1 - (SYM 49) Patterns of Emotion Reactivity and Regulation Across Borderline Personality Disorder and Posttraumatic Stress Disorder

Both borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are associated with emotion dysfunction and often co-occur. Emotional reactivity is also evident in some studies in BPD and PTSD. Despite frequent co-occurrence, only a few studies have examined the independent and joint effects of BPD and PTSD on emotional functioning. Some data suggest that co-occurring PTSD may drive discordance between domains of emotional reactivity in BPD, dampening physiological reactivity but increasing subjective reactivity. Low reliance on acceptance-based emotion regulation may also account for this divergence. The current study examined the independent and interactive effects of BPD and PTSD on emotional reactivity, regulation, and concordance across physiological and subjective measures. Furthermore, we examined the role of acceptance in driving concordance. Participants (N = 195) underwent diagnostic interviews and completed a computerized task with neutral and negative emotion inductions. Both subjective and physiological outcomes were examined after each induction. Linear regressions were used to examine relationships between diagnostic group and self-reported reactivity and regulation outcomes, as well the mediating role of acceptance on discordance. Multilevel models were used to examine the associations between diagnostic criteria and time on reactivity and regulation outcomes. Discordance indices were created to determine the degree to which changes in physiological reactivity and affective changes are aligned. Results show BPD and BPDxPTSD, but not PTSD, were significantly associated with greater difficulty regulating emotions (ps < .001) and accepting emotions (BPDonly: p = .001; BPDxPTSD: p < .001). No significant differences in physiological reactivity (ps > .203) and regulation (ps > .181)were present across diagnostic groups, and acceptance did not mediate the relationship between diagnostic groups and discordance indices. BPDxPTSD was significantly positively associated with discordance between SCR and positive emotions (p = .010). This study extends current literature examining unique patterns of emotional reactivity and regulation, and findings suggest that while there are no physiological differences across groups, those with BPD and BPDxPTSD report greater subjective difficulties regulating emotions. By understanding how people with BPD and PTSD react to idiographic stressors, we can better identify and prepare individuals for situations that induce heightened reactivity.