Borderline personality disorder traits and affect reactivity to positive affect induction followed by a stressor

BACKGROUND AND OBJECTIVES: Affective hyperreactivity is a core feature of Borderline Personality Disorder (BPD), yet little is known about reactivity of positive affect (PA). Objectives were to explore the relationship between BPD traits and affect reactivity in response to a personalized PA-induction and a subsequent stressor. Patient status (seeking outpatient treatment for personality-related problems; yes/no), depressive symptoms, and age were examined as alternative predictors of affect reactivity.

METHODS: One hundred and eight females (35 patients) reported on their BPD and depressive symptoms. They completed the Best Possible Self-exercise and a modified Trier Social Stress Task. Trajectories of high and low arousal PA (HAP and LAP) and negative affect (NA) were analyzed with mixed regression modelling.

RESULTS: Patient status (for HAP) and depressive symptoms (for LAP and NA) predicted affect reactivity better than BPD traits. Patients showed a weaker HAP increase after PA-induction, and a similar HAP decrease after the stressor, compared to non-patients. Higher depressive symptoms predicted stronger improvement of LAP and NA after PA-induction, and less pronounced deterioration of LAP and NA after the stressor, relative to baseline.

LIMITATIONS: The sample was a convenience sample amplified with outpatients. Future research should (1) use clinical groups, (2) randomize to neutral vs. PA-induction, and (3) continue to differentiate between HAP and LAP.

CONCLUSIONS: Our results do not support models postulating BPD-specific affective hyperreactivity. HAP and LAP have different trajectories, depending on the degree of psychopathology. The resilience-enhancing potential of a PA-focus in psychotherapy needs further research.