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Borderline Personality Features: Instability of Self–Esteem and Affect

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On the basis of clinical literature pertaining to borderline personality disorder, it was hypothesized that individuals with borderline personality features would show evidence of self–esteem and affective instability. In addition to this instability, it was hypothesized that these individuals would show evidence of stronger reac-tions to daily interpersonal stress (i.e., lability). These hypotheses were examined through the employment of an experience–sampling design. The present findings suggest that individuals with borderline personality features possess unstable low self–esteem as well as negative affect that is high and unstable. Individuals with borderline personality features were also found to possess self–esteem and feelings of rejection that were labile in response to daily interpersonal stress. The purpose of the present study was to examine whether features of borderline personality disorder (BPD) were associated with self–esteem and affective instability. BPD is characterized by a "pervasive pattern of instability" (American Psychiatric Association, 1994, p. 654) that is evi-dent in three primary areas: self–image, affect, and interpersonal rela-tionships. First, BPD is believed to be associated with dramatic shifts in feelings of self–worth. However, the link between BPD and unstable self–esteem has not been demonstrated empirically despite its theoreti-cal and diagnostic importance. Second, BPD has been shown to predict a highly negative baseline mood (Trull, 2001; Trull, Sher, Minks–Brown, Durbin, & Burr, 2000) as well as affective instability (Cowdry, Gardner, O'Leary, Leibenluft, & Rubinow, 1991; Henry et al., 2001; Koenigsberg et al., 2002; Stein, 1995, 1996). Third, BPD has been found to be associated with significant interpersonal problems and relationships characterized by sudden shifts between the idealization and devaluation of others as 668
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ZEIGLER–HILL AND ABRAHAMBORDERLINE PERSONALITY FEATURES
BORDERLINE PERSONALITY FEATURES:
INSTABILITY OF SELF–ESTEEM AND AFFECT
VIRGIL ZEIGLER–HILL AND JENNIFER ABRAHAM
University of Southern Mississippi
On the basis of clinical literature pertaining to borderline personality disorder, it
was hypothesized that individuals with borderline personality features wouldshow
evidence of self–esteem and affective instability. In addition to this instability, it
was hypothesized that these individuals would show evidence of stronger reac
-
tions to daily interpersonal stress (i.e., lability). These hypotheses were examined
through the employment of an experience–sampling design. The present findings
suggest that individuals with borderline personality features possess unstable low
self–esteem as well as negative affect that is high and unstable. Individuals with
borderline personality features were also found to possess self–esteem and feelings
of rejection that were labile in response to daily interpersonal stress.
The purpose of the present study was to examine whether features of
borderline personality disorder (BPD) were associated with self–esteem
and affective instability. BPD is characterized by a “pervasive pattern of
instability” (American Psychiatric Association, 1994, p. 654) that is evi
-
dent in three primary areas: self–image, affect, and interpersonal rela
-
tionships. First, BPD is believed to be associated with dramatic shifts in
feelings of self–worth. However, the link between BPD and unstable
self–esteem has not been demonstrated empirically despite its theoreti
-
cal and diagnostic importance. Second, BPD has been shown to predict a
highly negative baseline mood (Trull, 2001; Trull, Sher, Minks–Brown,
Durbin, & Burr, 2000) as well as affective instability (Cowdry, Gardner,
O’Leary, Leibenluft, & Rubinow, 1991; Henryetal., 2001; Koenigsberg et
al., 2002; Stein, 1995, 1996). Third, BPD has been found to be associated
with significant interpersonal problems and relationships characterized
by sudden shifts between the idealization and devaluation of others as
668
Journal of Social and Clinical Psychology, Vol. 25, No. 6, 2006, pp. 668-687
Correspondence concerning this article should be addressed to Virgil Zeigler–Hill, De
-
partment of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406.
E–mail: virgil@usm.edu.
individuals frantically strive to avoid either real or imagined
abandonment (e.g., Jovev & Jackson, 2004).
The instability that characterizes BPD may explain the frequent diffi
-
culties in occupational, social, and academic areas that often accompany
this diagnosis (Perry & Klerman, 1980; Skodol et al., 2002; Zweig–Frank
& Paris, 2002). Although clinical samples have often been used to docu
-
ment the various dysfunctions associated with BPD, it is also important
to examine individuals with borderline personality features—individu
-
als who possess a number of the characteristics associated with BPD but
may not necessarily meet the full diagnostic criteria. One reason that it
may be important to examine borderline personality features in
nonclinical samples is that personality disorders may be best conceptu
-
alized as continua rather than as discrete categorical diagnoses
(Widiger, 1992). If personality disorders are viewed as continua, then in
-
dividuals in the general population may possess differing levels of the
features that characterize these disorders. Previous research has shown
that borderline personality features are related to dysfunctions in a vari-
ety of areas within nonclinical samples. For example, borderline person-
ality features have been shown to be associated with poor academic
achievement and social maladjustment (Bagge et al., 2004), higher levels
of interpersonal distress (Trull, 1995), and violence among prisoners
(Raine, 1993). In addition, borderline personality features have been
shown to be predictive of future interpersonal distress (Daley, Burge, &
Hammen, 2000; Trull, Useda, Conforti, & Doan, 1997).
Despite the clear consensus that individuals with borderline personal-
ity features should experience greater self–esteem and affective lability
in response to their experiences, there is very little direct evidence in
support of this contention. For example, Tolpin, Gunthert, Cohen, and
O’Neill (2004) directly examined whether individuals with borderline
personality features have stronger self–esteem and affective reactions to
daily interpersonal stressors by using an experience–sampling ap
-
proach. Although individuals with borderline personality features re
-
ported experiencing more interpersonal stressors, these individuals did
not show evidence of the self–esteem and affective lability believed to
characterize those with borderline personality features. However, the
failure to find the expected self–esteem and affective lability may have
been due to the objective checklist measure of daily interpersonal stress
-
ors employed in the study. The assumption underlying objective mea
-
sures of stressors is that it is the event itself that leads to the consequence
of interest (e.g., changes in self–esteem or affect). This is in contrast to
views of stress that emphasize the importance of appraising events in
terms of available coping resources (Lazarus & Folkman, 1984). From
this perspective, stress occurs only when a situation is perceived as
BORDERLINE PERSONALITY FEATURES 669
threatening and the individual believes that insufficient resources are
available to cope with the situation. The importance of cognitive ap
-
praisals suggests that even though an individual may experience many
seemingly negative eventson a particular day, these eventsmay not lead
to changes in self–esteem or affect if the individual does not perceive
these events as stressful. Consequently, the hypothesized self–esteem
and affective lability of individuals with borderline personality features
may only emerge when their subjective experiences of stressful events
are measured.
The present study examined two basic hypotheses. The first hypothe
-
sis was that borderline personality features would be associated with
self–esteem and affective instability. That is, individuals with high lev
-
els of borderline personality features will experience more fluctuations
in their state self–esteem and affect over time than individuals with low
levels of borderline personality features. Further, it is possible that the
instability that characterizes the experiences of those with borderline
personality features may be tied to their perceptions of events in their
lives (e.g., Kernberg, 1975). However, instability, as defined in the pres-
ent study, does not account for the covariation of self–esteem and affect
with perceptions of daily events (i.e., self–esteem and affective lability).
In the present research, lability is assumed to be a specific instance of in-
stability such that changes in self–esteem and affect are directly linked to
daily experiences that occur in the individual’s life (Barnett & Gotlib,
1988; Butler, Hokanson, & Flynn, 1994). Thus, the second hypothesis
was that individuals with high levels of borderline personality features
would be more labile in response to the perceived importance of positive
and negative interpersonal events than individuals with low levels of
borderline personality features. That is, it was predicted that individuals
with high levels of borderline personality features would experience
greater changes in their self–esteem and affect following interpersonal
events than individuals with low levels of borderline personality fea
-
tures. Interpersonal events were chosen because individuals with
borderline personality features should be especially sensitive to these
events given the theoretical importance of negative relationships and
fears of abandonment for BPD.
The present study makes use of experience–sampling, which allows
for the documentation of thoughts, feelings, and behaviors within an in
-
dividual’s everyday life rather than within a laboratory context. By re
-
porting their experiences each day, systematic recall biases are mini
-
mized in participants because their experiences are reported much
closer in time to the actual experience rather than being averaged across
a much longer period of time (Tennen & Affleck, 2002). Another impor
-
tant advantage of experience–sampling is that the temporal covariation
670 ZEIGLER–HILL AND ABRAHAM
of internal states can be examined (Larsen, Billings, & Cutler, 1996;
Larsen & Kasimatis, 1990; Tennen, Suls, & Affleck, 1991). In the present
study, experience–sampling makes it possible to examine the extent to
which state self–esteem, affect, and feelings of rejection are associated
with interpersonal stress.
METHOD
PARTICIPANTS
Participants were 156 undergraduates (50 men and 106 women) en
-
rolled in introductory psychology courses who participated in return for
partial fulfillment of a research participation requirement. The mean age
of participants was 19.04 years (SD = 2.07). The racial/ethnic composi
-
tion of the sample was 79% White, 5% Black, 5% Hispanic, 4% Asian, 4%
Native American, and 3% Other.
MEASURES
Borderline Personality Features. The Borderline Features Scale of the
Personality Assessment Inventory (PAI–BOR; Morey, 1991) is a 24–item
scale that measures four commonly agreed upon components of border-
line personality functioning: affective instability, identity problems,
negative relationships, and self–harm. Responses were made on scales
ranging from 0 (false, not at all true) to 3 (very true). The PAI–BOR has
been shown to possess strong psychometric properties (Kurtz, Morey, &
Tomarken, 1993; Morey, 1991; Morey & Glutting, 1994; Trull, 1995). For
the present study, the internal consistency of this measure was high, α =
.87.
Self–Esteem Level. Participants completed the Rosenberg Self–Esteem
Scale (RSES; Rosenberg, 1965), a well–validated measure of explicit
self–esteem (Blaskovich & Tomaka, 1991; Demo, 1985). Participants
were instructed to complete the scale according to how they typically or
generally feel about themselves. Responses were made on scales rang
-
ing from 1 (strongly disagree) to 5 (strongly agree). For the present
study, the internal consistency of this measure was high, α = .85.
State Self–Esteem and Self–Esteem Instability. Participants were asked
to complete modified versions of the RSES to assess state self–esteem.
The RSES was modified so that participants were instructed to give the
response that best reflected how they felt at the moment they completed
the form. Responses were made on scales ranging from 1 (strongly dis
-
agree) to 10 (strongly agree). For the present study, the internal consis
-
tency of state self–esteem (averaged across the seven days) was .81. Con
-
BORDERLINE PERSONALITY FEATURES 671
sistent with previous research concerning self–esteem instability (e.g.,
Kernis, Grannemann, & Barclay, 1989), the within–subject standard de
-
viation across the repeated assessments of state self–esteem served as
the index of self–esteem instability such that higher standard deviations
indicated more unstable self–esteem.
Affect Level. Affect level was measured using the Positive and Nega
-
tiveAffect Schedule (PANAS; Watson,Clark, &Tellegen, 1988), which is
a reliable and well–validated self–report measure of affect. The PANAS
consists of scales that measure positive (e.g., interested, enthusiastic,
proud) and negative affect (e.g., distressed, scared, hostile). Participants
were instructed to complete the items according to how they typically or
generally feel. Responses were made on scales ranging from 1 (very
slightly or not at all) to 5 (extremely). For the present sample, the internal
consistencies of these scales were high (.81 and .87 for positive affect and
negative affect, respectively).
State Affect and Affective Instability. Participants were asked to com-
plete a modified version of the PANAS to assess state affect. The PANAS
was modified so that participants were instructed to give the response
that best reflected how they felt at the moment they completed the form.
Responses were made on scales ranging from 1 (very slightly or not at
all) to 5 (extremely). For the present study, the internal consistency of
state affect (averaged across the seven days) was .90 and .88 for state pos-
itive affect and state negative affect, respectively. For each participant,
the within–subject standard deviation across the repeated assessments
of state positive and negative affect served as the indices of affective in-
stability, with higher standard deviations indicating more unstable
affect.
Perceived Rejection. Because of the important role that abandonment
fears and social rejection are believed to play in the etiology and expres
-
sion of BPD (see Kernberg, 1984; Zanarini, Gunderson, Marino,
Schwartz, & Frankenberg, 1989), participants were asked to indicate
their current level of perceived social rejection by indicating their level
of agreement with the statement “At this moment, I feel rejected by oth
-
ers.” Responses were made on scales ranging from 1 (strongly disagree)
to 10 (strongly agree).
Daily Interpersonal Stress. Participants were asked to record their
daily social events each evening using a modified version of the Daily
Events Survey (DES; Butler et al., 1994). The modifications to the DES
employed in the current study were based on those used in previous re
-
search (e.g., Nezlek & Gable, 2001; Nezlek & Plesko, 2003). In the present
study, seven positive social events (e.g., “Had especially good interac
-
tions with friend[s] or acquaintances”) and six negative social events
(e.g., “Was excluded or left out by my group of friends”) were em
-
672 ZEIGLER–HILL AND ABRAHAM
ployed. In addition, two items were included to measure social events
that may not have been captured by the primary items (i.e., “Had other
type of pleasant event [not listed above] with friends, family, or date”
and “Had other type of unpleasant event [not listed above] with friends,
family, or date”). Each evening, participants rated each event using the
following scale: 0 = did not occur, 1 = occurred and not important, 2 = oc
-
curred andsomewhat important, 3 = occurred and pretty important, and
4 = occurred and extremely important. For the present study, the inter
-
nal consistency (averaged across the seven days) was .77 and .83 for pos
-
itive interpersonal events and negative interpersonal events,
respectively.
PROCEDURE
On the first day of the study, participants attended a laboratory session
during which they were informed about the procedure for the study and
completed the initial measures (i.e., demographic characteristics,
PAI–BOR, RSES, and PANAS). Participants were then given the packet
of daily measures (i.e., state RSES, state PANAS, perceived rejection,
and DES) to be completed at 24-hour intervals (at approximately 10pm
each evening) for seven consecutive days. To enhance compliance, par-
ticipants were instructed to return the completed measures to a
designated location every three to four days.
RESULTS
Of the 156 participants who began the study, 33 participants were ex
-
cluded due to failure to complete daily measures for five or more days.
Analyses concerning daily measures were conducted using the 123 re
-
maining participants. In sum, data were collected for 852 days.
DESCRIPTIVE STATISTICS
In the present sample, 14% of the participants reported PAI–BOR scores
greater than or equal to 38 (T scores 70), which is consistent with those
reported previously (e.g., Tolpin et al., 2004; Trull, 1995). Although this
criterion suggests the presence of prominent borderline personality fea
-
tures, it does not necessarily indicate that the individual would meet the
full diagnostic criteria for BPD. Male and female participants did not dif
-
fer in their PAI–BOR scores, t(121) = –.06, ns.
Table 1 presents the means, standard deviations, and intercorrelations
for borderline personality features, self–esteem level, self–esteem insta
-
BORDERLINE PERSONALITY FEATURES 673
674
TABLE 1. Intercorrelations and Descriptive Statistics
Variable 123456 7
1. Borderline Personality Features
2. Self–Esteem Level –.49***
3. Self–Esteem Instability .36*** –.28**
4. Positive Affect Level –.33*** .52*** –.16†
5. Positive Affect Instability .27** –.18* .34*** –.24**
6. Negative Affect Level .58*** –.43*** .28** –.11 .11
7. Negative Affect Instability .47*** –.16† .39*** –.11 .55*** .32***
M
29.03 41.98 3.93 36.63 5.82 21.90 4.51
SD
12.06 5.86 3.58 5.68 3.23 6.92 3.05
Note. N
= 123. †
p
< .10; *
p
< .05;**
p
< .01; ***
p
< .001.
bility, positive affect level, positive affect instability, negative affect
level, and negative affect instability. As in previous research, a negative
correlation emerged between self–esteem level and self–esteem instabil
-
ity, r = –.28, p < .01 (e.g., Greenier et al., 1999; Kernis et al., 1989). Simi
-
larly, positive affect level was negatively correlated with positive affect
instability, r = –.24, p < .01, and negative affect level was positively corre
-
lated with negative affect instability, r = .32, p < .001. Taken together,
these associations suggest those with poor psychological adjustment
(i.e., low self–esteem, low positive affect, or high negative affect) possess
psychological states that are relatively unstable.
BORDERLINE PERSONALITY FEATURES
AND SELF–ESTEEM INSTABILITY
The present analysis examined the association between borderline per
-
sonality features and self–esteem instability by regressing the PAI–BOR
onto measures of self–esteem level and self–esteem instability. For this
hierarchical multiple regression, all predictor variables were centered
for the purpose of testing interactions (Aiken & West, 1991). On Step 1,
the main effect terms for self–esteem level and self–esteem instability
were entered. On Step 2, the interaction of self–esteem level and self–es-
teem instability was entered. The hypothesized main effect of self–es-
teem instability was significant such that individuals with unstable
self–esteem tend to possess higher levels of borderline personality fea-
tures, β = .24, p < .01. In addition, a main effect of self–esteem level
emergedsuch that individuals withhigh levels of borderline personality
features were found to possess lower self–esteem, β = .24, p < .01. How
-
ever, these main effects were qualified by the interaction of self–esteem
level and self–esteem instability that emerged, β = .17, p < .05.
1
Predicted
values for this interaction are shown in Figure 1.
Because the interaction of self–esteem level and self–esteem instability
was significant, the procedures recommended by Aiken and West (1991)
were conducted in order to examine the pattern of this interaction. These
simple slopes tests found that individuals with unstable self–esteem re
-
BORDERLINE PERSONALITY FEATURES 675
1. An additional exploratory analysis was conducted, which included gender in the
model. In this analysis, a three–way interaction (self–esteem level ×self–esteem instability
×gender)emerged,β=.21,p<.05. The predicted valuesforthis analysis suggestthat the as
-
sociation between unstable high self–esteem and borderline personality features may be
more pronounced among men. However, extreme caution should be used when consider
-
ing this result because of the relatively small number of men who possessed unstable high
self–esteem (n = 6).
ported higher levels of borderline personality features than those with
stable self–esteem regardless of whether these individuals possessed
low self–esteem β = .17, p < .05) or high self–esteem β = .43, p < .001). In
addition, individuals with low self–esteem reported higher levels of
borderline personality features among individuals with both stable
self–esteem (β = –.57, p < .001) and unstable self–esteem (β = –.31, p <
.001). Taken together, these results show that individuals with stable
high self–esteem reported the lowest levels of borderline personality
features, whereas individuals with unstable low self–esteem reported
the highest levels of borderline personality features.
BORDERLINE PERSONALITY FEATURES AND POSITIVE AFFECT
INSTABILITY
This analysis examined the association between borderline personality
features and positive affect instability by regressing the PAI–BOR onto
measures of positive affect level and positive affect instability. On Step 1,
the main effect terms for positive affect level and positive affect instabil
-
ity were entered. On Step 2, the interaction of positive affect level and
positive affect instability was entered. Significant main effects emerged
for both positive affect level (β = –.28, p < .001) and positive affect insta
-
676 ZEIGLER–HILL AND ABRAHAM
18
20
22
24
26
28
30
32
34
36
38
Low High
Stable Self-Esteem Unstable Self-Esteem
Borderline Personality
Features
Self-Esteem Level
FIGURE 1. Predicted values for borderline personality features,
illustrating the interaction of self-esteem level and self-esteem instability
at values that are one standard deviation above and below the means.
bility (β = .20, p < .03). These main effects suggest that individuals with
borderline personality features possess positive affect that is generally
low and unstable. The interaction of positive affect level and positive af
-
fect instability did not approach conventional levels of significance, β =
.03, ns.
2
BORDERLINE PERSONALITY FEATURES
AND NEGATIVE AFFECT INSTABILITY
The present analysis examined the association between borderline per
-
sonality features and negative affect instability using the same approach
as the previous analyses. Significant main effects emerged for both nega
-
tive affect level (β = .48, p < .001) and negative affect instability (β = .32, p
< .001). However, these main effects were qualified by the interaction of
negative affect level and negative affect instability that emerged, β =
–.16, p < .03.
3
Predicted values for this interaction are shown in Figure 2.
Simple slopes tests found that individuals with unstable negative affect
reported higher levels of borderline personality features than those with
stable negative affect regardless of whether these individuals possessed
levels of negative affect that were either chronically low β = .49, p < .001)
or high β = .21, p < .02). In addition, individuals with chronically high
levels of negative affect reported higher levels of borderline personality
features than those with low levels of negative affect regardless of
whether their negative affect was stable (β = .63, p < .001) or unstable (β =
.35, p < .001). Taken together, these results show that individuals with
unstable negative affect reported the highest levels of borderline
personality features, whereas individuals with stable low negative
affect reported the lowest levels of borderline personality features.
OVERVIEW OF LABILITY ANALYSES
The present analyses had two goals. The first goal was to examine the
covariation between measures of state psychological adjustment (i.e.,
state self–esteem, state positive affect, state negative affect, and per
-
ceived social rejection) and daily interpersonal stress. The second goal
BORDERLINE PERSONALITY FEATURES 677
2. No additional interactions emerged when gender was included in the model.
3. An additional two–way interaction (negative affect instability × gender) emerged
when gender was included in the model, β = .22, p < .01. The predicted values for this inter
-
action suggest that the highest levels of borderline personality features may be found
among men with unstable negative affect. However, this result should be interpreted cau
-
tiously given the small number of men who reported unstable negative affect (n = 13).
was to examine how within–person relationships between the measures
of state psychological adjustment and daily interpersonal stress varied
as a function of borderline personality features. The daily measures
from the present study comprised a multilevel data structure because
observations at one level of analysis (i.e., days) were nested within an
-
other level of analysis (i.e., individuals). Due to the hierarchical struc
-
ture of the data, a series of multilevel random coefficient models
(MRCMs) using the program HLM (Bryk, Raudenbush, & Congdon,
1998) were employed. These models conceptually involved two steps.
First, a regression equation was estimated for each individual at Level 1
(the within–person level) which yielded intercept and slope coefficients
to index the association between variables at the daily level (e.g., “Does
state self–esteem tend to decrease on days when important negative so
-
cial events occur?”). Second, Level 2 (the between–persons level) exam
-
ined whether the regression slopes obtained from the within–person
level differed across individuals, depending on the level of an individ
-
ual–difference variable (e.g., “Is the tendency to experience lower
self–esteem on days when important negative social events occur
especially strong for individuals with borderline personality
features?”).
678 ZEIGLER–HILL AND ABRAHAM
16
21
26
31
36
41
Low High
Stable Negative Affect Unstable Negative Affect
Borderline Personality
Features
Negative Affect Level
FIGURE 2. Predicted values for borderline personality features,
illustrating the interaction of negative affect level and negative affect instability
at values that are one standard deviation above and below the means.
STATE PSYCHOLOGICAL ADJUSTMENT
AND DAILY INTERPERSONAL STRESS
A two–level MRCM was used to examine within–person relationships
between state psychological adjustment and daily interpersonal stress.
The Level 1 model was as follows:
y
ij
= β
0j
+ β
1j
POSITIVE SOCIAL EVENTS + β
2j
NEGATIVE SOCIAL EVENTS + r
ij
,
in which y is the state psychological adjustment of person j on day i, β
0j
is
a random coefficient representing the intercept for person j, β
1j
is a ran
-
dom coefficient for positive social events, β
2j
is a random coefficient for
negative social events, and r
ij
represents error. The average appraisal of
positive and negative social events varied considerably across persons
and days, such that positive social events were rated more important
than negative social events [(11.98 vs. 4.31, t(122) = 15.74, p < .001)]. To
eliminate the influence of these differences on parameter estimates, ap
-
praisals were group–mean centered, with group being defined as the in-
dividual participant (Raudenbush & Bryk, 2002). Because of this
group–mean centering, coefficients for appraisals describe relationships
between the deviation from each person’s average appraisal of events
and deviations from that person’s average level of state psychological
adjustment. Appraisals of positive and negative social events were
entered together in order to examine their unique associations with state
psychological adjustment.
Within–person relationships between state psychological adjustment
and daily interpersonal stress were examined by analyzing Level 1
(within–person level) coefficients at Level 2 (between–person level) us
-
ing the following model:
Intercept: β
0j
= γ
00
+ u
0j
;
Positive Social Events: β
1j
= γ
10
+ u
1j
;
Negative Social Events: β
2j
= γ
20
+ u
2j
.
In this model, γ
00
represented the average of the within–person inter
-
cepts, and γ
10
and γ
20
represented the average importance of the positive
and negative social events, respectively. All three within–person coeffi
-
cients are modeled as random (i.e., u
0j
,u
1j
, and u
2j
terms are included). As
expected, each measure of state psychological adjustment was associ
-
ated with both positive social events (|γ
10
s| > .05, ps < .001) and negative
social events (|γ
20
s| > .09, ps < .01). Across all participants, state psycho
-
logical adjustment was higher on days when the appraisals of positive
social events were more important and negative social events were less
important.
BORDERLINE PERSONALITY FEATURES 679
BORDERLINE PERSONALITY FEATURES AND DAILY MEASURES
A two–level MRCM was used to examine whether borderline personal
-
ity features were associated with state psychological adjustment and
daily interpersonal stress. These effects were examined at Level 2 by
modeling thevariability ofβ
oj
, thecoefficient from the Level 1 model rep
-
resenting the group mean. This type of analysis is referred to as a means
as outcomes analysis (Bryk & Raudenbush, 1992; Nezlek & Zyzniewski,
1998). To examine whetherthe average scores for state psychological ad
-
justment and daily interpersonal stress were associated with borderline
personality features, the following Level 2 model was used:
β
0j
= γ
00
+ γ
01
(PAI–BOR) + u
0j
.
Borderline personality features were found to be associated with the av
-
erage level of each measure of state psychological adjustment such that
individuals with high levels of borderline personality features tended to
report lower levels of state psychological adjustment, |γ
01
s| > .87, ps <
.01. Borderline personality features were also associated with the impor-
tance of negative social events, γ
01
= 1.65, p < .001, but were unrelated to
the importance of positive social events, γ
01
= .09, ns.
BORDERLINE PERSONALITY FEATURES AS A
MODERATOR OF WITHIN–PERSON RELATIONSHIPS
BETWEEN STATE PSYCHOLOGICAL ADJUSTMENT
AND DAILY INTERPERSONAL STRESS
This analysis examined whether individual differences in borderline
personality features moderated the association between state psycho
-
logical adjustment and daily interpersonal stress. To determine if the
within–person relationships described in the previous analyses varied
as a function of person–level differences in borderline personality fea
-
tures, coefficients from Level 1 were analyzed at Level 2 using a model
such as the following:
β
0j
= γ
00
+ γ
01
(PAI–BOR) + u
0j
;
β
1j
= γ
10
+ γ
11
(PAI–BOR) + u
1j
;
β
2j
= γ
20
+ γ
21
(PAI–BOR) + u
2j
.
In these models, the moderating effect of borderline personality features
was tested by the significance of the γ
11
and γ
21
coefficients (for positive
and negative social events, respectively). These coefficients can be inter
-
preted like standardized regression coefficients because Level 2 vari
-
ables were standardized prior to analysis (Nezlek & Plesko, 2003).
680 ZEIGLER–HILL AND ABRAHAM
Borderline personality features were found to moderate the association
between negative social events and state self–esteem, γ
21
= –.19, p < .03.
To examine the pattern of this cross–level interaction, simple slopes tests
were employed that have been adapted for multilevel models (Curran,
Bauer, & Willoughby, 2004, 2006).These analyses showed that individu
-
als with high levels of borderline features experienced a significant de
-
crease in state self–esteem on days when the importance of their
negative social eventswas high, γ
21
=–.49, p < .001. However, individuals
with low levels of borderline features did not experience a significant
decrease in state self–esteem on days when important negative social
events occurred, γ
21
= –.12, ns. Taken together, these results reveal that
the association between state self–esteem and the importance of nega
-
tive social events is much stronger among individuals with high levels
of borderline features. A complementary effect showing that individu
-
als with high levels of borderline personality features experienced
greater increases in state self–esteem on days with important positive
social events approached conventional levels of significance, γ
11
= .07, p <
.07. It is important to note that these coefficients remained relatively
unchanged when controlling for the present day’s state affect or the
previous day’s state self–esteem.
Borderline personality features also moderated the covariation of per-
ceived rejection with positive social events ?γ
11
= –.03, p < .04) and nega-
tive social events ?γ
21
= .10, p < .001). The predicted values for these re-
sults are shown in Figure 3. Simple slopes tests for these analyses
showed that individuals with high levels of borderline features reported
lower levels of perceived rejection on days when the importance of their
positive social events was high (γ
11
= –.07, p < .001) and higher levels of
perceived rejection on days when the importance of their negative social
events was high (γ
21
= .19, p < .001). Perceived rejection was unrelated to
daily interpersonal stress among individuals with low levels of border
-
line features, |γσ| < .03, ns. Taken together, these results reveal that the
feelings of rejection experienced by individuals with high levels of bor
-
derline personality features are closely tied to daily interpersonal stress.
These coefficients remained relatively unchanged when controlling for
the present day’s state affect, the present day’s state self–esteem, or the
previous day’s feelings of rejection.
Similar analyses were conducted separately for state positive affect
and state negative affect. An effect showing that individuals high in bor
-
derline features reported higher levels of state negative affect on days
with more important negative social events approached conventional
levels of significance, γ
21
= .12, p < .09. No other moderating effects of bor
-
BORDERLINE PERSONALITY FEATURES 681
682
1
2
3
4
5
6
7
Low High
Low Borderline Personality Features
High Borderline Personality Features
Perceived Rejection
Importance of Negative Social Events
1
2
3
4
5
6
7
Low High
Low Borderline Personality Features
High Borderline Personality Features
Perceived Rejection
Importance of Positive Social Events
FIGURE 3. Adjusted predicted values for perceived rejection, illustrating the cross-level interaction of borderline personality features (one stan
-
dard deviation above and below the grand mean) and the importance of (A) positive social events (two standard errors above and below the
group mean) and (B) negative social events (two standard errors above and below the group mean).
AB
derline personality features emerged between state affect and daily
interpersonal stress.
DISCUSSION
The present study used an experience–sampling design to examine the
association between borderline personality features and the stability of
self–esteem and affect. It was hypothesized that borderline personality
features would be associated with self–esteem and affective instability.
This simple hypothesis was supported for positive affect. That is, indi
-
viduals with high levels of borderline personality features reported un
-
stable positive affect. However, for state self-esteem and state negative
affect, the relationship between borderline personality features and in
-
stability depended on the respective level of self–esteem and negative
affect.
The present results show that individuals with stable high self–esteem
report the lowest levels of borderline personality features, whereas indi-
viduals with unstable low self–esteem report the highest levels. This as-
sociation betweenborderline personality features and self–esteem insta-
bility is consistent with previous research showing that individuals with
unstable self–esteem are more reactive to daily events (Greenier et al.,
1999; Kernis et al., 1998), focus more on the self-esteem-threatening as-
pects of unpleasant interpersonal situations (Waschull & Kernis, 1996),
and possess impoverished self–concepts (Kernis, Paradise, Whitaker,
Wheatman, & Goldman, 2000). In order to more fully understand the
self–esteem of individuals with borderline personality features, future
research should examine whether these individuals possess discrepant
self–esteem (e.g., Bosson, Brown, Zeigler–Hill, & Swann, 2003) or
contingent self–esteem (e.g., Crocker & Wolfe, 2001).
Similar to the finding concerning self–esteem instability, it was the in
-
teraction of negative affect level and negative affect instability that was
associated with borderline personality features. More specifically, the
lowest levels of borderline personality features were found among indi
-
viduals with stable low negative affect and the highest levels were found
among those with unstable high negative affect. This result builds upon
previous findings that suggest that BPD is characterized by unstable
affect (e.g., Stein, 1995, 1996).
In addition to the instability of self–esteem and affect, the present
study examined the lability of these constructs (i.e., their covariation
with daily interpersonal stress). It was hypothesized that the self–es
-
teem, affect, and perceived rejection of individuals with borderline per
-
sonality features would be especially reactive to interpersonal stress. As
expected, individuals with high levels of borderline personality features
BORDERLINE PERSONALITY FEATURES 683
reported experiencing more important negative interpersonal events
than individuals with low levels of borderline personality features (see
Tolpin et al., 2004 for similar results). More importantly for the present
study, the results found that the state self–esteem and feelings of rejec
-
tion of individuals with high levels of borderline personality features
are especially reactive to interpersonal stress. This suggests that certain
aspects of psychological adjustment may be closely tied to level of inter
-
personal stress experienced by individuals with borderline personality
features. On days when their social interactions are positive, these indi
-
viduals may experience feelings of relatively high self–worth and feel
accepted; however, on days when their social interactions are negative,
their self–worth may plummet and they may feel rejected.
It should be noted that there are important limitations associated with
the present study. First, the present sample consisted of college students
with the majority (86%) failing to report significant borderline personal
-
ity features (i.e., these participants had PAI–BOR raw scores less than 38
or T scores less than 70). Because the present sample was drawn from a
nonclinical population, it is difficult to generalize to individuals who
meetthe full diagnostic criteria for BPD. Second, the present study relied
on subjective ratings of event importance. This may be considered prob-
lematic because ratings of daily events (or the mere recollection of daily
events) may be associated with borderline personality features. How-
ever, the purpose of the present study was to examine the lability of indi-
viduals with high levels of borderline personality features in accordance
with their perceptions of daily events rather than their responses to objec-
tive events. Third, the date and time that participants provided their re-
sponses were not recorded or verified (cf. Reis & Gable, 2000; Tennen &
Affleck, 2002). This is an important limitation considering that large
numbers of participants delay completing one or more daily measures
during their participation in experience–sampling projects (Gable, Reis,
& Elliot, 2000; Litt, Cooney, & Morse, 1998). Despite this limitation, par
-
ticipants did appear to comply with instructions (e.g., returned the daily
measures every three to four days and skipped days when they forgot to
complete the daily measures).
CONCLUSION
The present study found that individuals with borderline personality
features were characterized by unstable low self–esteem, unstable posi
-
tiveaffect, and unstable high negative affect. In addition, these individu
-
als were found to possess state self–esteem and feelings of perceived
rejection that were highly reactive to daily interpersonal stress. Despite
the considerable importance of instability to the diagnosis and under
-
684 ZEIGLER–HILL AND ABRAHAM
standing of BPD, it appears that this is the first study to demonstrate the
instability and lability of individuals with borderline personality
features through the use of an experience–sampling design.
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BORDERLINE PERSONALITY FEATURES 687
... Their hypothesis was the impulse to avoid self-awareness because of the negative self-concept, expected rejection, shame, and negative body image perception. This might not be surprising considering the solid body of evidence showing that BPD patients tend to exhibit self-esteem instability, decreased self-concept (clarity about it as well), and poorer self-acceptance Santangelo et al., 2020;Zeigler-Hill & Abraham, 2006). This negative self-view might be primarily justified by the early experiences of abuse, trauma, neglect or invalidation usually reported by BPD patients (Bradley, Jenei, et al., 2005;Winsper et al., 2012;Zanarini et al., 2019). ...
... These processes are common in people with low self-esteem. In fact, BPD patients seem to exhibit self-esteem instability, which is associated with a poorer self-concept, decreased self-concept clarity, and diminished self-acceptance Santangelo et al., 2020;Zeigler-Hill & Abraham, 2006). Accordingly, other studies have shown that borderline symptoms are related to marked self-criticism, harshness, low compassion and feelings of disgust towards the self . ...
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Full-text available
Introduction: Borderline personality disorder (BPD) is a severe condition related to emotion, self-image and relationships instability, feelings of abandonment and emptiness, marked impulsivity, self-harm behaviors and suicide ideation. Patients with BPD often show decreased quality of life and well-being, and present one of the highest suicide rates of mental disorders. This disorder has a developmental path that often begins in childhood and the onset usually occurs in late adolescence or early adulthood. Identifying marked borderline features at early ages would be valuable to refer adolescents for appropriate treatment and prevent these features’ growth. Moreover, research on psychological processes in adolescence is scarce but crucial to understand the development of BPD and sustain and design psychotherapeutic interventions. Thus, this doctoral dissertation aimed (1) to provide valid and adapted instruments for early assessment of borderline symptoms in the Portuguese population, (2) to describe and characterize youth borderline features in Portugal, identify internal risk and protective factors and examine the relationships between them and finally, (3) to longitudinally explore different trajectories of borderline features and test the influence of self-disgust and self-compassion over time. Methods: This research included ten studies, of which four are psychometric, four cross-sectional and two longitudinal. Most studies were conducted with convenience adolescent samples from the general population. In one study was used a sample of parents, in two studies were used panels of experts in mental health, and in another was used a sample of adolescents with non-suicidal self- injury (NSSI) history. Data were collected in schools and online, mostly through self-report questionnaires. Additionally, data from parent-rated questionnaires and a clinical interview was also collected. Statistical analyses were conducted using the SPSS (and PROCESS Macro), AMOS and MPLUS. Results: The psychometric studies indicated that (I) the Borderline Personality Features Scale for Children (BPFS-C) and for Parents (BPFS-P) are valid, reliable and brief questionnaires to assess borderline features in youth; (II) the Multidimensional Self-Disgust Scale for Adolescents (MSDS-A) showed good psychometric quality, with good convergent validity and also temporal stability; (III) the Clinical Interview for Borderline Personality Disorder for Adolescents (CI-BOR- A) was accepted by youth and the expert panel classified the instrument as generally good, providing important suggestions and comments to improve its quality; (IV) and the English version of the CI-BOR-A was approved by English experts and is now also available to be used in other countries. In turn, cross- sectional studies showed that (V) the more prevalent borderline features amongst Portuguese youth were feelings of abandonment, emotional intensity, and an unstable self-image; and that impulse, suicide ideation, stress and depression were significant predictors of borderline features; (VI) girls exhibited higher borderline features and self-disgust than boys, and lower self-compassion; (VII) mindfulness, isolation, and self-judgement were the self-compassion factors that mediated the relationship between memories of subordination and threat in childhood and borderline features; (VIII) self-compassion stood in the way of self-disgust and borderline features, highlighting the mediating role of self-compassion. Longitudinal studies revealed that (IX) self-compassion protected adolescents with NSSI from developing borderline features over six months; and (X) adolescents who already had higher borderline features seem to present a gradually rising trajectory, and feelings of self-disgust increased borderline features over one year. Conclusions: Early assessment of borderline features, BPD and related constructs is essential to identify adolescents that need appropriate treatment. The BPFS-C, BPFS-P, MSDS-A, and the CI-BOR-A can now be used for this purpose in the Portuguese population. Self-disgust increases the risk of adolescents growing borderline symptoms and self-compassion might counter this effect and evolution. Targeting self-disgust and cultivating self-compassion in adolescents with subthreshold BPD symptoms could mitigate the development of borderline features, decreasing BPD occurrence in adulthood, with significant implications for patients, families, communities, and society. Keywords: borderline features, adolescence, self-compassion, self-disgust, non-suicidal self-injury, developmental trajectories, assessment, prevention
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Background: Borderline personality disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity, and interpersonal relationships, which typically result in significant and negative deterioration of the person's overall functioning and well-being. Measuring and characterizing the rapidly changing patterns of instability in BPD dysfunction as they occur in a person's daily life can be challenging. Ecological momentary assessment (EMA) is a method that can capture highly dynamic processes in psychopathology research and, thus, is well suited to study intense variability patterns across areas of dysfunction in BPD. EMA studies are characterized by frequent repeated assessments that are delivered to participants in real-life, real-time settings using handheld devices capable of registering responses to short self-report questions in daily life. Compliance in EMA research is defined as the proportion of prompts answered by the participant, considering all planned prompts sent. Low compliance with prompt schedules can compromise the relative advantages of using this method. Despite the growing EMA literature on BPD in recent years, findings regarding study design features that affect compliance with EMA protocols have not been compiled, aggregated, and estimated. Objective: This systematic meta-analytic review aimed to investigate the relationship between study design features and participant compliance in EMA research of BPD. Methods: A systematic review was conducted on November 12, 2021, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analyses of Observational Studies in Epidemiology) guidelines to search for articles featuring EMA studies of BPD that reported compliance rates and included sufficient data to extract relevant design features. For studies with complete data, random-effect models were used to estimate the overall compliance rate and explore its association with design features. Results: In total, 28 peer-reviewed EMA studies comprising 2052 participants were included in the study. Design features (sampling strategy, average prompting frequency, number of items, response window, sampling device, financial incentive, and dropout rate) showed a large variability across studies, and many studies did not report design features. The meta-analytic synthesis was restricted to 64% (18/28) of articles and revealed a pooled compliance rate of 79% across studies. We did not find any significant relationship between design features and compliance rates. Conclusions: Our results show wide variability in the design and reporting of EMA studies assessing BPD. Compliance rates appear to be stable across varying setups, and it is likely that standard design features are not directly responsible for improving or diminishing compliance. We discuss possible nonspecific factors of study design that may have an impact on compliance. Given the promise of EMA research in BPD, we also discuss the importance of unifying standards for EMA reporting so that data stemming from this rich literature can be aggregated and interpreted jointly.
... Mothers with BPD report feeling less competent and less satisfied with their parenting than healthy comparison mothers (Elliot et al., 2014;Newman et al., 2007;Steele et al., 2020), and the identity disturbance and unstable sense of self often experienced by those with BPD can manifest in low self-confidence and poor self-regard (e.g., Zeigler-Hill & Abraham, 2006). Perceptions of their parenting being judged by others as poor (Lerner, 2021) may be further exacerbated by BPD symptomatology and impact on their parenting self-efficacy. ...
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Borderline personality disorder (BPD) is a complex mental health condition often associated with previous childhood adversity including maladaptive parenting. When becoming a parent themselves, mothers with BPD have difficulties with various parenting cognitions and practices, but unknown is whether they have appropriate knowledge of sensitive parenting. This study explored whether differences in parenting knowledge or self-efficacy are specific to BPD or also found in mothers with depression, and whether symptom severity or specific diagnosis better explain parenting perceptions. Mothers with BPD (n = 26), depression (n = 25) or HCs (n = 25) completed a Q-sort parenting knowledge task and a parenting self-efficacy questionnaire. Results showed mothers with BPD had the same knowledge of sensitive parenting behaviors as mothers with depression and healthy mothers. Self-reported parenting self-efficacy was lower in mothers with BPD and depression compared with healthy mothers, with symptom severity most strongly associated. A significant but low correlation was found between parenting self-efficacy and knowledge. Findings suggest that mothers with BPD and depression know what good parenting is but think they are not parenting well. Mental health difficulties are not associated with parenting knowledge, but symptom severity appears to be a common pathway to lower parenting self-efficacy. Future interventions should test whether reduction of symptom severity or positive parenting feedback could improve parenting self-efficacy.
... The study by Stiglmayr et al [14] found that dissociation was correlated with distress in patients with BPD, which varied over time. The study by Zeigler-Hill and Abraham [15] reported interesting findings revealing that patients with BPD show increased self-esteem variability, especially in response to stressful interpersonal situations with peers. The study by Links et al [16] examined the link between emotional disturbances (specifically, the intensity of negative mood, mood amplitude, mood dyscontrol, and mood triggering) and suicide attempts. ...
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BACKGROUND Borderline Personality Disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity and interpersonal relationships, which typically result in significant and negative deterioration of the person’s overall functioning and wellbeing. Measuring and characterizing rapidly changing patterns of instability in BPD dysfunction as they occur in a person’s daily life can be challenging. Ecological Momentary Assessment (EMA) is a method that can capture highly dynamic processes in psychopathology research, and thus, is well-suited to study intense variability patterns across areas of dysfunction in BPD. EMA studies are defined by using frequent repeated assessments that are delivered to participants in real-life, real-time settings, using handheld devices capable of registering responses to short self-report questions in daily life. Compliance in EMA research is defined as the proportion of prompts answered by the participant considering all planned prompts sent. Low compliance to prompt schedules can compromise the relative advantages of using this method. Despite the growing EMA literature on BPD in recent years, findings regarding study design features that affect compliance with EMA protocols have not been compiled, aggregated and estimated. OBJECTIVE This meta-analytic review aimed to investigate the relationship between study design features and participant compliance in EMA research of BPD. METHODS A systematic review was conducted on November 12th 2021, following the PRISMA and MOOSE guidelines to search for articles featuring EMA studies for BPD that reported compliance rates and included sufficient data to extract relevant design features. The PsycInfo, PubMed, Scopus, and Web of Science databases were explored to identify relevant articles. For studies with complete data, random-effect models were conducted to estimate the overall compliance rate and explore its association to study design features. RESULTS 28 peer-reviewed EMA studies totaling 2,052 participants were included in the study. Design features including sampling strategy, average prompting frequency, number of items, response window, sampling device utilized, financial incentive, and drop-out rate showed a large variability across studies, and many studies did not report design features. The metanalytic synthesis was, thus, restricted to 18 articles, revealing a pooled compliance rate of 79% across participants. We did not find any a significant relationship between design features and compliance rates. CONCLUSIONS Our results show a wide variability in the design and reporting of EMA studies assessing BPD. Compliance rates appear to be stable across varying set-ups, and it is likely that standard design features are not directly responsible for improving or diminishing compliance. We discuss possible “nonspecific factors” of the study design that may have an impact on compliance. Given the promise of EMA research in BPD, we also discuss the importance of unifying standards for EMA reporting so that data stemming from this rich literature can aggregated and interpreted jointly.
... In general, self-esteem variability resulted associated with key adverse psychological outcomes related to affective dysregulation (i.e., depression, see de Man et al., 2001;Hayes et al., 2004;Kernis & Goldman, 2006;Santangelo et al., 2017;Tolpin et al., 2004;Yamawaki et al., 2004) or psychopathology (such as paranoia, borderline personality disorders or post-traumatic stress disorder; see Kashdan et al., 2006;Raes & Van Gucht, 2009;Santangelo et al., 2017;Thewissen et al., 2008;Zeigler-Hill & Abraham, 2006), supporting the idea that self-esteem variability is linked to stress perception. ...
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