Philip S. Santangelo

• Doctor of Philosophy
• Professor (Associate) at Luxembourg University

Objective Longitudinal and cross‐sectional studies suggest that affective instability is inversely related to greater age in borderline personality disorder (BPD). However, existing studies relied on retrospective self‐reports of perceived instability. We examined affective instability in everyday life in patients with BPD and healthy controls (HCs...

Dysfunctional behaviors are conceptualized as maladaptive affective coping attempts in borderline personality disorder (BPD). The recent benefits-and-barriers model extended the affective function assumption by adding self-esteem as a barrier to engaging in dysfunctional behaviors. Patients with BPD ( N = 119) carried e-diaries to report their curr...

Borderline personality disorder (BPD) is commonly characterized by pervasive instability. Affective instability, despite being a diagnostic criterion in the DSM-5, is commonly seen as a transdiagnostic feature, but recent studies have brought new attention to the importance of self-esteem instability as a potential defining feature of BPD. However,...

Background Universal Mental Health Training for Frontline Professionals (UMHT) is an educational programme developed and piloted in Ukraine in 2021-2023. The UMHT trains frontline professionals (FLPs) to interact with, support, and refer individuals with mental health conditions for professional help. Methods To assess the UMHT feasibility in four...

Ambulatory Assessment (AA) studies have proliferated in mental health science, promising unparalleled insights into the dynamic nature of mental health. The high methodological heterogeneity of AA studies calls for the harmonization of approaches and the establishment of research standards. This expert consensus provides an overview of best-practic...

The aim of this study was to assess emotional dysregulation (ED) and sexual risk behavior (SRB) in borderline personality disorder (BPD) and to investigate the relationship between ED, SRB and other clinical variables. Sixty-one women with BPD and 76 healthy controls (HCs) completed: SRB Scale, DERS, Inventory of Statements About Self-Injury, SUPPS...

Background Universal Mental Health Training for Frontline Professionals (UMHT) is an educational programme developed and piloted in Ukraine in 2021-2023. The UMHT trains frontline professionals (FLPs) to interact with, support, and refer individuals with mental health conditions for professional help. Methods To assess the UMHT feasibility in four...

Background Nonsuicidal self-injury (NSSI) is highly prevalent in adolescents and young adults worldwide. It is linked to a broad variety of mental disorders and an increased suicide risk. Despite its high prevalence, research on the underlying mechanisms and on potential risk and resilience factors for maintaining or quitting NSSI remains scarce. T...

Background Non-suicidal self-injury (NSSI) is of high clinical relevance due to its high prevalence and negative long-term implications. In 2016, the German consensus-based clinical guidelines for diagnostic, assessment and treatment of NSSI in childhood and adolescence were published. However, research indicates that clinical guidelines are often...

Background Universal Mental Health Training for Frontline Professionals (UMHT) is an educational programme developed and piloted in Ukraine in 2021-2023 to bridge the mental health treatment gap. The UMHT trains frontline professionals (FLPs) to interact with, support, and refer individuals with mental health conditions for professional help. Metho...

In the last two decades, e-diary studies have gained increasing interest, with a dominant focus on mood and affect. Although requested in current guidelines, psychometric properties are rarely reported, and methodological investigations of factor structure, model fit, and the reliability of mood and affect assessment are limited. We used a seven-da...

Longitudinal models suited for the analysis of panel data, such as cross-lagged panel or autoregressive latent-state trait models, assume population homogeneity with respect to the temporal dynamics of the variables under investigation. This assumption is likely to be too restrictive in a myriad of research areas. We propose an extension of autoreg...

Our everyday lives, which are largely shaped in particular settings, are being increasingly affected by technological innovations. For example, work processes and organisational structures are becoming increasingly digital, which creates new health opportunities but also poses risks. From the perspective of science, practice and politics, this book...

Altered emotion dynamics and emotion regulation (ER) have been indicated in theoretical descriptions of abnormal emotional functioning, which contributes to the development and maintenance of anorexia nervosa (AN). Ecological momentary assessment (EMA) has recently become popular in research on eating disorders. It is a source of new insights into...

Persistent, interpersonal difficulties are a core feature of borderline personality disorder (BPD). Theories propose that these may result from an insufficient object constancy, for example, the insufficient capacity to maintain feelings of closeness (FC) toward a person when he or she is absent. Based on this assumption, this study examined whethe...

Academic stress is associated with a wide range of adverse outcomes, including detrimental effects on mental health, achievement, and well-being. Numerous studies have shown an association between the cortisol awakening response (CAR) and various health and risk factors. Some studies revealed a protective function of the CAR as a stress buffer prev...

Study Objectives Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results. Methods We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a gro...

Background Inefficient mechanisms of emotional regulation appear essential in understanding the development and maintenance of binge-eating disorder (BED). Previous research focused mainly on a very limited emotion regulation strategies in BED, such as rumination, suppression, and positive reappraisal. Therefore, the aim of the study was to assess...

Non-suicidal self-injury (NSSI) is a considerable health problem among adolescents. Affect regulation by means of self-injury may promote the maintenance of NSSI. However, existing findings have limited ecological validity. The present study aimed to assess emotional and interpersonal states preceding and following incidents of NSSI in female adole...

Background Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affectiv...

Background: Digital phenotyping promises to unobtrusively obtaining a continuous and objective input of symptomatology from patients’ daily lives. The prime example are bipolar disorders, as smartphone parameters directly reflect bipolar symptomatology. Empirical studies, however, have yielded inconsistent findings. We believe that three main short...

Objective Academic examinations are a frequent and significant source of student stress, but multimodal, psychophysiological studies are still missing. Participants & methods: Psychological and physiological variables were assessed on 154 undergraduate students in daily life using e-diaries resp. blood pressure devices at the beginning of the semes...

Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic...

Background: Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affecti...

Background: Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. According to prior findings and clinical theories, self-esteem instability and affective instability are key features of BPD. Previous e-diary studies showed that instability in self-esteem is heightened and that it is highly intertwined with affecti...

Early experiences of childhood sexual or physical abuse are often associated with functional impairments, reduced well-being and interpersonal problems in adulthood. Prior studies have addressed whether the traumatic experience itself or adult psychopathology is linked to these limitations. To approach this question, individuals with posttraumatic...

Borderline personality disorder (BPD) is characterized by more frequent and more intense negative emotions and less frequent positive emotions in daily life than healthy controls (HC) experience, but there is limited empirical evidence regarding whether this is a transdiagnostic or disorder-specific finding and which specific emotions are especiall...

Real-time functional magnetic resonance imaging (fMRI) neurofeedback training of amygdala hemodynamic activity directly targets a neurobiological mechanism, which contributes to emotion regulation problems in borderline personality disorder (BPD). However, it remains unknown which outcome measures can assess changes in emotion regulation and affect...

Real-time functional magnetic resonance imaging neurofeedback training of amygdala hemodynamic activity directly targets a neurobiological mechanism, which contributes to emotion regulation problems in borderline personality disorder (BPD). However, it remains unknown which outcome measures are suited to assess changes in emotion regulation and aff...

Popular descriptions of studying frequency show remarkable discrepancies: students complain about their workload, and alumni describe freedom and pleasure. Unfortunately, empirical evidence on student time use is sparse. To investigate time use and reveal contributing psychological factors, we conducted an e-diary study. One hundred fifty-four stud...

With great interest, we read the recently published review on emotion regulation in binge eating disorder (BED) by Dingemans et al. [1].[...].

Background Patients with borderline personality disorder (BPD) exhibit dysregulated emotion sequences in daily life compared to healthy controls (HC). Empirical evidence regarding the specificity of these findings is currently lacking. Methods To replicate dysregulated emotion sequences in patients with BPD and to investigate the specificity of th...

Background: Ambulatory assessment (AA) is increasingly recommended for assessing symptoms of posttraumatic stress disorder (PTSD). Previous AA studies provided new insights into the phenomenology of trauma-related memories, but also divergent findings. Notably, the range of trauma-related memories (a major target of psychotherapeutic interventions)...

Borderline personality disorder (BPD) is defined by a pervasive pattern of instability. Although there is ample empirical evidence that unstable self-esteem is associated with a myriad of BPD-like symptoms, self-esteem instability and its temporal dynamics have received little empirical attention in patients with BPD. Even worse, the temporal inter...

Einleitung: Affektive und interpersonelle Instabilität gelten als zentrale Charakteristika der Borderline-Persönlichkeitsstörung (BPS) und als bedeutende Mechanismen im Kontext nicht-suizidal selbst-verletzenden Verhaltens (NSSV). Im Vergleich zu klassischen, psychometrischen Methoden der Fragebogenerhebung, ermöglicht Ecological Momentary Assessme...

In longitudinal studies with short time lags, classical models of latent state-trait (LST) theory that assume no carry-over effects between neighboring occasions of measurement are often inappropriate, and have to be extended by including autoregressive effects. The way in which autoregressive effects should be defined in LST models is still an ope...

Affective and interpersonal instability, both core features of Borderline Personality Disorder (BPD), have been suggested to underlie non-suicidal self-injury (NSSI). Ecological momentary assessment (EMA) is the method of choice when investigating dynamic processes. Previously no study addressed affective and interpersonal instability in daily life...

Background Affective dysregulation is widely regarded as being the core problem in patients with borderline personality disorder (BPD). Moreover, BPD is the disorder mainly associated with affective dysregulation. However, the empirical confirmation of the specificity of affective dysregulation for BPD is still pending. We used a validated approach...

Affective instability is widely regarded as being the core problem in patients with borderline personality disorder (BPD) and the driving force behind the severe clinical manifestations of BPD symptoms. In ICD-10, BPD is even labelled as emotionally unstable personality disorder. In the last years, the advent of electronic diaries, in combination w...

In an attempt to better understand the nature of emotion dysregulation in the daily lives of persons with a borderline personality disorder (BPD), Houben et al. (2016) recently identified emotional switching, which refers to the tendency to make large changes between positive and negative emotional states over time, as a possible defining character...

In ambulatory assessment, psychologists apply experience sampling methods (ESM) on mobile devices to assess self-reports from subjects. One major challenge is to support domain experts to create ESM apps themselves without prior programming knowledge. When running ESM apps, subjects are prompted to answer self-reports time-triggered at fixed points...

The experience sampling method (ESM) is applied in ambulatory assessment to prompt subject self-reporting. Existing mobile apps provide time-triggered prompts but lack event-triggers. Hence, the sampling might not occur in moments that are of interest for a psychologist. To identify relevant sensor sources and contexts we conducted an online survey...

We present MoA², a context-aware smartphone app for the ambulatory assessment of mood, tiredness and stress level. In principle, it has two features: (1) mood assessment and (2) mood recognition. The mood assessment system combines benefits of state of the art approaches. The mood recognition is concluded by smartphone-based wearable sensing. In a...

In ambulatory assessment, subjects are monitored in everyday life. Though, it is diffcult to unobtrusively assess information - e.g. about their context and affective state - which results in an increased burden for the subjects. This burden is caused by a complex self-report that they need to provide or by additional wearables that need to be carr...

Although emotion dysregulation has consistently been conceptualized as a core problem of borderline personality disorder (BPD), a comprehensive, and empirically and ecologically validated model that captures the exact types of dysregulation remains absent. In the present article, we combine insights from basic affective science and the biosocial th...

Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affec...

Die Symptomatik einer Depression ist durch reduzierte emotionale Schwingungsfähigkeit, negative Kognitionen, sozialen Rückzug und negatives Selbstwerterleben charakterisiert. Es wird eine erhöhte Reaktivität auf negative Stimuli (negative potentiation) bzw. eine reduzierte Sensitivität auf den emotionalen Kontext (emotion context insensitivity) ang...

To continue to move the science of clinical psychology forward, this handbook brings together some of the field's foremost experts to explicate the essential research strategies currently used across the modern clinical psychology landscape that maximize both precision and significance. This volume addresses design, measurement, and analytic strate...

The Experience Sampling Method (ESM) can improve our understanding of how psychopathological symptoms unfold over time in everyday life. We discuss major benefits of ESM by presenting selected studies involving (a) real-time assessment (i.e., assessments focusing on individuals' momentary states, experiences, or behaviors); (b) real-world assessmen...

The use of Ecological Momentary Assessment (EMA) has led to increased insight into borderline personality disorder (BPD) symptoms, especially regarding affective instability. EMA is characterized by a series of repeated assessments of current affective, behavioral, and contextual experiences or physiological processes while participants engage in n...

Over the past two decades, a growing body of research in Borderline Personality Disorder (BPD) has been accumulated using computer-assisted infield methods to assess self-report data, physiological data as well as environmental aspects of BPD patients in everyday life situations. In psychological and psychiatric research, the assessment method unit...