Nomothetic and idiographic patterns of responses to emotions in borderline personality disorder.

Abstract

According to Linehan’s (1993) biosocial theory, emotion dysregulation is a core feature of borderline personality disorder (BPD). Despite significant advances in our understanding of emotion dysregulation in BPD, the specific associations among prompting events, discrete emotions, and selected regulation strategies (adaptive and maladaptive) have not yet been detailed. We explored these relations in a daily diary study of 8 participants (Mage = 21.57, 63% female; 63% Asian) with BPD over 10–12 weeks. Participants reported prompting events of interpersonal conflict, emotional experiences of anxiety, and strategies of problem-solving and intentional avoidance most frequently. We found several unique relations between regulation strategies and both prompting events and discrete emotions, nomothetically (across all participants) and idiographically (within specific participants). These patterns contribute to an enriched understanding of the emotional experiences of people with BPD and demonstrate the value of collecting and considering both group-level and person-specific data on emotion regulation processes within this population.

Measuring Emotion Regulation Skill Use During Treatment: A Promising Methodological Approach

“…Participants completed measures at least once-a-day via text message or email assessing the frequency of their emotional experiences and corresponding behaviors during baseline (2–4 weeks), treatment (4 weeks), and follow-up (4 weeks) phases. Participants reported on the type and intensity of each emotion experienced that day, the circumstances prompting each emotional experience, and their behavioral response to each emotion (Cardona et al, 2021; Sauer-Zavala et al, 2020; Southward, Semcho, et al, 2020). Behavioral responses were classified by the research team as either adaptive (e.g., allowed the emotion to be there, collected the facts about a situation before responding, used assertive behaviors, set a limit, asked for help) or maladaptive (e.g., used substances, engaged in self-injury, sought reassurance, lashed out) based on previous theory and research (Naragon-Gainey et al, 2017; Southward & Cheavens, 2020).…”

“…Idiographic multilevel logistic regressions can be used to examine whether specific emotions (e.g., sadness, anger, fear, shame, guilt) are related to the use of specific emotion regulation strategies and whether these relations vary by treatment phase (Cardona et al, 2021). Interestingly, and despite the visual patterns above, there were no significant relations between emotions and emotion regulation skills across study phases ( ps > 0.05) for participant 007.…”

“…However, one subarea of emotion regulation research that has yet to widely embrace EMA is treatment outcome research. To date, only a few studies (e.g., Cardona et al, 2021; Sauer-Zavala et al, 2020; Southward, Semcho, et al, 2020) have used EMA to study emotion regulation (including changes in emotion regulation strategy use) in the context of treatment outcome studies. This represents a significant gap in both emotion regulation research and treatment outcome research for emotional disorders.…”

Do You See What I See? Researcher–Participant Agreement on Single-Item Measures of Emotion Regulation Behaviors in Borderline Personality Disorder

“…Participants also provided qualitative descriptions of each behavior. In the current study, we conducted a secondary data analysis of the agreement between participants and researchers regarding participants' reports and descriptions of their emotion regulation behaviors from Sauer-Zavala et al (2020), and Cardona et al (2020). Specifically, our research team independently categorized participants' qualitative responses as one of five behavioral response options presented to participants during the parent study and examined agreement with participants' own categorizations of their behaviors.…”

Using case formulation for prediction of the therapeutic alliance in treatment for borderline personality disorder.

“…Idiographic assessment has been defined as “the measurement of variables and functional relations that have been individually selected, or derived from assessment stimuli or contexts that have been individually tailored, to maximize their relevance for a particular client” (Haynes et al, 2009, p. 179), and it was developed to complement nomothetic, or group-based, methods that may tend to overlook singular features that may be determinant for a specific context. Typically, research relying on such assessments either aims at describing patterns of time-intensive responses (i.e., using ecological momentary assessment; Cardona et al, 2020; Fisher & Boswell, 2016) or aims at explaining a particular problem area using individual case formulations methodology from a variety of theoretical perspectives (Eells, 2013; Persons, 1991). It was argued that case formulation has the unique potential to personalize assessment and psychotherapy.…”