The mediating effect of difficulties in emotion regulation on the association between childhood maltreatment and borderline personality disorder

• Published in: European journal of psychotraumatology Vol. 12; no. 1; p. 1934300
• Main Authors: Schaich, Anja, Assmann, Nele, Köhne, Sandra, Alvarez-Fischer, Daniel, Borgwardt, Stefan, Schweiger, Ulrich, Klein, Jan Philipp, Faßbinder, Eva
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01-01-2021; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Abuso emocional; Adult; Adult Survivors of Child Abuse - statistics & numerical data; Basic; Borderline personality disorder; Borderline Personality Disorder - epidemiology; Child; childhood maltreatment; Control de impulsos; Depressive Disorder, Major - epidemiology; emotion regulation; Emotional abuse; Emotional regulation; Emotional Regulation - physiology; Emotions; Humans; impulse control; Impulsive Behavior - physiology; major depressive disorder; Maltrato infantil; Personality disorders; Regulación emocional; Surveys and Questionnaires - statistics & numerical data; Trastorno depresivo mayor; Trastorno límite de personalidad; 冲动控制; 情绪滥用; 情绪调节; 童年期虐待; 边缘性人格障碍; 重性抑郁障碍; 冲动控制; emotional abuse; 重性抑郁障碍; Abuso emocional; 边缘性人格障碍; childhood maltreatment; Trastorno depresivo mayor; Regulación emocional; 情绪滥用; 情绪调节; emotion regulation; impulse control; major depressive disorder; 童年期虐待; Trastorno límite de personalidad; Control de impulsos; Maltrato infantil; Borderline personality disorder
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2021.1934300

Background: Childhood maltreatment and difficulties in emotion regulation are common in patients with Borderline Personality Disorder (BPD) and Depressive Disorders (DD).
Objective: This study examines differences between patients with BPD and patients with DD, regarding childhood maltreatment and difficulties in emotion regulation as well as the mediating effect of different aspects of emotion regulation deficits on the association between childhood maltreatment and BPD-symptoms.
Method: A total of 305 participants, 177 with BPD and 128 with DD completed an assessment including the Childhood Trauma Questionnaire (CTQ), the Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the Structured Clinical Interview for DSM-IV (SCID). Data was analyzed using multiple analyses of variances and mediation analyses.
Results: Patients with BPD reported more childhood maltreatment and more difficulties in emotion regulation than patients with DD. When general symptom severity, age, and gender were included in the analysis as covariates only group differences regarding 'impulse control difficulties' (F(1,299) = 38.97, p < .001, η
p
2
= .115), 'limited access to emotion regulation strategies' (F(1,299) = 4.66, p = .032, η
p
2
= .015), and 'lack of emotional clarity' (F(1,299) = 9.38, p = .002, η
p
2
= .030) remained statistically significant. A mediation analysis, including above-mentioned covariates, indicated an association between emotional abuse and BPD-symptoms, which was mediated by difficulties in emotion regulation (indirect effect B = .012, 95% CI [.001; .031], R
2
= .429). Subscale analyses revealed 'impulse control difficulties' as the aspect of difficulties in emotion regulation that has the greatest impact on this association (B = .021, 95% CI [.003; .045]).
Conclusions: Patients with BPD display more childhood maltreatment and difficulties in emotion regulation than patients with DD. Difficulties in emotion regulation, especially difficulties in impulse control, seem to play an important role in the association between childhood emotional abuse and BPD-symptoms.
Patients with BPD report more childhood maltreatment and more emotion regulation difficulties than patients with DD and difficulties in emotion regulation, specifically impulse control, play an important role in the association between childhood emotional abuse and BPD symptoms.