Increases in Negative Affective Arousal Precede Lower Self-esteem in Patients with Borderline Personality Disorder but Not in Patients with Depressive Disorders: an Experience Sampling Approach

Overview

Journal Borderline Personal Disord Emot Dysregul

Publisher Biomed Central

Date 2023 Oct 2

PMID 37784203

Authors

Johannes Bodo Heekerens

Lars Schulze

Juliane Enge

Babette Renneberg

Stefan Roepke

Affiliations

Soon will be listed here.

Abstract

Background: Instability in self-esteem and instability in affect are core features of borderline personality disorder (BPD). For decades, researchers and theorists have been interested in the temporal dynamics between these constructs. Some hypothesize that changes in affective states should precede changes in self-esteem (Linehan, Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993), while others suggest that changes in self-esteem should precede changes in affective states (Kernberg, Borderline conditions and pathological narcissism, 1975).

Methods: In this study, we investigated the temporal relations between negative affective arousal states and current self-esteem in daily life. Patients with BPD (n = 42) or depressive disorders (DD; n = 40), and non-clinical controls (NCC; n = 40) were assessed every 15 min for 13 h.

Results: As expected, dynamic structural equation modeling showed higher levels of average daily negative affective arousal and lower levels of average daily self-esteem in the BPD group compared with the NCC group, and scores in the DD group were in-between the BPD and the NCC groups. In line with predictions based on Linehan's (Cognitive-behavioral treatment of borderline personality disorder. Diagnosis and treatment of mental disorders, 1993) model of affective dysregulation in BPD, negative affective arousal (t) and subsequent self-esteem (t+ 1) were significantly linked only in the BPD group, implying that higher negative affective arousal is followed by lower current self-esteem in the next measurement (ca. 15 min later). Importantly, self-esteem (t) and subsequent negative affective arousal (t + 1) were not significantly related (Kernberg, Borderline conditions and pathological narcissism, 1975).

Conclusions: Our findings suggest close dynamic temporal relations between affective instability and self-esteem instability in BPD, which highlights the importance of providing patients with means to effectively modulate high negative affective arousal states.

Citing Articles

The impact of physical exercise on adolescents' mobile phone dependency: the serial mediating role of self-esteem and depression.

Wu J, Shao Y, Zang W Front Psychol. 2025; 16:1471657.

PMID: 39995430 PMC: 11847896. DOI: 10.3389/fpsyg.2025.1471657.

References

Kaufman E, Meddaoui B . Identity pathology and borderline personality disorder: an empirical overview. Curr Opin Psychol. 2020; 37:82-88. DOI: 10.1016/j.copsyc.2020.08.015. View

Fuchs T . Fragmented selves: temporality and identity in borderline personality disorder. Psychopathology. 2007; 40(6):379-87. DOI: 10.1159/000106468. View

Tolpin L, Gunthert K, Cohen L, ONeill S . Borderline personality features and instability of daily negative affect and self-esteem. J Pers. 2003; 72(1):111-37. DOI: 10.1111/j.0022-3506.2004.00258.x. View

Hamaker E, Asparouhov T, Brose A, Schmiedek F, Muthen B . At the Frontiers of Modeling Intensive Longitudinal Data: Dynamic Structural Equation Models for the Affective Measurements from the COGITO Study. Multivariate Behav Res. 2018; 53(6):820-841. DOI: 10.1080/00273171.2018.1446819. View

Heekerens J, Schulze L, Enge J, Renneberg B, Roepke S . The temporal relation of arousal and perceived rejection in patients with borderline personality disorder and depressive disorders: An experience sampling approach. Personal Disord. 2022; 13(6):597-608. DOI: 10.1037/per0000546. View

Renneberg B, Schmidt-Rathjens C, Hippin R, Backenstrass M, Fydrich T . Cognitive characteristics of patients with borderline personality disorder: development and validation of a self-report inventory. J Behav Ther Exp Psychiatry. 2005; 36(3):173-82. DOI: 10.1016/j.jbtep.2005.05.001. View

Song J, Howe E, Oltmanns J, Fisher A . Examining the Concurrent and Predictive Validity of Single Items in Ecological Momentary Assessments. Assessment. 2022; 30(5):1662-1671. PMC: 10248304. DOI: 10.1177/10731911221113563. View

Dejonckheere E, Mestdagh M, Houben M, Rutten I, Sels L, Kuppens P . Complex affect dynamics add limited information to the prediction of psychological well-being. Nat Hum Behav. 2019; 3(5):478-491. DOI: 10.1038/s41562-019-0555-0. View

Trull T, Ebner-Priemer U . Ambulatory assessment in psychopathology research: A review of recommended reporting guidelines and current practices. J Abnorm Psychol. 2019; 129(1):56-63. DOI: 10.1037/abn0000473. View

10.

Abela J, Payne A, Moussaly N . Cognitive vulnerability to depression in individuals with borderline personality disorder. J Pers Disord. 2003; 17(4):319-29. DOI: 10.1521/pedi.17.4.319.23968. View

11.

Mneimne M, Fleeson W, Arnold E, Furr R . Differentiating the everyday emotion dynamics of borderline personality disorder from major depressive disorder and bipolar disorder. Personal Disord. 2017; 9(2):192-196. PMC: 5708157. DOI: 10.1037/per0000255. View

12.

Santangelo P, Reinhard I, Mussgay L, Steil R, Sawitzki G, Klein C . Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls. J Abnorm Psychol. 2014; 123(1):258-72. PMC: 4254796. DOI: 10.1037/a0035619. View

13.

Geldhof G, Preacher K, Zyphur M . Reliability estimation in a multilevel confirmatory factor analysis framework. Psychol Methods. 2013; 19(1):72-91. DOI: 10.1037/a0032138. View

14.

Muthen B, Asparouhov T . Bayesian structural equation modeling: a more flexible representation of substantive theory. Psychol Methods. 2012; 17(3):313-35. DOI: 10.1037/a0026802. View

15.

Trull T, Solhan M, Tragesser S, Jahng S, Wood P, Piasecki T . Affective instability: measuring a core feature of borderline personality disorder with ecological momentary assessment. J Abnorm Psychol. 2008; 117(3):647-61. DOI: 10.1037/a0012532. View

16.

Roepke S, Schroder-Abe M, Schutz A, Jacob G, Dams A, Vater A . Dialectic behavioural therapy has an impact on self-concept clarity and facets of self-esteem in women with borderline personality disorder. Clin Psychol Psychother. 2010; 18(2):148-58. DOI: 10.1002/cpp.684. View

17.

Nezlek J, Kuppens P . Regulating positive and negative emotions in daily life. J Pers. 2008; 76(3):561-80. DOI: 10.1111/j.1467-6494.2008.00496.x. View

18.

Harp Th T, Hepp J, Trull T, Bateman A, Kongerslev M, Simonsen E . Positive Affect Is Associated With Decreased Symptom Severity in the Daily Lives of Individuals With Borderline Personality Disorder. J Pers Disord. 2019; 35(3):355-372. DOI: 10.1521/pedi_2019_33_453. View

19.

Kelley K . Methods for the behavioral, educational, and social sciences: an R package. Behav Res Methods. 2008; 39(4):979-84. DOI: 10.3758/bf03192993. View

20.

Brose A, Schmiedek F, Gerstorf D, Voelkle M . The measurement of within-person affect variation. Emotion. 2019; 20(4):677-699. DOI: 10.1037/emo0000583. View