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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
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Borderline Personality Disorder: A Clinical Guide
Gunderson, J. G., & Links, P. S. (1984) · Cited by 388
(2009) · Journal of American College Health · doi:10.3200/jach.57.5.477-488 · Cited by 360
Borderline personality disorder and emotional responding: a review of the research literature
Rosenthal, M. Z., Gratz, K. L., Kosson, D. S., Cheavens, J. S., Lejuez, C. W., & Lynch, T. R. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.04.001 · Cited by 245
Dialectical behavior therapy (DBT) applied to college students: A randomized clinical trial.
Pistorello, J., Fruzzetti, A. E., MacLane, C., Gallop, R., & Iverson, K. M. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029096 · Cited by 240
Self-citationBorderline Personality Disorder and Deliberate Self‐Harm: Does Experiential Avoidance Play a Role?
Chapman, A. L., Specht, M. W., & Cellucci, T. (2005) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2005.35.4.388 · Cited by 198
Affect Regulation in Borderline Personality Disorder
Conklin, C. Z., Bradley, R. G., & Westen, D. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000198138.41709.4f · Cited by 189
Borderline personality disorder and multiple aspects of emotional intelligence
Leible, T. L., & Snell, W. E. (2003) · Personality and Individual Differences · doi:10.1016/j.paid.2003.09.011 · Cited by 173
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Nick, B., Delany-Brumsey, A., Lynch, T. R., Kosson, D., & Lejuez, C. W. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.07.014 · Cited by 152
Coping strategies in relation to personality disorders
Bijttebier, P., & Vertommen, H. (1999) · Personality and Individual Differences · doi:10.1016/s0191-8869(98)00187-1 · Cited by 127
Berking, M., Neacsiu, A., Comtois, K. A., & Linehan, M. M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.011 · Cited by 124
Measuring changes in emotion during psychotherapy: Conceptual and methodological issues.
Sloan, D. M., & Kring, A. M. (2007) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2007.00092.x · Cited by 123
Gratz, K. L., Tull, M. T., & Gunderson, J. G. (2008) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2007.05.011 · Cited by 121 · cited 2×
“…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…”
BackgroundResult(2010) · Cited by 114
Self-citationMiller, A. L., Wyman, S. E., Huppert, J. D., Glassman, S. L., & Rathus, J. H. (2000) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(00)80029-2 · Cited by 100
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Distress tolerance: Theory, research, and clinical applications.
Zvolensky, M. J., Bernstein, A., & Vujanovic, A. A. (2011) · Cited by 57
The concurrent validity of three self-report measures of borderline personality
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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
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The structure of common emotion regulation strategies: A meta-analytic examination
Naragon-Gainey, K., McMahon, T. P., & Chacko, T. P. (2017) · Psychological Bulletin · doi:10.1037/bul0000093 · Cited by 588
Daros, A. R., & Williams, G. E. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000212 · Cited by 169
Tomko, R. L., Lane, S. P., Pronove, L. M., Padovano, H. T., Brown, W. C., Solhan, M. B., Wood, P. K., & Trull, T. J. (2015) · Journal of Abnormal Psychology · doi:10.1037/abn0000064 · Cited by 119
The Role of Distress Tolerance in the Use of Specific Emotion Regulation Strategies
Jeffries, E. R., McLeish, A. C., Kraemer, K. M., Avallone, K. M., & Fleming, J. B. (2016) · Behavior Modification · doi:10.1177/0145445515619596 · Cited by 105
Osborne, T. L., Michonski, J. D., Sayrs, J. H. R., Welch, S. S., & Anderson, L. K. (2017) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-017-9586-x · Cited by 115
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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