An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.

Iverson, Katherine M.; Follette, Victoria M.; Pistorello, Jacqueline; Fruzzetti, Alan E.

doi:10.1037/a0023703

Cited by 133Personality Disorders and PsychopathologyAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMindfulness and Compassion Interventions

An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.

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Iverson, Katherine M., Follette, Victoria M., Pistorello, Jacqueline, Fruzzetti, Alan E.·2012·Personality Disorders: Theory, Research, and Treatment

DOI 10.1037/a0023703PMC PMC3387350

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Abstract

In this study we investigated 3 domains of emotional functioning--emotion dysregulation, distress tolerance, and experiential avoidance--in young adult outpatients with borderline personality disorder (BPD) symptoms. Participants were 40 young adult outpatients at a university counseling center who reported current suicidal ideation and met diagnostic criteria for BPD or experienced subthreshold BPD symptoms (i.e., met diagnostic criteria for 3 or 4 symptoms). Participants completed 3 self-report measures of emotional functioning-experiential avoidance (Acceptance and Action Questionnaire-2; Bond et al., 2011; Hayes et al., 2004), emotion dysregulation (Difficulties in Emotion Regulation Scale; Gratz & Roemer, 2004), and distress tolerance (Distress Tolerance Scale; Simons & Gaher, 2005)-and a behavioral measure of distress tolerance (Paced Auditory Serial Addition Task-Computerized; Lejuez, Kahler, & Brown, 2003), in addition to self-report measures of depression and BPD symptom severity. Partial correlations demonstrated that both emotion dysregulation and experiential avoidance were significantly associated with BPD symptom severity after accounting for depression. However, neither the self-report nor behavioral measure of distress tolerance were related to BPD symptom severity. A regression analysis with emotion dysregulation and experiential avoidance as independent variables revealed that only experiential avoidance was significantly associated with BPD symptom severity after controlling for depression symptoms. The current findings suggest that experiential avoidance may be a central process in BPD symptom severity. Future research directions are discussed.

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Taken together, the prior evidence indicates that experiential avoidance is an important correlate of BPD.
“Taken together, this evidence suggests that EA is an important correlate of BPD.”
From First evidence of a prospective relation between avoidance of internal states and borderline personality disorder features in adolescents. (2015) · cites this paper as [24]
Iverson et al. found that experiential avoidance uniquely predicted BPD features after controlling for depressive symptoms and emotion dysregulation.
“For example, Iverson et al. [24] found that EA uniquely predicted BPD features when controlling for depressive symptoms and emotion dysregulation, signifying that EA may uniquely underlie BPD symptom severity.”
From First evidence of a prospective relation between avoidance of internal states and borderline personality disorder features in adolescents. (2015) · cites this paper as [24]

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“The column labeled “Comparative” provides examples of means from other studies which utilized the measure: a Gratz & Gunderson, 2006 (clinical BPD sample); b Simon & Gaher, 2005 (college normative sample); c Bond et al. (2009) (normative sample); d Gratz et al. 2006 (clinical BPD sample).”
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“…replicate and extend previous work demonstrating a relationship between experiential avoidance and BPD symptom severity (Chapman et al., 2005; Gratz et al., 2008; Pistorello, 1998) and research showing that experiential avoidance is an important mechanism of change in the treatment of BPD…”
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Authors: Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzzetti, A. E.
Affiliations: VA Boston Healthcare System (US)
University of Nevada, Reno (US)
ORCID: Iverson, Katherine M.
Follette, Victoria M.
Pistorello, Jacqueline
Fruzzetti, Alan E.
Venue: Personality Disorders: Theory, Research, and Treatment
Publisher: American Psychological Association (APA)
Published: 2012-10
Volume: 3
Issue: 4
Pages: 415-422
ISSN: 1949-2715 (ISSN-L)
1949-2723
DOI: 10.1037/a0023703
PMC: PMC3387350
OpenAlex: W2083391989
Cited by: 133
References: 27
Citations by year: 2026: 4 · 2025: 7 · 2024: 4 · 2023: 9 · 2022: 6 · 2021: 10 · 2020: 15 · 2019: 9 · 2018: 12 · 2017: 11 · 2016: 9 · 2015: 13 · 2014: 13 · 2013: 7 · 2012: 4
FWCI: 8.27
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Personality Disorders Theory Research and Treatment (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (T32MH019836, R34MH071904)
Topics: Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords: borderline personality disorder, experiential avoidance, emotional dysregulation, distress tolerance, young adults, suicidal ideation, depression, emotional functioning
MeSH terms: Adolescent, Adult, Borderline Personality Disorder, Cross-Sectional Studies, Depressive Disorder, Emotions, Female, Humans, Male, Outpatients, Young Adult, Self Report, Suicidal Ideation

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An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.

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