Master of Social Work, The Ohio State University, 2024, Social Work

Borderline Personality Disorder (BPD) is a mental disorder characterized by an intense fear of abandonment, impulsivity, and pervasive patterns of instability across several aspects of an individual's life including their interpersonal relationships, self-esteem, and affect. Individuals with this disorder are prone to engaging in suicidal and self-injurious behaviors that can result in lethal consequences (American Psychiatric Association, 2022). Research has examined genetic vulnerabilities and childhood traumatic experiences that can lead to the development of this disorder and dysfunctional methods of attaching to others. Studies have repeatedly implicated that individuals with BPD possess insecure attachment styles. However, there have been inconsistent results regarding which insecure attachment style is most prevalent in this population. The purpose of this study was to determine whether there would be differences in insecure attachment styles among individuals diagnosed with BPD and whether there is a relationship between BPD symptom severity and specific insecure attachment styles. This study was exploratory with a correlational design and used self-report measures to determine the most common attachment styles among individuals in this population and their levels of BPD symptomatology. Descriptive statistics and measures of central tendency were used to describe and present the results from this sample. After collecting data from 64 participants (N = 64), their responses to the Zanarini Rating Scale for BPD (ZAN-BPD) and Relationship Structures (ECR-RS) instruments were evaluated to determine their severity of BPD symptoms and attachment styles towards two attachment figures, respectively. One-Way ANOVAs were conducted to determine whether there were differences in the mean number of BPD symptoms between attachment styles with respect to a primary caregiver and significant other (or close friend) to the participants. After completing One-Way ANOVAs, Post (open full item for complete abstract)

Committee: Susan Yoon Dr. (Committee Chair); Joseph Guada Dr. (Advisor) Subjects: Behavioral Psychology; Behavioral Sciences; Clinical Psychology; Personality; Personality Psychology; Psychology; Social Psychology; Social Work

Master of Science, The Ohio State University, 2023, Psychology

Several teams of researchers have created promising self-report tools to measure borderline personality disorder features (Bohus et al., 2009; Maples et al., 2015; Morey, 1991; Pfohl et al., 2009). However, recent theoretical developments have made comparison between self-report measures of BPD difficult (Zimmerman et al., 2020) as some measures assume a DSM-5 Section II conceptualizations of BPD (Bohus et al., 2009; Pfohl et al., 2009) whereas others assume DSM-5 Section III alternative conceptualizations (Maples et al., 2015). As such, existing measures lack comprehensive item coverage over salient borderline personality disorder criteria. In short, a measure that covers all (i.e., both Section II and Section III) important facets of borderline personality disorder is needed. Using the items derived from four self-report measures of borderline personality disorder, we sought to create a global self-report measure called the Borderline Ohio State Scale. Using a collegiate sample and exploratory factor analysis we found evidence for a six-factor structure: Emotion Dysregulation, Self-Destructive Thoughts and Behaviors, Impulsivity, Abandonment Anxiety, Hostility, and Depressivity. Using this same dataset, we examined whether a bifactor model fit and explained the data well. We found that it did and that the general factor (i.e., BPD) was reliable. The Borderline Ohio State Scale converged with other important self-report measures of borderline personality disorder. It also strongly converged with theoretically relevant constructs such as emotion dysregulation, impulsivity, suicidality, and identity disturbance. A strength of this study is the creation of a new self-report measure of borderline personality disorder which provides at least some degree of item coverage across all Section II and Section III DSM-5 criteria. In future work, researchers should aim to reduce the item load of the Borderline Ohio State Scale and replicate the factor structure using a new sam (open full item for complete abstract)

Committee: Jennifer Cheavens (Advisor); Daniel Strunk (Committee Member); Paulus De Boeck (Committee Member) Subjects: Clinical Psychology

Psy. D., Antioch University, 2020, Antioch Santa Barbara: Clinical Psychology

The purpose of this dissertation is to examine the impact unlimited connectivity and unlimited access to voice, text, and video communication as well as multimedia content consumption through mobile social technology has on personality integration. The increased use of mobile social technology has changed how the user engages social relationships. Through mobile social technology, the user places importance in an inanimate object for engagement of social relationships. A reliance on the inanimate object as a social relationship is thought to compromise the ability to internalize integrated object relations and develop stable personality organization. This theoretical research uses hermeneutic analysis of Kernberg's Object Relations theory, Winnicott's theory on Transitional Objects, Anthropomorphism, and Kohut's Self Psychology as it pertains to the relationship with mobile social technology. Through the hermeneutic process of understanding the presented experience of each of these theories the aim is to form a clearer picture of how our relationship with mobile social technology impacts personality functioning. Further research is needed to continue to expand our understanding of the impact of our relationship with social technologies. This Dissertation is available in Open Access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd

Committee: Allen Bishop Ph.D. (Committee Chair); Agnes Regeczkey Ph.D. (Committee Member); Michael Grandner Ph.D. (Committee Member); Jennifer Newhard Psy.D. (Committee Member) Subjects: Mental Health; Personality Psychology; Psychology; Technology

Doctor of Psychology (PsyD), Wright State University, 2020, School of Professional Psychology

Inaccurate diagnoses due to clinician bias may lead to the facilitation of inappropriate mental health treatment and poor prognosis for treating clients presenting concern, as the cause of the disordered behaviors that led to their incarceration are not being addressed. The current study sought to determine whether clinician gender bias and clinician setting bias affects the diagnosis of Antisocial Personality Disorder and Borderline Personality Disorder amongst clients in correctional settings. Determining whether bias affects diagnosis of these disorders amongst clients in correctional settings is important in order to assure clients are receiving appropriate mental health treatment. Incarcerated individuals who receive appropriate mental health treatment may have lower rates of recidivism, with obvious societal benefits. The current study surveyed a sample of 124 mental health professionals to determine whether manipulating gender and/or setting bias impacted mental health professionals' abilities to accurately diagnose Borderline Personality Disorder. Results suggest setting bias impacts mental health professionals' abilities to accurately diagnose Borderline Personality Disorder.

Committee: Wendy R. Dragon Ph.D. (Committee Chair); Michelle S. Schultz Psy.D. (Committee Member); LaTrelle D. Jackson Ph.D., CCFC, ABPP (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy, The Ohio State University, 2015, Psychology

Borderline personality disorder (BPD) is a psychological disorder that effects mostly women (75%) and is characterized by symptoms that may impact social networks such as intense anger, emotional instability, impulsivity, unstable interpersonal relationships, and fears of abandonment. Furthermore, distress resulting from interpersonal events is related to serious consequences such as self-harm and suicide attempts for those with BPD. Despite the clear disruption in the interpersonal domain, and the severe associated outcomes, few research attempts have been made to understand the social networks of women with BPD and how they may differ from the networks of others. In the present study, we aimed to do this using a longitudinal design to compare the social networks of women with BPD and a group of age and education matched healthy control women. Participants recruited from the community and local clinics were assessed at a baseline evaluation and completed follow-up questionnaires one and three months later. The effect of group on perceptions of social network quality, composition, and stability was examined. Women in the BPD group reported less satisfaction and support and more conflict and criticism from network members than healthy control women. Further, those diagnosed with BPD had social networks that were more variable in terms of these same characteristics. The BPD group reported having fewer partners at baseline and more relationships in which there had been a significant rupture or change in the past month. The effect of group on stability of network perceptions over time was significant, but the two groups did not differ in dropout rates over three-months. These results inform our understanding of the social dysfunction experienced by individuals with BPD by clarifying the nature of unstable relationships. Specifically, while those with BPD reported having lower quality relationships and more change in how they viewed their partners over time (open full item for complete abstract)

Committee: Jennifer Cheavens S (Advisor); Daniel Strunk R (Committee Member); Robert Cudeck (Committee Member) Subjects: Personality; Psychology

Master of Arts in Psychology, Cleveland State University, 2015, College of Sciences and Health Professions

Intro: Borderline personality disorder (BPD) is a mood disorder that affects 2-4% of the general population, up to 20% of psychological inpatients, and 10% outpatients. It is characterized by unstable affect, behavior, mood, interpersonal relationships, and self-image, and tends to stem from a history of abuse. The DSM-5 scales are labeled as: impulsivity, affect inability, abandonment, unstable relationships, self-image, suicide, emptiness, anger, and quasi-psychotic states. A general finding shows those with BPD tend to have difficulty recognizing and reacting to negative emotions (mainly fear, anger, and disgust). Additionally, researchers have found the brain areas that relate to emotion, planning, attention, memory, and decision-making are smaller in borderlines than healthy subjects. Objective: The purpose of this study was to examine participants with subclinical borderline features and determine the relationships between facial affect recognition deficits. Methods: Two-hundred-and-three potential participants were screened using the Borderline Personality Questionnaire (BPQ). Thirty-five undergraduates from Cleveland State University participated in a computer-based study assessing reaction times (RT) and accuracy to Ekman's Pictures of Facial Affect, the now-standard emotional facial stimuli. Results: The majority of participants were Caucasian (68.8%), female (88.6%), and right-handed (94.3%). Mean age was 20.89 ± 4.75 (range= 23). There were 3 (8.6%) subjects of Hispanic ethnicity. Sixteen (45.7%) of the 35 subjects exhibited high borderline traits, as defined as scoring at least 1.5 standard deviations above the mean on the BPQ. There were no significant differences comparing RT and accuracy between groups (all p values = .124). With regard to lateralization, there is a significant difference in the relative disgust index when comparing borderlines (M= .61 ± .08) to controls (M= .73 ± .12) (t(33)=1.31, p= .002). Conclusions: Our sample of adults with (open full item for complete abstract)

Committee: Amir Poreh PhD (Advisor); Boaz Kahana PhD (Committee Member); Andrew Slifkin PhD (Committee Member) Subjects: Personality Psychology

Master of Arts in Psychology, Cleveland State University, 2024, College of Sciences and Health Professions

Despite extensive research highlighting elevated rates of suicidality among people with borderline personality disorder (BPD), the underlying factors that contribute to this risk remain less understood. Theory-driven research elucidating pathways to suicidality may inform the development of targeted treatments to mitigate this risk. Prior studies have established a strong link between BPD features and use of ineffective emotion regulation strategies, especially rumination (Bud et al., 2023). Additionally, prior studies suggest attention disengagement difficulties may underlie rumination (Koster et al., 2011). Therefore, these studies investigated longitudinal and cross-sectional components of the emotional cascade model (Selby et al., 2008). Study 1 investigated the intervening role of rumination and potentiating role of eye-tracking attention disengagement from sad facial content on the relationship between BPD and suicide-related rehospitalization among inpatient adults (N = 95). The results confirm a robust relationship between elevated BPD features and ruminative tendencies; however, the hypothesized mediating and moderating roles were not supported. Study 2 investigated an extension of the emotional cascade model by testing the relationships between mindfulness, rumination, and their sequential effects on suicidogenic cognitions among diverse community adults diagnosed with BPD (N = 81). This study found support for the hypothesized intervening role of rumination between BPD features and suicide cognitions. Although BPD and difficulty employing mindfulness were strongly related, the mediation was not supported. Collectively, these studies provide partial support for ruminative cycles as an intervention target to alleviate suicide-related outcomes for BPD. Additionally, these results provide thought-provoking insights into study limitations. They also suggest considerations for the conceptualization of BPD and the incorporation of attention paradigms in future r (open full item for complete abstract)

Committee: Ilya Yaroslavsky (Committee Chair); Amir Poreh (Committee Member); Kelsey Pritchard (Committee Member); Eric Allard (Committee Member) Subjects: Clinical Psychology; Psychology

Psy. D., Antioch University, 2024, Antioch New England: Clinical Psychology

Empirical research on clinician experience of competency treating borderline personality disorder is scarce, and that which does exist focuses on the negative experiences of those who treat this population. Utilizing an interpretive phenomenological analysis approach, this qualitative research investigation explored the lived experience of feelings of competency in clinicians treating borderline personality disorder using the evidence-based model of Transference-Focused Psychotherapy. To better comprehend this phenomenon and address research questions, data were collected via one, semi-structured interview given to five different clinicians who practice Transference-Focused Psychotherapy. Four themes emerged from the researched data: Positive treatment outcomes for patients, Using negative countertransference for positive therapeutic intervention, Reliability of treatment framework, and Effectively dealing with crisis and suicidality. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu)

Committee: Theodore Ellenhorn Ph.D. (Committee Chair); Gina Pasquale Psy.D (Committee Member); Sabine Dorleans Psy.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, University of Toledo, 2022, Psychology - Clinical

Borderline personality disorder (BPD), a disorder marked by affective, cognitive, behavioral, and interpersonal dysregulation, is theorized to onset during adolescence. Previous research has demonstrated a link between parental BPD pathology and adolescent BPD pathology. Emotion regulation (ER) difficulties have been implicated as a likely mechanism of transmission of BPD from parent to child, as ineffective parental ER may serve as both a model of ER for their offspring and may interfere with the parents' ability to regulate their offspring's emotions. Thus, the present study aimed to investigate the role of intrapersonal ER and interpersonal ER (IER) in the transmission of BPD symptoms from mothers to their adolescent offspring. Dyads (N = 47) of mothers and their adolescent children (ages 12-17) with a range of BPD symptoms completed self-report measures, interviews, social rejection laboratory tasks, and an emotion discussion task in order to examine the role of intrapersonal ER and IER through multiple methods (i.e., self-report, physiological responding, behavioral observations). Results revealed a significant indirect relation of maternal BPD symptoms to adolescent BPD symptoms through maternal and adolescent self-reported trait and state intrapersonal ER. However, the indirect relations through other measures of intrapersonal ER (i.e., physiological indices) and all measures of IER were not significant. Results support previous research highlighting the importance of ER in the development and transmission of BPD. Implications, limitations, and future directions of this research are discussed.

Committee: Kim Gratz (Committee Chair); Matthew Tull (Committee Member); Katherine Dixon-Gordon (Committee Member); Peter Mezo (Committee Member); Jason Rose (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, The Ohio State University, 2022, Psychology

Emotion regulation is a process that involves attempts to modify or sustain emotional experiences and often involves utilizing other people in attempts to effectively do so. Interpersonal emotion regulation (IER) has been defined as seeking out other individuals to regulate one's own emotional experience (Zaki & Williams, 2013). While emotion regulation has been extensively examined in psychopathology, the social context and interpersonal nature of emotion regulation have largely been ignored, with the focus of most emotion regulation research being on intrapersonal emotion regulation strategies (e.g., suppression or reappraisal). Borderline personality disorder (BPD) is particularly relevant to the study of emotion regulation and is likely to be an important model to aid in understanding IER in light of the extensive emotional and interpersonal difficulties associated with the disorder. There were two primary aims to the current study: 1) to better characterize IER in the context of current relationships and 2) to characterize the relations among BPD features, IER partner characteristics, and IER effectiveness. Participants, 149 MTurk workers, completed a social network assessment of important relationships in their lives. They also indicated which, if any, of those partners they utilize for IER. IER partners were characterized by greater closeness and centrality in the network compared to partners who do not serve an IER function. Closeness and centrality were positively related to the frequency of going to a partner for IER. Partners with whom participants had greater relationship quality and who were perceived as being more willing to assist in IER were rated as more effective in helping to regulate participants' emotions. Furthermore, BPD features were unrelated to the frequency of using IER but were negatively related to the perceived efficacy of IER and willingness of partners to assist in IER. There was also evidence that those higher in BPD features may mak (open full item for complete abstract)

Committee: Jennifer Cheavens PhD (Advisor); Daniel Strunk PhD (Committee Member); Baldwin Way PhD (Committee Member) Subjects: Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2022, Psychology

Psychoanalysis has undergone an evolution in which classic techniques have been augmented by more modern relational techniques (Diamond, et al., 2020). This shift in thought and practice may be most relevant to patients classified with Borderline Personality Organization (BPO) – a group historically challenging to treat using psychoanalytic and other treatment methods (Lingiardi & McWilliams, 2017). The current study compares the psychoanalytic treatment of two individuals with BPO symptomatic presentations, one of whom experienced a positive outcome and the other a negative outcome. The eight sessions near the beginning of treatment, four in the middle of treatment, and eight near the end of each analysis are analyzed for Therapist Dynamic Competence, Therapist Relational Competence, and Interaction Quality (Gazzillo et al., 2018) to determine how relational and classical techniques were associated with positive versus negative treatment outcomes. Results indicate that the therapeutic process in the positive outcome case was characterized by significantly greater levels of Therapist Relational Competence and Interaction Quality, as predicted; however Therapist Dynamic Competence was also higher in the positive outcome case, contrary to the prediction. Limitations and future research directions are discussed.

Committee: Karl W. Stukenberg Ph.D., ABPP (Committee Chair); Nicholas L. Salsman Ph.D., ABPP (Committee Member); Kathleen J. Hart Ph.D., ABPP (Committee Member) Subjects: Clinical Psychology; Psychology

Doctor of Philosophy, University of Akron, 2021, Counseling Psychology

Prior research has consistently related borderline personality features (BPF) to internalized and externalized violence. Fortunately, development of treatment interventions to mitigate maladaptive behaviors associated with BPF has been a distinct aim within the extant literature. Mentalization-based therapy (MBT) has emerged as a promising intervention to improve adaptive functioning of persons with BPF by enhancing a form of social cognition to attend to mental states (Bateman & Fonagy, 2006). Further research is needed to bridge the gap between the theoretical mentalization literature (Fonagy & Bateman, 2007) and the randomized control trials demonstrating the efficacy of MBT (Bateman & Fonagy, 1999; 2001; 2008; 2009; Rossouw & Fonagy, 2012). Specifically, the present study examined the relationships among BPF, mentalization errors, deliberate self-harm, suicidal behaviors, aggression, and violence using Fonagy and Bateman's (2007) mentalization model. Furthermore, the present study considered the potential moderating influence of gender on the indirect effects of BPF on violence through mentalization errors. A sample of 215 adults recruited from social media community groups related to BPF completed self-report measures of BPF, mentalization errors, deliberate self-harm, suicidal behaviors, aggression, and violence. Additionally, a separate dimensional screener of mentalization errors was developed and piloted within the present study. Analyses included bivariate correlations, analyses of variance, and conditional process analyses of indirect effects. Results partially supported Fonagy and Bateman's (2007) mentalization model. Hypo- and hyper-mentalization errors mediated select relationships between BPF and internalized/externalized violence. Moreover, gender was found to moderate the indirect effect of BPF on violence in a manner that ran contrary to gender norms. Limitations of an existing mentalization measure are discussed. The alternative instrument (open full item for complete abstract)

Committee: Ingrid Weigold (Committee Chair); John Queener (Advisor); Heather Katafiasz (Committee Member); Andrea Snell (Committee Member); Charles Waehler (Committee Member) Subjects: Counseling Psychology

Doctor of Psychology (Psy.D.), Xavier University, 2022, Psychology

More research is needed in order to determine how childhood invalidation may contribute toward the development of borderline personality disorder (BPD) symptoms. Two possible mediators that may explain the relationship between childhood invalidation and BPD symptoms are rejection sensitivity and experiential avoidance. Previous researchers have found rejection sensitivity to mediate the relationship between parental rejection and BPD symptoms (Rosenbach & Renneberg, 2014), and experiential avoidance has consistently been found to be positively associated with BPD symptoms (e.g., Cavicchioli et al., 2015). It is possible that individuals with histories of childhood invalidation by parents may engage in experiential avoidance in order to cope with heightened rejection sensitivity, leading to the symptoms of BPD. The hypothesis for the current study was that childhood invalidation will significantly influence increased rejection sensitivity, which will significantly influence increased experiential avoidance, which then would significantly influence increased BPD symptoms. Using a cross-sectional and correlational design, a sample of 416 individuals ranging from ages 19 to 70 completed self-report measures of mother and father childhood invalidation, rejection sensitivity, experiential avoidance, and BPD symptoms through Amazon's Mechanical Turk (MTurk). The main hypothesis was fully supported in that childhood invalidation by both mother and father significantly influenced rejection sensitivity, which significantly influenced experiential avoidance, which then significantly influenced BPD symptoms. The results of this study highlight how two psychological processes, rejection sensitivity and experiential avoidance, further explain the relationship between childhood invalidation and BPD symptoms.

Committee: Nicholas Salsman Ph.D., ABPP (Advisor); Kathleen Hart Ph.D., ABPP (Committee Member); Christine Dacey Ph.D., ABPP (Committee Member) Subjects: Psychology

Doctor of Psychology (PsyD), Wright State University, 2022, School of Professional Psychology

Trauma-sensitive yoga (TSY) is an adjunctive trauma treatment paradigm that modifies a studio-style yoga class to make it more accessible for individuals who have experienced trauma. A core outcome of TSY practice is greater connection to one's physical body and ability to read one's own physical signals. Since individuals with chronic trauma often engage in body-based avoidant behaviors, such as self-harm, substance abuse, or dissociation, they may benefit from a treatment that promotes embodiment, such as TSY. Dialectical Behavior Therapy (DBT) is a therapy often used with individuals who have emotional reactivity resulting from trauma. However, DBT focuses on internal and cognitive processes that are different from those employed in yoga, suggesting these two treatments work via different mechanisms. A program was developed for individuals with Borderline Personality Disorder which formally integrates Trauma Center TSY, a protocolized yoga treatment for trauma, with DBT, so that clients can learn a wider array of skills to target trauma reactions. The integration of TSY and DBT modalities are likely to complement and enhance one another's effectiveness in treating chronically traumatized individuals through increased embodiment.

Committee: Wendy Dragon (Advisor); Michelle Schultz (Committee Member); Crystal Williams (Committee Member); David Emerson (Committee Member) Subjects: Psychology

Master of Arts in Psychology, Cleveland State University, 2021, College of Sciences and Health Professions

Borderline Personality Disorder (BPD) is characterized by emotion dysregulation, reflected by intense, negative emotions, and instability in interpersonal relationships. Recent research has investigated the physiological underpinnings that may contribute to this emotion dysregulation, although results have been mixed and certain physiological measures have not been thoroughly investigated. Therefore, the current study set to examine the subjective emotional and pupillary reactivity in response to interpersonal distress in individuals with BPD symptom profiles. A sample consisting of undergraduate participants (N = 89), who reported BPD features (PAI-BOR; Stein et al., 2007), underwent a social rejection protocol (Cyberball: Version 3; Williams & Jarvis, 2006) while anger and sympathetic reactivity (using pupillometry) were assessed. Multiple moderation models and Pearson correlations were used to examine the impact of social rejection on the relationship between BPD features and emotion dysregulation and sympathetic arousal. Results did not reveal significance, except in which a negative relationship between Affective Instability features of BPD and peak pupil dilations emerged. Though non-significant, these findings contribute to the etiological theories of emotion dysregulation and autonomic disfunction within BPD. Furthermore, these results suggest that it's imperative that research examines emotion dysregulation across a variety of emotions and greater insight into sympathetic reactivity is needed.

Committee: Ilya Yaroslavsky Ph.D. (Committee Chair); Eric Allard Ph.D. (Committee Member); Elizabeth Goncy Ph.D. (Committee Member) Subjects: Clinical Psychology

Master of Science, The Ohio State University, 2021, Psychology

Extant research suggests that borderline personality disorder (BPD) may be particularly prevalent among lesbian, gay, and bisexual (LGB) individuals. Given that invalidation plays a critical role in the development of BPD, one possible explanation for the increased prevalence of BPD among sexual minorities is due to high levels of invalidation. One particularly salient risk factor for invalidation and psychopathology among sexual minorities may be gender nonconformity (GNC), which is associated with various forms of invalidation and negative psychological outcomes. In this study, I aimed to provide preliminary insights into the relations among these constructs in a cross-sectional sample of LGB individuals. Childhood gender nonconformity (CGN) was associated with paternal and maternal invalidation, adverse childhood experiences, and BPD features in men but was only associated with paternal invalidation in women. Further, composite invalidation was indirectly associated with BPD features through CGN for men but not women. Although cross-sectional, these results are consistent with the interpretation that for men, CGN may serve as an impetus for invalidation, which increases risk for BPD features. Future researchers should examine these constructs in heterosexual and clinical samples, as well as longitudinally to establish temporal order of the associations.

Committee: Jennifer Cheavens PhD (Advisor); Kristen Carpenter PhD (Committee Member); Daniel Strunk PhD (Committee Member) Subjects: Clinical Psychology; Psychology

Master of Arts in Psychology, Cleveland State University, 2019, College of Sciences and Health Professions

Borderline Personality Disorder (BPD) is associated with emotion dysregulation, reflected by frequent use of maladaptive responses and infrequent use of adaptive responses. However, studies on emotion regulation (ER) use and BPD have primarily employed survey methodology and it's unclear whether these responses are deployed in daily life. Further, it is unclear if there are differences in the effectiveness of various ER responses among individuals with elevated BPD symptoms. Therefore, this study examined whether BPD symptoms predict increased use of maladaptive strategies, including rumination, suppression, and substance use, and decreased use of adaptive strategies, distraction and problem solving, in daily life. Finally, we explored the effect that BPD symptoms have on ratings of perceived effectiveness of a given ER strategy. Participants were undergraduate students and community adults (N=145) who completed measures of BPD features, demographic information, and a 7-day Ecological Momentary Assessment (EMA) protocol that measured the frequency of ER strategies and the perceived effectiveness of those strategies during peak times of distress in daily life. Results indicate that elevated BPD symptoms predict increased use of rumination and substance use, decreased use of problem solving, and increased perceived effectiveness of rumination and problem solving.

Committee: Ilya Yaroslavsky Ph.D. (Committee Chair); Elizabeth Goncy Ph.D. (Committee Member); Christopher France Ph.D. (Committee Member) Subjects: Psychology

Doctor of Philosophy, The Ohio State University, 2019, Psychology

One of the leading theories of Borderline Personality Disorder (BPD), Linehan's (1993) biosocial theory, posits that the problems associated with BPD (i.e., emotion dysregulation, poor interpersonal relationships, low distress tolerance) result, in part, from coping skills deficits. However, limited empirical evidence has been conducted to demonstrate the existence of or characterize the specific types of skill deficits in BPD. Previous researchers have examined the frequency with which people use both adaptive and maladaptive emotion regulation strategies but, to date, there are no examinations of the quality of relevant skills among those with BPD. I developed a measure of coping skill quality (Dialectical Behavior Therapy – Ways of Responding Scale; DBT-WOR) that describes hypothetical stressful situations relevant to three domains of DBT skills (i.e., Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness) and asked participants to provide free response descriptions of how they would handle each situation. I tested this measure across two studies. In Study 1, I recruited 272 participants from a web-based platform (i.e., Amazon's MTurk) who were oversampled for those elevated on BPD features and/or Major Depressive Disorder (MDD) symptoms. In Study 2, I recruited 90 participants in three groups: 30 healthy controls, 30 participants with MDD, and 30 participants with BPD, as assessed by an in-person structured diagnostic interview. Participants in both studies completed measures of DBT skill use frequency, DBT skill quality, general coping skill quality, and maladaptive response frequency to determine a) whether people with BPD demonstrated any skills deficits and b) whether these skills deficits were unique to BPD or general deficits associated with psychopathology/mood disorders. I found evidence that the DBT-WOR could be reliably rated by trained teams of undergraduate coders. When meta-analyzed across both studies, the results indicated that peop (open full item for complete abstract)

Committee: Jennifer Cheavens PhD (Advisor); Daniel Strunk PhD (Committee Member); Robert Cudeck PhD (Committee Member) Subjects: Clinical Psychology

Master of Arts in Psychology, Cleveland State University, 2018, College of Sciences and Health Professions

This study examined whether Borderline Personality Disorder (BPD) features predict increased rumination in response to interpersonal contexts, leading to increased negative affect (NA) outcomes across self-report, experimental, and daily life settings. As BPD is characterized by sustained NA, emotion dysregulation, and pervasive difficulties in interpersonal relationships, interpersonal contexts may present a specific liability for individuals with BPD to ruminate, and subsequently, experience enduring NA. Undergraduate participants (N=119) completed measures of BPD features, dispositional rumination, emotion dysregulation, and both 1) a laboratory protocol that measured spontaneous rumination and affective reactivity to non-interpersonal (sad film clip) and interpersonal (Cyberball) stimuli and 2) a 7-day Ecological Momentary Assessment (EMA) that measured hourly peak NA, deployment of rumination at time of peak NA, interpersonal context at peak NA, and immediate NA relative to the EMA prompt. Multiple mediation models and general linear models were fit to examine study hypotheses. Results suggest differences in the relationships at trait level compared to state and momentary levels, wherein BPD predicts trait rumination and emotion dysregulation only. However, findings support that interpersonal contexts produce increased rumination that, in turn, may sustain negative affective states. Results suggest the need to include interpersonal considerations as a context for understanding ruminative cycles and affective outcomes.

Committee: Ilya Yaroslavsky Ph.D. (Committee Chair); Elizabeth Goncy Ph.D. (Committee Member); Christopher France Psy.D. (Committee Member); Eric Allard Ph.D. (Committee Member) Subjects: Psychology

Master of Arts in Psychology, Cleveland State University, 2017, College of Sciences and Health Professions

The present study explored the role of parental physiological state and parental emotion regulation (ER) deficits on the relationship between parent borderline personality disorder (BPD) symptoms and child BPD symptoms. Participants were 110 adolescents aged 11-13 years and their legal guardians who completed measures of BPD symptom severity and emotion dysregulation before engaging in an interpersonal conflict discussion task while being monitored for peripheral psychophysiological signals (i.e., respiratory sinus arrhythmia; RSA). Multiple mediation analyses were conducted to examine the model proposed in this study. The results revealed that parent BPD symptoms predicted lower parent baseline RSA at trend level, but was not predictive of RSA reactivity. Parent RSA did not predict parent ER deficits or child BPD symptoms. However, parental BPD symptoms predict increased parent ER deficits which, in turn, predict greater child BPD symptoms. These findings suggest that the transmission of BPD from parent to child may be in part due to the ER strategies at use during parenting and not merely the existence of the disorder itself.

Committee: Ilya Yaroslavsky PhD (Committee Chair); Amir Poreh PhD (Committee Member); Christopher France PsyD (Committee Member) Subjects: Psychology