Borderline Personality Disorder and Eating Disorders: Investigating the Role of Emotion Regulation

Samantha C. Dashineau, MS; Caroline E. Balling, MS; Susan C. South, PhD; Mark Zimmerman, MD

J Clin Psychiatry 2024;85(3):23m15152

Abstract

Objective: Borderline personality disorder (BPD) and eating disorders (EDs) both cause significant distress and co-occur at rates higher than expected, signifying potential overlapping regulatory mechanisms between both disorders. More specifically, both disorders involve emotion regulation deficits, suggesting they may share specific maladaptive regulatory components. The present study sought to examine the predictive role of emotion dysregulation within the comorbidity between EDs and BPD.

Methods: A sample of psychiatric outpatients (N = 872) collected from a longitudinal study spanning the mid-1990s to 2015 completed the Structured Clinical Interview for DSM-IV for Axis I Disorders as well as a measure of emotion regulation strategies, the Difficulties in Emotion Regulation Scale, in order to assess overall functioning.

Results: In a regression analysis, BPD was significantly predicted by emotion regulation deficits and was strongly related to categories of emotion dysregulation. EDs were not significantly predicted by emotion regulation deficits but did predict BPD diagnoses (B = −0.14, P < .001). Overall, BPD demonstrated strong relationships to emotion regulation deficits.

Conclusions: Results indicate that targeted treatment focusing on emotion regulation deficits may be particularly indicated with co-occurring BPD and ED diagnoses.

J Clin Psychiatry 2024;85(3):23m15152

Author affiliations are listed at the end of this article.

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