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An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms.
Open accessAbstract
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, 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]
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“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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Gratz, K. L., & Roemer, L. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000007455.08539.94 · Cited by 8,942
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.03.007 · Cited by 3,950
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1152 · Cited by 3,595
Self-citationMeasuring experiential avoidance: A preliminary test of a working model
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., et al. (2004) · The Psychological Record · doi:10.1007/bf03395492 · Cited by 2,140
Self-citationThe Distress Tolerance Scale: Development and Validation of a Self-Report Measure
Simons, J. S., & Gaher, R. M. (2005) · Motivation and Emotion · doi:10.1007/s11031-005-7955-3 · Cited by 1,730
Gratz, K. L., & Gunderson, J. G. (2006) · Behavior Therapy · doi:10.1016/j.beth.2005.03.002 · Cited by 618 · cited 1×
“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).”
MethodDelineating components of emotion and its dysregulation in anxiety and mood psychopathology
Mennin, D. S., Holaway, R. M., Fresco, D. M., Moore, M. T., & Heimberg, R. G. (2007) · Behavior Therapy · doi:10.1016/j.beth.2006.09.001 · Cited by 527
An experimental investigation of emotion dysregulation in borderline personality disorder
Gratz, K. L., Rosenthal, M. Z., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.115.4.850 · Cited by 518
Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. (2006) · Psychological Assessment · doi:10.1037/1040-3590.18.3.303 · Cited by 486
Emotion Processing in Borderline Personality Disorders
LEVINE, D., Marziali, E., & Hood, J. E. (1997) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199704000-00004 · Cited by 430
Flagged first, then by citations
Research works printed but not linked: 4
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- Gratz KL Tull MT 2011 The role of distress tolerance in the pathogenesis and treatment of borderline personality disorder Zvolensky MJ Bernstein A Vujanovic AA Distress tolerance: Theory, Research and Clinical Practice 198 220 New York, NY Guilford Press
- Linehan MM 1993 Cognitive-behavioral treatment of borderline personality disorder New York The Guilford Press
- Pistorello J 1998 Acceptance, suppression, and monitoring of an unwanted thought among women diagnosed with borderline personality disorder Dissertation Reno, NV
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Hashemi, M. S., Zargarinejad, G., Zahedi Tajrishi, K., & Asgharnejad Farid, A. (2026) · Journal of College Student Mental Health · doi:10.1080/28367138.2025.2493891 · Cited by 1
Acceptance and Commitment Model of Borderline Personality Disorder
Salavati, M., & Selby, E. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-75503-3_11 · Cited by 1
Emotion Recognition and Personality Traits: a pilot study
Tighe, H. (2012) · Sound Ideas (University of Puget Sound) · Cited by 1
김혜원, & Lee, J. (2016) · The Korea Journal of Youth Counseling · doi:10.35151/kyci.2016.24.1.009 · Cited by 1
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Sauer-Zavala, S. E., Bentley, K. H., & Wilner, J. G. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813521-1.00013-8 · Cited by 1
The role of distress tolerance in aggressive behavior
McIntyre, A. W. (2013) · Aquila Digital Community (University of Southern Mississippi) · Cited by 1
McCluskey, D. L. (2017) · The Research Repository @ WVU (West Virginia University) · doi:10.33915/etd.6192 · Cited by 2
Feeney, J. (2012) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 1
Vestin, N., & María, A. (2013) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Emotion regulation and Borderline Personality features
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Lee, J., & Hyun, M. (2020) · Korean Journal of Stress Research · doi:10.17547/kjsr.2020.28.4.262
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Mann, A. J., Tull, M. T., & Gratz, K. L. (2023) · Behavior Modification · doi:10.1177/01454455231191710
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Metadata
- Authors
- Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzzetti, A. E.
- Affiliations
- VA Boston Healthcare System (US)
- University of Nevada, Reno (US)
- Venue
- Personality Disorders: Theory, Research, and Treatment
- Published
- 2012-10
- Volume
- 3
- Issue
- 4
- Pages
- 415-422
- ISSN
- 1949-2715 (ISSN-L)
- 1949-2723
- 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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