Quality or quantity? A multi-study analysis of emotion regulation skills deficits associated with Borderline Personality Disorder

Linehan’s (1993) biosocial theory posits that people with Borderline Personality Disorder (BPD) have emotion regulation skills deficits characterized by 1) less frequent use of adaptive emotion regulation strategies, 2) more frequent use of maladaptive strategies, or 3) poorer quality strategy implementation (i.e., strategies implemented less skillfully). We tested these possibilities among participants with BPD, Major Depressive Disorder (MDD), or no disorder (controls). Study 1 participants (N = 272) were recruited online; Study 2 participants (N = 90) completed in-person diagnostic assessments. The BPD groups reported greater use of maladaptive strategies than the MDD (d = .35) and control (d = 1.54) groups and lower quality implementation than the MDD (d = .33) and control groups (d = .97). BPD participants reported similar use of adaptive strategies as the MDD group (d = .09) but less use than controls (d = .47). BPD may be uniquely characterized by overuse of maladaptive strategies and poorer quality emotion regulation implementation.