Emotion regulation strategies in borderline personality disorder: a meta-analysis

ABSTRACT

Objectives

Many theoretical models pinpoint emotional dysregulation not only as a symptom of borderline personality disorder (BPD) but also as a component in the development and maintenance of the disorder. In this meta-analysis, results from studies that examined the association between emotion regulation strategies and BPD symptoms were systematically analysed.

Design

A quantitative meta-analysis approach was used to systematically assess previous research studies and conduct subgroup and meta-regression analysis to test for theoretical, methodological and demographic moderating variables.

Results

Emotion regulation strategies are significantly and largely associated with BPD symptoms. Negative associations were found between BPD symptoms and acceptance (r = −.558), mindfulness (r = −.581) and reappraisal (r = −.303) and positive associations were found between BPD symptoms and avoidance (r = .528), distraction (r = .336), rumination (r = .551) and suppression (r = .449). As heterogeneity was high, moderating variables (clinical status, type of reporting, comorbidity control, type of population, mean age, percentage of females) were also investigated.

Conclusion

The findings highlight the need for active involvement of emotion regulation in explaining BPD psychopathology, as well as promoting interventions focused on individual emotion regulation strategies.

KEY POINTS

• What is already known about this topic:

  (1) The biosocial model of BPD and dialectical behaviour therapy focuses on emotion dysregulation as a core characteristic of BPD.

• (2) Emotional dysregulation is a core feature of BPD and is strongly involved in the appearance and maintenance of BPD pathology.

• (3) Emotional regulation difficulties in BPD are also well reflected in the diagnostic criteria according to DSM-5 (APA, 2013).

• What this topic adds:

  (1) In the present review, acceptance and mindfulness are considered different emotion regulation strategies.

• (2) Problem solving is not seen as an emotion regulation strategy because it refers to meta-cognitive processes of dealing with emotions and does not target direct attempts to regulate emotions.

• (3) Psychological treatments that target the reduction of BPD associated symptoms should continue to focus on emotional dysregulation as a core component of BPD psychopathology.

KEYWORDS:

• Borderline personality disorder
• emotional regulation strategies
• meta-analysis

Acknowledgments

The present work has received financial support through the project: Entrepreneurship for innovation through doctoral and postdoctoral research, POCU/360/6/13/123886 co-financed by the European Social Fund, through the Operational Programme for Human Capital 2014–2020.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available from the corresponding author ([email protected]), upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/13284207.2022.2152668

Additional information

Funding

The work was supported by the European Social Fund, through the Operational Programme for Human Capital 2014–2020 [POCU/360/6/13/123886]. This work was funded through grants PN-III-P4-ID-PCE-2020-2894 (Aurora Szentágotai-Tătar) and PN-III-P4-ID-PCE-2020-2609 (Andrei Miu) from the Romanian Ministry of Education and Research, CNCS – UEFISCDI. CNCS - UEFISCDI had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.