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J Pers Disord. 2019 Mar 28:1-17. doi: 10.1521/pedi_2019_33_427. [Epub ahead of print]

Interpersonal Problems in Borderline Personality Disorder: Associations with Mentalizing, Emotion Regulation, and Impulsiveness.

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Department of Psychiatry, University of Basel, Basel, Switzerland, Department of Consultation Psychiatry and Psychosomatics, University Hospital of Zürich, Zürich, Switzerland, and University College London, London, UK.
Research Department of Clinical, Educational and Health Psychology, University College London.
Wellcome Centre for Human Neuroimaging, University College London.
Fralin Biomedical Research Institute and Department of Physics, Virginia Tech Carilion Research Institute, Roanoke, Virginia.


Interpersonal problems are a core symptom of borderline personality disorder (BPD). This study investigated the relationship between emotion dysregulation, impulsiveness, and impaired mentalizing in the context of predicting interpersonal problems in BPD. A total of 210 patients with BPD completed the Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Reflective Functioning Questionnaire (RFQ), and Inventory of Interpersonal Problems (IIP-32). The authors conducted three path models, with either mentalizing, emotion regulation, or impulsiveness as the exogenous variable. Emotion dysregulation and attentional impulsiveness predicted interpersonal problems directly, whereas hypomentalizing predicted interpersonal problems only indirectly throughout emotion dysregulation and attentional impulsiveness. The results suggest that these domains contribute significantly to interpersonal problems in BPD. Moreover, hypomentalizing might affect on interpersonal problems via its effect on impulsiveness and emotion regulation. The authors argue that focusing on emotion regulation and mentalizing in BPD treatments might have interlinked beneficial effects on interpersonal problems.


borderline personality disorder; emotion regulation; impulsiveness; interpersonal problems; mentalizing; reflective function


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