Reactivity to Sensations in Borderline Personality Disorder: A Preliminary Study

Abstract

Individuals with borderline personality disorder (BPD) are widely considered to have problems with emotional reactivity. However, the specific kinds of stimuli that are associated with heightened emotional reactivity in BPD have not been well characterized. Thus, it is unclear whether the emotional dysfunction in BPD occurs in response to any emotionally evocative stimuli, or to specific classes of stimuli. In this study, we used subjective measures (self-report and interview-based) to compare reactivity to sensations (auditory, gustatory, olfactory, tactile, visual) between participants with BPD (n = 30) and healthy controls (n = 50). Controlling for trait negative emotional reactivity, individuals with BPD reported being significantly more reactive across sensory stimuli. However, the difference between controls and BPD was significantly greater for reactivity to auditory stimuli compared to other sensory stimuli. Findings from this study provide preliminary data suggesting individuals with BPD may be characterized by heightened self-reported reactivity to aversive sounds.

A laboratory examination of emotion regulation skill strengthening in borderline personality disorder.

“…It is possible that the stimuli used were not of sufficient intensity to provoke heightened emotional response among individuals with BPD relative to HCs, and thus regulation of these responses was not sufficiently "challenging." While the present study used static images to elicit emotional responding, research suggests that heightened emotional responses in BPD may be particularly evident when dynamic stimuli are used (Kuo et al, 2014;Rosenthal et al, 2011). Alternatively, perhaps our "control" condition did not effectively function as a true "control."…”

“…Contrary to our second hypothesis, no between-groups differences were found on skill strengthening for either emotion regulation strategy. It is possible that the stimuli used were not of sufficient intensity to provoke heightened emotional response among individuals with BPD relative to HCs, and thus regulation of these responses was not sufficiently “challenging.” While the present study used static images to elicit emotional responding, research suggests that heightened emotional responses in BPD may be particularly evident when dynamic stimuli are used (Kuo et al, 2014; Rosenthal et al, 2011). Alternatively, perhaps our “control” condition did not effectively function as a true “control.” Although the intent of the “React” condition functioned as a nonvolitional emotion regulation control, it is unclear what each participant did when reacting naturally.…”

“…However, several other studies have failed to provide evidence for heightened reactivity in response to both standardized and idiographic paradigms, and across self-report and physiological indices such as heart rate, skin conductance, respiratory sinus arrhythmia, and cortisol (Elices et al, 2012; Gratz et al, 2010; Herpertz, Kunert, Schwenger, & Sass, 1999; Herpertz et al, 2001; Kuo & Linehan, 2009). Although reasons accounting for the mixed findings are unclear, recent evidence suggests the type of stimulus used to elicit emotion may moderate the extent of emotional reactivity (Kuo, Neacsiu, Fitzpatrick, & MacDonald, 2014; Limberg et al, 2011; Rosenthal, Ahn, & Geiger, 2011). Regardless of why the findings are mixed, researchers have responded by concluding that elevated emotional intensity alone may be sufficient to cause the difficulties with emotion regulation among individuals with BPD (Schmahl et al, 2014).…”

Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability

“…The distinction between ASD and personality disorders is very challenging indeed, especially in the case of mild and high-functioning autism and when the onset of the personality disorder is precocious [ 20 ]. Interestingly, women with a history of misdiagnosis showed higher scores in the AdAS Spectrum domain exploring sensory reactivity, a dimension involved in a tightly interwoven network with emotional dysregulation, borderline personality and ASD, [ 39 , 40 , 41 ] and only recently included among ASD symptom criteria. Subjective sensory overload has been shown to be more pronounced among adult females compared to males [ 42 ] and to relate to the risk of self-injuring in ASD populations [ 43 ].…”

A laboratory examination of emotion regulation skill strengthening in borderline personality disorder

“…First, it is possible that the stimuli used were not of sufficient intensity to provoke heightened emotional response in individuals with BPD relative to HCs and thus, regulation of these responses was not sufficiently "challenging." Although the present study did select images rated by experts as BPD-relevant from a standardized testing bank, research suggests that heightened emotional response may be particularly evident among individuals with BPD when dynamic (i.e., auditory or visual) stimuli are used (Kuo, Fitzpatrick, Neausciu & McDonald, 2013;Rosenthal et al, 2011). Furthermore, some individuals with BPD, but no HCs, reported to the study experimenter that their strongest emotional responses were provoked by neutral images because these recalled memories from past traumas.…”