Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study

Timothy A. Allen; Alexandre Y. Dombrovski; Paul H. Soloff; Michael N. Hallquist

doi:10.1017/s003329172000255x

journal article Jul 27, 2020

Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study

Timothy A. Allen

Alexandre Y. Dombrovski Paul H. Soloff Michael N. Hallquist

Psychological Medicine Vol. 52 No. 6 pp. 1014-1021 · Cambridge University Press (CUP)

View at Publisher Save 10.1017/s003329172000255x

Abstract

AbstractBackgroundIndividuals diagnosed with borderline personality disorder (BPD) often describe their lives as stressful and unpredictable. However, it is unclear whether the adversity faced by those with BPD is a product of stress reactivity or stress generation. Here, we examined the dynamic, prospective associations between BPD and stressful life events over 3 years. Given the heterogeneity present in BPD, we sought to understand which empirically derived dimensions of this heterogeneous disorder explain stress reactivity v. stress generation.MethodsParticipants included 355 individuals diagnosed with BPD and followed longitudinally at three annual assessments. Auto-regressive cross-lagged panel models were used to examine prospective associations between stressful life events and three latent dimensions implicated in BPD: negative affect, disinhibition, and antagonism.ResultsAntagonism and disinhibition, but not negative affect, prospectively predicted dependent stressful life events (events the individual may have some role in). Evidence for decompensation under stress was more tenuous, with independent stressful life events (those presumably outside the individual's control) predicting increases in negative affect.ConclusionsOur longitudinal study of a well-characterized clinical sample found more evidence for stress generation than for stress-induced decompensation in BPD. Stress generation in BPD is driven by externalizing dimensions: antagonism and disinhibition. These results highlight the utility of empirically derived dimensions for parsing heterogeneity present in BPD, leading to improvements in diagnostic evaluation, clinical prediction, and individualized approaches to treatment planning.

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Details

Published: Jul 27, 2020
Vol/Issue: 52(6)
Pages: 1014-1021
License: View

Authors

T

Timothy A. Allen

From the Comparative Nephrology Unit, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

A

Alexandre Y. Dombrovski

Cite This Article

Timothy A. Allen, Alexandre Y. Dombrovski, Paul H. Soloff, et al. (2020). Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study. Psychological Medicine, 52(6), 1014-1021. https://doi.org/10.1017/s003329172000255x

Borderline personality disorder: stress reactivity or stress generation? A prospective dimensional study

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