions.Results: At the within-person level, there was support for the I-I-A pathway: suicidal ideation accounted for the association between interpersonal dysfunction and suicide attempts. Personality further moderated each component of the I-I-A pathway: negative affect was associated with a stronger coupling between interpersonal dysfunction and ideation; and disinhibition was associated with a stronger coupling between ideation and attempts. Conclusions and Relevance: The escalation from interpersonal difficulties to a suicidal crisis in BPD involves two psychologically distinct process. An internalizing process links interpersonal dysfunction to suicidal ideation and is facilitated by trait negative. An additional externalizing process links suicidal ideation to suicide attempts, and is facilitated by trait disinhibition. Assessment of these intra- and interindividual risk factors may inform clinical decisions about when, and for whom, crisis intervention is necessary.


2020 ◽  
pp. 1-11
Author(s):  
Aleksandra Kaurin ◽  
Alexandre Y. Dombrovski ◽  
Michael N. Hallquist ◽  
Aidan G. C. Wright

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.


2022 ◽  
pp. 216770262110566
Author(s):  
Timothy A. Allen ◽  
Michael N. Hallquist ◽  
Aidan G. C. Wright ◽  
Alexandre Y. Dombrovski

In this longitudinal study, we examined whether personality traits moderate the link between interpersonal dysfunction and suicidal behavior in a high-risk sample of 458 individuals diagnosed with borderline personality disorder. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Using multilevel structural equation modeling, we examined (a) longitudinal, within-persons relationships among interpersonal dysfunction, suicidal ideation, and suicide attempts and (b) moderation of these relationships by negative affectivity and disinhibition. Negative affectivity predicted a stronger within-persons coupling between interpersonal dysfunction and suicidal ideation. Disinhibition predicted a stronger coupling between ideation and suicide attempts. Assessing negative affectivity and disinhibition in a treatment setting may guide clinician vigilance toward people at highest risk for interpersonally triggered suicidal behaviors.


Author(s):  
Denisa Ghinea ◽  
Anna Fuchs ◽  
Peter Parzer ◽  
Julian Koenig ◽  
Franz Resch ◽  
...  

Abstract Background There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM. Methods Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans’ rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews. Results Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity. Conclusions Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM.


2015 ◽  
Vol 27 (4) ◽  
pp. 559-581 ◽  
Author(s):  
Jeremy J. Sierra ◽  
Michael R. Hyman ◽  
Byung-Kwan Lee ◽  
Taewon Suh

Purpose – The purpose of this paper is to advance the understanding of antecedents and consequences of superstitious beliefs. Design/methodology/approach – From survey data drawn from 206 South Korean and 218 US respondents, structural equation modeling is used to test the posited hypotheses. Findings – To extrinsic superstitious beliefs, both the South Korean and US models support the subjective happiness through self-esteem path and the anthropomorphism path; from these beliefs, both models support the horoscope importance path and the behavioral superstitious beliefs path. Only the US model supports the path from self-esteem to extrinsic superstitious beliefs, and only the South Korean model supports the path from intrinsic religiosity to extrinsic superstitious beliefs. Research limitations/implications – South Korean and US student data may limit generalizability. As effect sizes in this context are established, researchers have a benchmark for future quantitative superstition research. Practical implications – By further understanding antecedents and consequences of superstitious beliefs, marketers are in a better position to appeal to targeted customers. Anthropomorphism and intrinsic religiosity, not fully studied by marketing scholars, show promise as segmentation variables related to consumers’ attitudes and behaviors. Social implications – To avoid unethical practice, marketers must limit themselves to innocuous superstition cues. Originality/value – Leaning on experiential consumption theory and the “magical thinking” literature, this study augments the superstition literature by exploring carefully selected yet under-researched determinants and consequences of superstitious beliefs across eastern and western consumer groups.


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