Differential Associations between Trauma Types and Borderline Personality Disorder from the Perspective of Emotion Dysregulation

Background: Borderline Personality Disorder (BPD) is characterized by pervasive instability in a range of areas including interpersonal relationships, self-image, and affect. Extant studies have consistently identified significant correlations between childhood trauma and BPD. While exploring this trauma-BPD link, a number of cross-sectional studies commonly emphasize the role of emotion dysregulation (ED). A better understanding of the association between trauma and BPD is essential in formulating early, effective intervention approaches, and in addressing varied adverse impacts. Methods: : We analyzed a subset of data collected for a larger community-based longitudinal study. Given that our current focus on trauma and ED, only those participants who completed the baseline assessment measures of trauma and ED (N=144) were included for the primary analyses. We conducted stepwise multivariate linear models to examine the differential relationships between BPD features, ED, and specific traumas. A path analysis with latent factors using the structural equation modeling (SEM) method was performed to test the indirect effect from trauma to BPD features via ED. Results: : Linear regression models revealed that emotional abuse (relative to other trauma types) was significantly associated with high BPD features. The SEM, by constructing direct and indirect effects simultaneously, showed that (1) ED partially mediated the path from trauma to BPD features; and (2) trauma played a complex role in which the direct effect remained significant even after accounting for the indirect effect through ED. Conclusions: : Our results highlight a most consistent association between emotional abuse and trauma, indicating its unique role in understanding BPD features in the context of childhood adversity. Further, shame-related negative appraisal and ED were found critical when examining the association between trauma and BPD, possibly providing promising treatment targets for future practices.