Joumal of Abnormal Psychology
20i2, Vol. 121.No. 3, 680-691
© 2012 American Psychological Association
0021-843X/12/$12.00 DOI: 10.]037/a0028513
Understanding Heterogeneity in Borderline Personality Disorder:
Differences in Affective Reactivity Explained by the Traits of Dependency
and Self-Criticism
Daniel C. Kopala-Sibley and David C. Zuroff
McGill University
Jennifer J. Russell
McGill University and McGill University Health Centre, Canada
D. S. Moskowitz
McGill University
Joel Paris
McGill University and McGill University Health Centre, Canada
This study examined whether the personality traits of self-criticism and dependency respectively
moderated the effects of perceived inferiority and emotional insecurity on negative affect during
interpersonal interactions in individuals with borderline personality disorder (BPD). A sample of 38
patients with BPD and matched community comparison participants completed event-contingent record
forms after each signifieant interaetion for a 20-day period. Multilevel models showed that, controlling
for baseline levels of depressive symptoms and neuroticism, as well as lagged negative affect, event-level
elevations in perceived inferiority and emotional insecurity were related to more negative affect in both
groups. Event-level perceived inferiority was more strongly associated with negative affect in patients
with BPD who reported higher levels of self-criticism, while event-level perceived emotional insecurity
was more strongly associated with negative affect in patients with BPD who reported higher levels of
dependency. No significant interactions emerged for the comparison group. These findings further our
understanding of differences among patients with BPD and support the application of personality-
vulnerability or diathesis-stress models in predicting negative affect in BPD. Results have implications
for the design of therapies for patients with BPD.
Keywords: borderline personality disorder, self-criticism, dependency, negative affect, personality-
vulnerability, affective reactivity
Borderline personality disorder (BPD) is a pervasive, disabling, and
difficult to treat psychiatric disorder characterized by affective insta-
bility, impulsivity, and unstable interpersonal relationships (American
Psychiatric Association, 2000). Some factor analytic work has sup-
ported this three-factor structure (Skodol et al., 2002), with a sizable
body of literature focusing on the nature of affective instability in
BPD (e.g., Henry et al., 2(X)1 ; Koenigsberg et al., 2002; Nica & Links,
2009; Russell, Moskowitz, Zuroff, Sookman, & Paris, 2007), as weU
as the effects of unstable relationships or interpersonal interactions on
affective instability (Russell et al., 2007; Sadikaj, Russell, Moskowitz,
& Paris, 2010; Stepp et al., 2011). However, despite general agree-
ment about these core features of BPD (Leichsenring, Leibing,
Kruse, New, & Leweke, 2011), there is considerable heterogeneity
among patients with BPD, such as those who are relatively more
or less concerned about interpersonal rejection and emotional
This article was published Online First June 11, 2012.
Daniel C. Kopala-Sibley, David C. Zuroff, and D. S. Moskowitz, De-
partment of Psychology, McGill University; Jennifer J. Russell and Joel
Pads, Department of Psychiatry, McGill University and McGill University
Health Centre, Montreal, Quebec, Canada.
Correspondence concerning this article should be addressed to Daniel C.
Kopala-Sibley, Department of Psychology, McGill University, 1205 Dr.
Penfield Avenue, Montreal, Quebec, H3A lBI Canada. E-mail:
daniel.kopala-sibleyCs'mail.mcgill.ca
security (Bomstein et al., 2010) or those who are more or less
preoccupied with issues of failure and inferiority (Gunderson,
2007; Stiglmayr et al., 2005). Consistent with this research, some
authors have argued that certain phenotypes or underlying person-
ality structures within patients with BPD may act as diatheses that
render them particularly vulnerable to the effects of Stressors that
are congruent with the underlying personality factor (Gunderson,
2007). Despite this, little research has attempted to identify per-
sonality factors that may elucidate the apparent heterogeneity of
patients with BPD, even though a large body of evidence from
other fields has shown that some personality factors are prospec-
tively associated with higher levels of negative affect (Kopala-
Sibley & Santor, 2009) and may confer vulnerability to increased
negative affect following Stressors or negative events that threaten
a person's sense of self-worth or security in relationships (e.g.,
Blatt, 2004; Kopala-Sibley & Zuroff, 2010; Zuroff & Mongrain,
1987). Understanding heterogeneity in BPD may be important for
improving prediction of self-destructive symptoms, prognosis in
treatment (see Leichsenring et al., 2011), and effectiveness of
specific treatment approaches working with some patients with
BPD. Accordingly, the purpose of the present study was to better
understand this heterogeneity by examining the infiuence of two
personality factors that may moderate the association of cognitions
refiecting perceived emotional insecurity or perceived inferiority
on negative affect during interpersonal interactions.
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