Two exploratory studies to investigate the role of self and emotional dysregulation in borderline personality disorder

Background and objectivesEmotion dysregulation is traditionally considered a core characteristic of Borderline Personality Disorder (BPD), while alterations in self-concept are often viewed as secondary to emotional dysregulation. "Delusion of Me" (DoM) is a unidimensional construct comprising three domains: acceptance, decentering, and non-attachment. It could be considered closely related to the concept of “self-as-content” and may potentially serve as a measure of this dimension of identity. Across two exploratory studies, the role of DoM as a measure of self-disturbance applied to BPD was investigated.MethodStudy 1: A descriptive study comparing disturbances in self-concept (measured by DoM index) and emotional dysregulation in 127 individuals with BPD and 283 non-clinical comparison participants. Correlations between DoM scores and other clinical variables in BPD were also analyzed. Study 2: An exploratory intervention study comparing changes in DoM scores after participation in a mindfulness skills training (n = 32) with a control group (n = 31) receiving interpersonal effectiveness training.ResultsIndividuals with BPD exhibited significantly lower DoM scores compared to non-clinical controls. DoM index correlated with borderline symptoms and emotional overproduction, independent of emotional dysregulation. Additionally, mindfulness training resulted in a significant increase in DoM scores compared to interpersonal effectiveness intervention. Post-intervention, changes in the DoM index predicted improvements in borderline symptoms, independent of changes in emotion dysregulation.ConclusionThese findings support DoM as a promising transdiagnostic marker of self-disturbances, related to identification, in BPD and suggesting that mindfulness-based interventions may facilitate therapeutic change in part by transforming this component of the self beyond emotional regulation.