3 - (SYM 49) a Mixed Methods Examination of How Individuals with Borderline Personality Disorder Express Emotion and Whether This Influences Emotion Regulation Effectiveness

Emotion dysregulation involves disrupted emotional experiences and emotion regulation deficits (i.e., problems modulating emotion), and is theoretically central to Borderline Personality Disorder (BPD). Emotional expression (i.e., identifying and describing emotion using specific words) theoretically decreases negative emotion, and increases emotion regulation effectiveness. However, it is unclear whether and in what ways emotional expression is deficient in BPD, if any, and whether emotional expression influences emotion regulation effectiveness in BPD. Accordingly, this study had two aims. First, we examined whether emotional expression based on word valence, emotionality, and depth of emotional vocabulary in BPD differed from healthy controls (HCs). Second, we examined whether such emotional expression characteristics predicted emotion regulation effectiveness across self-reported and physiological emotion domains differentially in BPD and HC groups. Participants with BPD (n=29) and age and sex-matched HCs (n=30) listened to an evocative story, expressed emotion by typing their emotions into a computer, and regulated emotion using mindfulness (i.e., noticing present emotion without judgment) or cognitive reappraisal (i.e., thinking about an emotional experience differently). Emotion regulation was indexed by changes in self-report, sympathetic (skin conductance responses; SCR), and parasympathetic (respiratory sinus arrhythmia; RSA) emotion, while applying mindfulness or cognitive reappraisal. The words participants used to express emotion were coded based on their valence, emotionality, and depth of emotional vocabulary (i.e., how many words were used). Generalized estimating equations revealed no differences between BPD and HC groups in valence, emotionality, and vocabulary. Additionally, across groups, using a larger vocabulary predicted more effective self-reported (B = -1.65, SE = 1.08), χ²(1) = 3.68, p = 0.055 and sympathetic (B = -.038, SE = .0278), χ²(1) = 4.874, p = .027 emotion regulation. Using more negatively valenced words also predicted more effective parasympathetic emotion regulation across groups (B = .271, SE = .135), χ²(1) = 4.768, p = .029. Results suggest that emotional expression may not be deficient in BPD across the examined characteristics. Findings also suggest that BPD and healthy groups may benefit from deploying a broader emotional vocabulary and more negatively valenced words to express emotion before applying an emotion regulation strategy.