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Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms

  • Stephanie D. Stepp (a1), Lori N. Scott (a1), Neil P. Jones (a1), Diana J. Whalen (a2) and Alison E. Hipwell (a1)...


Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multimethod approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across 3 years (ages 16–18) in a diverse, at-risk sample of adolescent girls (N = 113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: self-report, emotion ratings to stressors from ecological assessments across 1 week, and observer-rated negative affectivity during a mother–daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. The results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. In addition, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms.


Corresponding author

Address correspondence and reprint requests to: Stephanie D. Stepp, Western Psychiatric Institute and Clinic, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213; E-mail:


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Achenbach, T. M. (2006). As others see us: Clinical and research implications of cross-informant correlations for psychopathology. Current Directions in Psychological Science, 15, 9498.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Bagge, C. L., Nickell, A., Stepp, S. D., Durrett, C., Jackson, K., & Trull, T. J. (2004). Borderline personality disorder features predict negative outcomes 2 years later. Journal of Abnormal Psychology, 113, 279288.
Bandelow, B., Krause, J., Wedekind, D., Broocks, A., Hajak, G., & Rüther, E. (2005). Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls. Psychiatry Research, 134, 169179.
Barnard, K. E. (1994). Difficult Life Circumstances Scale. Seattle, WA: NCAST Publications.
Bateman, A. W., & Fonagy, P. (2003). The development of an attachment-based treatment program for borderline personality disorder. Bulletin of the Menninger Clinic, 67, 187211.
Battle, C. L., Shea, M. T., Johnson, D. M., Yen, S., Zlotnick, C., Zanarini, M. C., et al. (2004). Childhood maltreatment associated with adult personality disorders: Findings from the collaborative longitudinal personality disorders study. Journal of Personality Disorders, 18, 193211.
Beauchaine, T. P., Klein, D. N., Crowell, S. E., Derbidge, C., & Gatzke-Kopp, L. (2009). Multifinality in the development of personality disorders: A Biology × Sex × Environment interaction model of antisocial and borderline traits. Development and Psychopathology, 21, 735770.
Bornovalova, M. A., Hicks, B. M., Iacono, W. G., & McGue, M. (2009). Stability, change, and heritability of borderline personality disorder traits from adolescence to adulthood: A longitudinal twin study. Development and Psychopathology, 21, 13351353.
Bornovalova, M. A., Huibregtse, B. M., Hicks, B., Iacono, W., & McGue, M. (2013). Tests of a direct effect of childhood abuse on adult borderline personality disorder traits: A longitudinal discordant twin design. Journal of Abnormal Psychology, 122, 180194.
Bradley, R., Zittel Conklin, C., & Westen, D. (2005). The borderline personality disorder diagnosis in adolescents: Gender differences and subtypes. Journal of Child Psychology and Psychiatry, 46, 10061019.
Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Erlbaum.
Carlson, E. A., Egeland, B., & Sroufe, L. A. (2009). A prospective investigation of the development of borderline personality symptoms. Development and Psychopathology, 21, 13111334.
Chanen, A. M., Jovev, M., Djaja, D., McDougall, E., Yuen, H. P., Rawlings, D., et al. (2008). Screening for borderline personality disorder in outpatient youth. Journal of Personality Disorders, 22, 353364.
Clark, L. A., & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7, 309319.
Clifton, A., & Pilkonis, P. A. (2007). Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Comprehensive Psychiatry, 48, 7078.
Coid, J., Yang, M., Tyrer, P., Roberts, A., & Ullrich, S. (2006). Prevalence and correlates of personality disorder among adults aged 16 to 74 in Great Britain. British Journal of Psychiatry, 188, 423431.
Conger, R. D., Conger, K. J., & Martin, M. J. (2010). Socioeconomic status, family processes, and individual development. Journal of Marriage and the Family, 72, 685704.
Conger, R. D., Ge, X., Elder, G. H., Lorenz, F. O., & Simons, R. L. (1994). Economic stress, coercive family process, and developmental problems of adolescents. Child Development, 65, 541561.
Conger, R. D., Wallace, L. E., Sun, Y., Simons, R. L., McLoyd, V. C., & Brody, G. H. (2002). Economic pressure in African American families: A replication and extension of the family stress model. Developmental Psychology, 38, 179193.
Crowell, S. E., Beauchaine, T. P., & Linehan, M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological Bulletin, 135, 495510.
de Clercq, B., van Leeuwen, K., van den Noortgate, W., de Bolle, M., & de Fruyt, F. (2009). Childhood personality pathology: Dimensional stability and change. Development and Psychopathology, 21, 853869.
Duncan, T. E., Duncan, S. C., & Strycker, A. (2006). An introduction to latent variable growth curve modeling: Concepts, issues, and application (2nd ed.). Mahwah, NJ: Erlbaum.
Eppright, T. D., Kashani, J. H., Robinson, B. D., & Reid, J. C. (1993). Comorbidity of conduct disorder and personality disorders in an incarcerated juvenile population. American Journal of Psychiatry, 150, 12331236.
Evans, G. W. (2004). The environment of childhood poverty. American Psychologist, 59, 7792.
Evans, G. W., & Cassells, R. C. (2013). Childhood poverty, cumulative risk exposure, and mental health in emerging adults. Clinical Psychological Science. Advance online publication.
Evans, G. W., & Kim, P. (2007). Childhood poverty and health: Cumulative risk exposure and stress dysregulation. Psychological Science, 18, 953957.
Evans, G. W., Li, D., & Whipple, S. S. (2013). Cumulative risk and child development. Psychological Bulletin, 139, 13421396.
Fossati, A., Madeddu, F., & Maffei, C. (1999). Borderline personality disorder and childhood sexual abuse: A meta-analytic study. Journal of Personality Disorders, 13, 268280.
Furman, W., & Shomaker, L. B. (2008). Patterns of interaction in adolescent romantic relationships: Distinct features and links to other close relationships. Journal of Adolescence, 31, 771788.
Glaser, J. P., van Os, J., Mengelers, R., & Myin-Germeys, I. (2008). A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorder. Psychological Medicine, 38, 12311239.
Glaser, J. P., van Os, J., Portegijs, P. J., & Myin-Germeys, I. (2006). Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. Journal of Psychosomatic Research, 61, 229236.
Goodman, M., Patil, U., Triebwasser, J., Diamond, E., Hiller, A., Hoffman, P., et al. (2010). Parental viewpoints of trajectories to borderline personality disorder in female offspring. Journal of Personality Disorders, 24, 204216.
Goodyer, I. M., Ashby, L., Altham, P. M., Vize, C., & Cooper, P. J. (1993). Temperament and major depression in 11- to 16-year-olds. Journal of Child Psychology and Psychiatry and Allied Disciplines, 34, 14091423.
Gottesman, I. I., & Gould, T. D. (2003). The endophenotype concept in psychiatry: Etymology and strategic intentions. American Journal of Psychiatry, 160, 636645.
Grant, B. F., Chou, S. P., Goldstein, R. B., Huang, B., Stinson, F. S., Saha, T. D., et al. (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: Results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 69, 533545.
Grilo, C. M., Becker, D. F., Walker, M. L., Levy, K. N., Edell, W. S., & McGlashan, T. H. (1995). Psychiatric comorbidity in adolescent inpatients with substance use disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 10851091.
Hankin, B.L., Mermelstein, R., & Roesch, L. (2007). Sex differences in adolescent depression: Stress exposure and reactivity models. Child Development, 78, 279295.
Hipwell, A. E., Loeber, R., Stouthamer-Loeber, M., Keenan, K., White, H. R., & Kroneman, L. (2002). Characteristics of girls with early onset disruptive and antisocial behaviour. Criminal Behaviour and Mental Health, 12, 99118.
Holm, A. L., & Severinsson, E. (2011). Struggling to recover by changing suicidal behaviour: Narratives from women with borderline personality disorder. International Journal of Mental Health Nursing, 20, 165173.
Holmbeck, G. N., Li, S. T., Schurman, J. V., Friedman, D., & Coakley, R. M. (2002). Collecting and managing multisource and multimethod data in studies of pediatric populations. Journal of Pediatric Psychology, 27, 518.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155.
Johnson, J. G., Smailes, E. M., Cohen, P., Brown, J., & Bernstein, D. P. (2000). Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: Findings of a community-based longitudinal study. Journal of Personality Disorders, 14, 171187.
Jovev, M., & Jackson, H. J. (2006). The relationship of borderline personality disorder, life events and functioning in an Australian psychiatric sample. Journal of Personality Disorders, 20, 205217.
Keenan, K., Hipwell, A., Chung, T., Stepp, S., Stouthamer-Loeber, M., Loeber, R., et al. (2010). The Pittsburgh Girls Study: Overview and initial findings. Journal of Clinical Child and Adolescent Psychology, 39, 506521.
Kernberg, O. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press.
Lataster, T., Wichers, M., Jacobs, N., Mengelers, R., Derom, C., Thiery, E., et al. (2009). Does reactivity to stress cosegregate with subclinical psychosis? A general population twin study. Acta Psychiatrica Scandinavica, 119, 4553.
Lenzenweger, M. F., Lane, M., Loranger, A. W., & Kessler, R. C. (2007). DSM-IV personality disorders in the national comorbidity replication (NCSR). Biological Psychiatry, 62, 553564.
Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press.
Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Buchheim, P., Channabasavanna, S. M., et al. (1994). The International Personality Disorder Examination. Lutz, FL: Psychological Assessment Resources.
McDonald, R. P., & Ho, M. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7, 6482.
McMakin, D. L., Burkhouse, K. L., Olino, T. M., Siegle, G. J., Dahl, R. E., & Silk, J. S. (2011). Affective functioning among early adolescents at high and low familial risk for depression and their mothers: A focus on individual and transactional processes across contexts. Journal of Abnormal Child Psychology, 39, 12131225.
Miller, A. L., Muehlenkamp, J. J., & Jacobson, C. M. (2008). Fact or fiction: Diagnosing borderline personality disorder in adolescents. Clinical Psychology Review, 28, 969981.
Morey, L. C. (1991). Personality Assessment Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.
Muthén, B. O., & Muthén, L. K. (2012). Mplus user's guide (7th ed.). Los Angeles: Author.
Myers, W. C., Burkett, R. C., & Otto, T. A. (1993). Conduct disorder and personality disorders in hospitalized adolescents. Journal of Clinical Psychiatry, 54, 2126.
Myin-Germeys, I., & van Os, J. (2007). Stress-reactivity in psychosis: Evidence for an affective pathway to psychosis. Clinical Psychology Review, 27, 409424.
Nunnally, J. C. (1978). Psychometric theory (2nd ed., pp. 229230). New York: McGraw–Hill.
O'Connor, T. G., Hetherington, E. M., Reiss, D., & Plomin, R. (1995). A twin-sibling study of observed parent-adolescent interactions. Child Development, 66, 812829.
Pagano, M. E., Skodol, A. E., Stout, R. L., Shea, M. T. ,Yen, S., Grilo, C. M., et al. (2004). Stressful life events as predictors of functioning: Findings from the Collaborative Longitudinal Personality Disorders Study. Acta Psychiatrica Scandinavica, 110, 421429.
Pfohl, B., Blum, N., & Zimmerman, M. (1997). Structured Interview for DSM-IV Personality: SIDP-IV. Washington, DC: American Psychiatric Association.
Pietrek, C., Elbert, T., Weierstall, R., Müller, O., & Rockstroh, B (2013). Childhood adversities in relation to psychiatric disorders. Psychiatry Research, 206, 103110.
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437448.
Rothbart, M. K. (2007). Temperament, development, and personality. Current Directions in Psychological Science, 16, 207212.
Sansone, R. A., & Sansone, L. A. (2009). The families of borderline patients: The psychological environment revisited. Psychiatry, 6, 1924.
Shiner, R. L., Buss, K. A., McClowry, S. G., Putnam, S. P., Saudino, K. J., & Zentner, M. (2012). What is temperament now? Child Development Perspectives, 6, 436444.
Silk, J. S., Forbes, E. E., Whalen, D. J., Jakubcak, J. L., Thompson, W. K., Ryan, N. D., et al. (2010). Daily emotional dynamics in depressed youth: A cell phone ecological momentary assessment study. Journal of Experimental Child Psychology, 110, 214257.
Silk, J. S., Steinberg, L., & Morris, A. S. (2003). Adolescents’ emotion regulation in daily life: Links to depressive symptoms and problem behavior. Child Development, 74, 18691880.
Sinha, B. K., & Watson, D. C. (1997). Psychosocial predictors of personality disorder traits in a non-clinical sample. Personality and Individual Differences, 22, 527537.
Skodol, A. E., & Bender, D. S. (2003). Why are women diagnosed borderline more than men? Psychiatric Quarterly, 74, 349360.
Skodol, A. E., Pagano, M. E., Bender, D. S., Shea, M. T., Gunderson, J. G., Yen, S., et al. (2005). Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years. Psychological Medicine, 35, 443451.
Smith, D. J., Muir, W. J., & Blackwood, D. H. R. (2005). Borderline personality disorder characteristics in young adults with recurrent mood disorders: A comparison of bipolar and unipolar depression. Journal of Affective Disorders, 87, 1723.
Soloff, P. H., Lynch, K. G., & Kelly, T. M. (2002). Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. Journal of Personality Disorders, 16, 201214.
Stepp, S. D. (2012). Development of borderline personality disorder in adolescence and young adulthood: Introduction to the Special Section. Journal of Abnormal Child Psychology, 40, 15.
Stepp, S. D., Burke, J. D., Hipwell, A. E., & Loeber, R. (2012). Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls. Journal of Abnormal Child Psychology, 40, 720.
Stepp, S. D., Keenan, K., Hipwell, A E., & Krueger, R. R. (2014). The impact of childhood temperament on the development of borderline personality disorder symptoms over the course of adolescence. Borderline Personality Disorder and Emotion Dysregulation, 1, 18.
Stepp, S. D., Pilkonis, P. A., Hipwell, A. E., Loeber, R., & Stouthamer-Loeber, M. (2010). Stability of borderline personality disorder features in girls. Journal of Personality Disorders, 24, 460472.
Stepp, S. D., Whalen, D. J., Scott, L. N., Zalewski, M., Loeber, R., & Hipwell, A. E. (2014). Reciprocal effects of parenting and borderline personality disorder symptoms in adolescent girls. Development and Psychopathology, 20, 118.
Stiglmayr, C. E., Grathwol, T., Linehan, M. M., Ihorst, G., Fahrenberg, J., & Bohus, M. (2005). Aversive tension in patients with borderline personality disorder: A computer-based controlled field study. Acta Psychiatrica Scandinavica, 111, 372379.
Trull, T. J. (1995). Borderline personality disorder features in nonclinical young adults: I. Identification and validation. Psychological Assessment, 7, 3341. doi:10.1037/1040-3590.7.1.33
Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010). Revised NESARC personality disorder diagnoses: Gender, prevalence, and comorbidity with substance dependence disorders. Journal of Personality Disorders, 24, 412426. doi:10.1521/pedi.2010.24.4.412
Trull, T. J., Useda, J. D., Conforti, K., & Doan, B. T. (1997). Borderline personality disorder features in nonclinical young adults: 2. Two-year outcome. Journal of Abnormal Psychology, 106, 307314.
van Os, J., Kenis, G., & Rutten, B. P. (2010). The environment and schizophrenia. Nature, 468, 203212.
Westen, D., & Chang, C. (2000) Personality pathology in adolescence: A review. Adolescent Psychiatry, 25, 61100.
Whalen, D. J., Scott, L. N., Jakubowski, K., McMakin, D., Hipwell, A. E., Silk, J., et al. (in press). Affective behavior during mother–daughter conflict and borderline personality disorder severity across adolescence. Personality Disorders: Theory, Research, and Treatment.
Wichers, M. C., Geschwind, N., Jacobs, N., Kenis, G., Peeters, F., Derom, C., et al. (2009). Transition from stress sensitivity to a depressive state: Longitudinal twin study. British Journal of Psychiatry, 195, 498503.
Wichers, M. C., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., et al. (2007). Evidence that moment-to-moment variation in positive emotions buffer genetic risk for depression: A momentary assessment twin study. Acta Psychiatrica Scandinavica, 115, 451457.
Winsper, C., Zanarini, M., & Wolke, D. (2012). Prospective study of family adversity and maladaptive parenting in childhood and borderline personality disorder symptoms in a nonclinical population at 11 years. Psychological Medicine, 42, 24042420.
Zanarini, M., Williams, A., Lewis, R., Reich, R., Vera, S., Marino, M., et al. (1997). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154, 11011106.
Zweig-Frank, H., & Paris, J. (2002). Predictors of outcome in a 27-year follow-up of patients with borderline personality disorder. Comprehensive Psychiatry, 43, 103107.


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