A comprehensive examination of delayed emotional recovery in borderline personality disorder

Abstract

Background and Objectives Despite growing attention to emotion processes in borderline personality disorder (BPD), little research has examined delayed emotional recovery (i.e., long-lasting emotions after the termination of an emotionally evocative stimulus) in this population. The extant data on delayed emotional recovery in BPD are limited by a lack of assessment across a range of indices and emotions. The present study addresses these gaps by comparing emotional recovery between individuals with BPD, social anxiety disorder (SAD), and healthy controls (HCs) using a multi-modal assessment approach. Methods Participants underwent fear, anger, and sadness inductions followed by a 5-minute “washout” phase wherein emotional recovery was assessed via self-report, respiratory sinus arrhythmia (RSA), and skin conductance responses (SCR). Results After controlling for state dissociation, the BPD and SAD group exhibited decreases in RSA, while the HC group showed no changes in RSA after the anger induction only. Groups did not differ in rate of emotional recovery across self-report, RSA, or SCR after fear and sadness inductions. Limitations The present study is limited by a solely female and small sample, and the short time frame in which emotional recovery was assessed. Conclusions Findings indicate that individuals with BPD generally do not exhibit delayed emotional recovery, but may show decreases in parasympathetic activity during the recovery period after experiencing anger. However, this pattern may not be specific to this disorder.

The effects of respiratory sinus arrhythmia on anger reactivity and persistence in major depression

“…Reduced vagal functioning was also associated with increased anger ruminations following an anger provocation (e.g., receiving an unfair offer; Vögele, Sorg, Studtmann, & Weber, ). Finally, in a clinical sample of borderline and socially anxious individuals, as compared to controls, lower RSA was associated with greater emotional reactivity in response to an anger‐inducing film (Fitzpatrick & Kuo, ). Although not specific to depression, these findings suggest that anger regulation (i.e., reactivity and recovery) may be associated with low RSA and RSA withdrawal.…”

Ruminative responses to interpersonal precipitants mediate borderline personality disorder features’ effects on distress reactivity and recovery in daily life

“…This pattern of findings may help to clarify a mixed literature on the relationship between BPD and prolonged distress recovery (e.g., Feliu-Soler et al, 2013;Fitzpatrick & Kuo, 2015;Gratz et al, 2010;Jacob et al, 2009;Scheel et al, 2013): positive findings may reflect instances in which ruminative responses were deployed. Specifically, though BPD features directly predicted heightened distress reactivity, their effect was indirect for distress recovery via ruminative response deployment and the dispositional tendency to ruminate (or to brood).…”

“…For example, following a mood induction during which participants were instructed to identify with an embarrassed protagonist under evaluation, women with BPD reported stronger feelings of shame across an 8-min follow-up period relative to depressed and healthy control participants (Scheel et al, 2013). On the other hand, BPD patients did not differ from their depressed, anxious, or healthy counterparts in the time course of NA following exposure to unpleasant images (Feliu-Soler et al, 2013) or evocative film clips that have been previously validated to elicit discrete emotional states (Fitzpatrick & Kuo, 2015). However, findings from laboratory studies are mixed, with some failing to note differences in the time course of distress recovery following an interpersonal betrayal-themed story between women diagnosed with BPD, depression, and their healthy peers (Jacob et al, 2009), and others observing more enduring feelings of shame among those with BPD in response to computerized negative performance feedback within a failure paradigm (Gratz et al, 2010).…”

“…Less is known about the relationship between BPD and the recovery component of emotion dysregulation, though results from a number of laboratory and EMA studies suggest that protracted NA among those with BPD may more readily be observed within an interpersonal context (Feliu-Soler et al, 2013;Fitzpatrick & Kuo, 2015;Gratz et al, 2010;Jacob et al, 2009;Scheel et al, 2013). For example, following a mood induction during which participants were instructed to identify with an embarrassed protagonist under evaluation, women with BPD reported stronger feelings of shame across an 8-min follow-up period relative to depressed and healthy control participants (Scheel et al, 2013).…”

Emotional processes in borderline personality disorder: An update for clinical practice.

“…Still other studies found that those with BPD reported higher negative emotions at baseline (Jacob et al, 2009; Kuo & Linehan, 2009; Reitz et al, 2012), but no differences in reactivity than controls. In addition, whereas some research revealed that, compared with healthy participants, those with BPD took longer to recover emotionally (Reitz et al, 2012) or evidenced more prolonged experiences of specific emotions, such as shame (Gratz, Rosenthal, Tull, Lejuez, & Gunderson, 2010), another study revealed no such differences (Fitzpatrick & Kuo, 2015). Such inconclusive findings raise the question of under what conditions we can expect to see elevated emotional vulnerability in BPD.…”