The specificity of emotion dysregulation in adolescents with borderline personality disorder: comparison with psychiatric and healthy controls
Open accessAbstract
BACKGROUND: Research has supported the notion that emotion dysregulation is a core feature of BPD. However, given that this feature is typical of healthy adolescents as well as adolescents with other psychiatric disorders, the specificity of emotion dysregulation to BPD in this age group has not yet been determined. The overall aim of this study was to examine emotion dysregulation in adolescent inpatients with BPD compared with non-BPD inpatient adolescents and healthy non-clinical adolescents, taking into account both global emotion dysregulation deficits and more specific impairments. METHOD: = 1.22), all of whom were between the ages of 12 and 17. Borderline personality features were assessed, along with emotion dysregulation and psychiatric severity. RESULTS: After controlling for age, gender, and psychiatric severity, results revealed that adolescents with BPD had higher overall emotional dysregulation compared with non-BPD psychiatric controls and healthy controls. These differences were apparent in only two domains of emotion dysregulation including limited access to emotion regulation strategies perceived as effective and impulse control difficulties when experiencing negative emotions. CONCLUSIONS: Findings suggest BPD-specific elevations on emotion dysregulation generally, and subscales related to behavioral regulation specifically.
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Emotion dysregulation is a trans-diagnostic factor with negative impact on various domains of psychopathology in adolescents.
“Emotion dysregulation is seen as a trans-diagnostic factor with negative impact on various domains of psychopathology in adolescents (1), although specifics could be identified in the subgroup of patients suffering from borderline personality disorder (BPD) (2).”
From Radical Acceptance of Reality: Putting DBT®-A Skill Groups Online During the COVID-19 Pandemic: A Qualitative Study (2022) · cites this paper as [2]
The Discussion says emotion dysregulation cuts across multiple forms of psychopathology, and the Background links high levels of it in adolescents to elevated rates of several psychiatric problems. Those passages support the trans-diagnostic framing, but they describe associations rather than establishing a negative causal impact on psychopathology. (LLM, conf=0.85)
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“As a result, DBT has been successful in reducing impulsive behavior in individuals with the disorder [59, 60].”
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Reliability and validity of borderline personality disorder in hospitalized adolescents.
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“As a result, DBT has been successful in reducing impulsive behavior in individuals with the disorder [59, 60].”
BackgroundEmotion Dysregulation Among Adolescents with Borderline Personality Disorder
Matusiewicz, A. K., Weaverling, G. C., & Lejuez, C. W. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0591-1_13 · Cited by 10 · cited 1× · see citing works
“In this context, emotion dysregulation can be generally defined as “the frequent and intense experience of emotions combined with an inability to cope with their occurrence” [8].”
BackgroundEmotion Dysregulation in Adolescents with Borderline Personality Disorder
Sharp, C., & Trull, T. J. (2017) · Oxford University Press eBooks · doi:10.1093/med:psych/9780198765844.003.0013 · Cited by 4 · see citing works
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Mentalization and dissociation after adverse childhood experiences
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“Another recent study, displayed how BPD patients compared to non-BPD psychiatric controls and healthy controls, showed more dysfunctional emotion regulation, even when controlling for important sociodemographic and clinical variables [40].”
ResultGarcía‐Alandete, J., de Tejada, B. G.-H., Pérez, S., & Marco, J. H. (2018) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2327 · Cited by 33 · see citing works
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“Besides more intense negative emotional reactions to experiences of social exclusion, deficits in the regulation of emotions have been found in adolescents with BPD compared to healthy controls but also adolescents with other psychiatric disorders, using psychometric (Ibraheim et al., 2017) as well as ambulatory asses…”
MethodKim, M.-K., Kim, J.-S., Park, H., Choi, S., Oh, W.-J., & Seok, J. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.119 · Cited by 33 · see citing works
Emotion regulation difficulties and psychopathology among Pakistani adolescents
Zafar, H., Debowska, A., & Boduszek, D. (2020) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104520969765 · Cited by 31 · see citing works
“…consistent with the findings of previous research, which reported adolescents with borderline personality to have elevated scores on overall DERS, and higher scores on two DERS dimensions: “impulse control difficulties” and “limited access to emotion regulation strategies” (Ibraheim et al., 2017).”
BackgroundResultWeiner, L., Costache, M. E., Bemmouna, D., Rabot, J., Weibel, S., Dubreucq, M., Dubreucq, J., & Coutelle, R. (2023) · Women s Health · doi:10.1177/17455057231174763 · Cited by 29 · see citing works
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“This result is different from Ibraheim and coworker’s findings in an adolescent sample, where only two subscales ("limited access to strategies" and "impulse control difficulties") differed significantly [24].”
MethodResultLedden, S., Rains, L. S., Schlief, M., Barnett, P., Ching, B. C. F., Hallam, B., Günak, M. M., Steare, T., Parker, J., Labovitch, S., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-022-04171-z · Cited by 17 · see citing works
Kolla, N. J., Tully, J., & Bertsch, K. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02612-1 · Cited by 23 · see citing works
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Yang, C., Wang, J., Shao, Y., Liu, M., & Geng, F. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105822 · Cited by 19 · see citing works
Xiao, Q., Fu, Y. H. H., Yi, X., Ding, J., Han, Z., Zhang, Z., Tan, Z.-M., Wang, J., Wu, Z., Pi, J., et al. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2163768 · Cited by 18 · see citing works
“Borderline personality disorder (BPD) is characterized by a persistent pattern of emotional dysregulation, marked impulsivity, interpersonal disturbances, and identity instability (Bohus et al., 2021), which often begins during adolescence (Ibraheim et al., 2017).”
BackgroundIMPACT OF TINNITUS PERCEPTION ON PSYCHOLOGICAL DISTRESS IN MALE AND FEMALE TINNITUS PATIENTS
Ahmed, B., Ahmed, A., Akhtar, T., & Salim, S. (2017) · Foundation University Journal of Psychology · doi:10.33897/fujp.v1i1.56 · Cited by 18 · see citing works
Effectiveness of a 5-Week Inpatient Dialectical Behavior Therapy for Borderline Personality Disorder
Probst, T., O’Rourke, T., Decker, V., Kießling, E., MEYER, S., Bofinger, C., Niklewski, G., Mühlberger, A., & Pieh, C. (2019) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000383 · Cited by 17 · see citing works
Harpøth, T. S. D., Hepp, J., Trull, T. J., BATEMAN, A. W., Kongerslev, M., & Simonsen, E. H. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_453 · Cited by 17 · see citing works
Benzi, I. M. A., Fontana, A., Lingiardi, V., Parolin, L. A. L., & Carone, N. (2023) · Current Psychology · doi:10.1007/s12144-023-05440-0 · Cited by 18 · see citing works
Adolescent Sleep Disturbance, Emotion Regulation and Borderline Features in an Inpatient Setting
Wall, K., Vanwoerden, S., Penner, F., Patriquin, M. A., Alfano, C. A., & Sharp, C. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1772081 · Cited by 17 · see citing works
“Lastly, Lereya et al. (2017) longitudinally assessed the relation between childhood sleep problems and nightmares with BPD symptoms in early adolescence.”
BackgroundUnconscious loss processing in diabetes: associations with medication adherence and quality of care
Marchini, F., Langher, V., Napoli, A., Balonan, J. T., Fedele, F., Martino, G., Amorosi, F. R., & Caputo, A. (2021) · Psychoanalytic Psychotherapy · doi:10.1080/02668734.2021.1922492 · Cited by 16 · see citing works
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Introduction to Mentalization-Based Approaches for Parents, Children, Youths, and Families
Volkert, J., Taubner, S., Byrne, G., Rossouw, T. I., & Midgley, N. (2021) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20210020 · Cited by 14 · see citing works
Thomson, M., Cavelti, M., Lerch, S., Koenig, J., Reichl, C., Mürner-Lavanchy, I. M., Wyssen, A., & Kaess, M. (2024) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-024-00252-5 · Cited by 12 · see citing works
Self-reported childhood family adversity is linked to an attenuated gain of trust during adolescence
Reiter, A. M. F., Hula, A., Vanes, L. D., Hauser, T. U., Kokorikou, D., Goodyer, I. M., NSPN Principle Investigators, staff, N., Fonagy, P., Moutoussis, M., et al. (2023) · Nature Communications · doi:10.1038/s41467-023-41531-z · Cited by 14 · see citing works
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“, which in turn results in positive affect (Howard 2017; Ibraheim et al. 2017).”
BackgroundParr, A. C., Calancie, O. G., Coe, B. C., Khalid‐Khan, S., & Munoz, D. P. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.667399 · Cited by 13 · see citing works
“, assessed using the difficulties in emotion regulation scale DERS; Gratz and Roemer, 2004), particularly with regard to lacking access to emotion regulation strategies and impulse control difficulties (Ibraheim et al., 2017), may lead to exacerbated impulsivity, particularly in the context of negative affect (Koenigs…”
MethodPinto, A. L. D. C. B., Pasian, S. R., & Malloy‐Diniz, L. F. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23213 · Cited by 10 · see citing works
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Seeing oneself through the eyes of another: A look at psychedelic insight
Fischman, L. G. (2022) · Neuropsychoanalysis · doi:10.1080/15294145.2022.2052163 · Cited by 7 · see citing works
Xiao, Q., Wang, X., Yi, X., Fu, Y. H. H., Ding, J., Jiang, F., Wang, J., Han, Z., & Chen, B. T. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.04.055 · Cited by 6 · see citing works
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“In this development period, heightened emotional distress is also a characteristic (Ibraheim et al., 2017).”
BackgroundMungo, A., Delhaye, M., & Hein, M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15031047 · Cited by 5 · see citing works
“The global elevation of DERS scores in our sample thus indicates that emotion regulation deficits are not secondary symptoms, but rather structural characteristics of borderline functioning [4,27].”
InfluentialSharp, C., Venta, A. C., & McLaren, V. (2023) · Journal of Personality Disorders · doi:10.1521/pedi.2023.37.5.475 · Cited by 4 · see citing works
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“…inpatient sample, adolescents with BP disorder displayed greater concurrent self-reported impulse control difficulties when emotional and had more limited access to emotion regulation strategies as compared to youth with other psychiatric disorders, including ADHD (Ibraheim et al., 2017).”
BackgroundResultInfluentialMaffly‐Kipp, J., McCredie, M. N., & Morey, L. C. (2022) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-022-00189-7 · Cited by 4 · see citing works
Wyrzykowski, J., Kostecka, B., Santangelo, P., & Kucharska, K. (2025) · Journal of Personality Disorders · doi:10.1521/pedi.2025.39.1.77 · Cited by 3 · see citing works
Gupta, N., Gupta, M., Madabushi, J. S., & Zubiar, F. (2023) · Cureus · doi:10.7759/cureus.40295 · Cited by 7 · see citing works
“The Difficulties in Emotion Regulation Scale (DERS) has been established as a reliable tool with good construct validity and predictive validity in adolescents [90].”
MethodNewhill, C. E., Yuan, Y., Wojtalik, J. A., & Eack, S. M. (2021) · Journal of the Society for Social Work and Research · doi:10.1086/713820 · Cited by 2 · see citing works
“However, only a few crossdiagnostic studies have been conducted showing how the relevance of the emotion dysregulation construct compares across a range of psychiatric disorders (Aldao et al., 2010; Ibraheim et al., 2017; Jazaieri et al., 2013).”
BackgroundBorderline and Depression: A Thin EEG Line
Vukojević, J., Mulc, D., Kinder, I., Jovičić, E., Friganović, K., Savić, A., Cifrek, M., & Vidović, D. (2021) · Clinical EEG and Neuroscience · doi:10.1177/15500594211060830 · Cited by 2 · see citing works
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Current Neuroscientific Concepts and Psychotherapy: Possibilities for Integration
Dobrushina, O. R. (2024) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-024-01649-z · Cited by 1 · see citing works
Mittermeier, S., Gregorová, K., Göttfert, C., Merz, C., Weiss, M. H., Krauss, J., Franke, S., Reiter, A. M. F., Wienrich, C., & Buerger, A. (2025) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2025.100583 · Cited by 1 · see citing works
“Adolescent BPD patients particularly struggle with EA management as part of their broader emotion dysregulation (Ibraheim et al., 2017).”
Wang, X., Yi, X., Xiao, Q., Wang, J., Fu, Y., Shen, L., Zhang, J., Wu, F., Wu, H., Grecucci, A., et al. (2026) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2026.112181 · Cited by 1 · see citing works
Das Mentalisieren des Körpers braucht den Gegenwartsmoment der Gruppe
Felsberger, H. (2022) · Gruppenpsychotherapie und Gruppendynamik · doi:10.13109/grup.2022.58.3.235 · Cited by 1 · see citing works
Parr, A. C., Calancie, O. G., Coe, B. C., Khalid‐Khan, S., & Munoz, D. P. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.02.11.430783
“…DERS; Gratz & Roemer, 2004), particularly with regard to lacking access to emotion regulation strategies and impulse control difficulties (Ibraheim et al., 2017), may lead to exacerbated impulsivity, particularly in the context of negative affect (Chapman et al., 2008; Hallquist et al.,…”
BackgroundBorderline and Other Personality Disorders: New Directions in 2022
(2022) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.22020013
Linking Trauma-Exposure with Violent Offending – Narrative Review and Clinical Implications
Møeller, S. B., Bo, S., & Arendt, I. T. P. (2022) · Springer eBooks · doi:10.1007/978-3-030-98711-4_42-1
Linking Trauma-Exposure with Violent Offending: Narrative Review and Clinical Implications
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The Therapeutic Relationship as an Attachment Relationship: The Role of Epistemic Trust
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Naïve Observers’ Perceptions of Hospitalized and Community Adolescents’ Depressive Symptoms
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Nonsuicidal Self-Harm and Suicide in Borderline Personality Disorder
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Dissociation in Borderline Personality Disorder
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Eating Disorders and Borderline Personality Disorder
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Parenting Styles and Borderline Personality Disorder
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Anger Rumination Uniquely Contributes to Emerging Personality Pathology in Adolescent Boys
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“…as factors relevant to the devel - opment of BPD and its associated consequences among both adults and adolescents (e.g., Daros & Williams, 2019; Ibraheim et al., 2017; Salgó et al., 2021; Scott et al., 2014; Sorgi-Wilson & McCloskey, 2022; Terzi et al., 2017; Vaillancourt et al., 2014).”
InfluentialLedden, S., Rains, L. S., Schlief, M., Barnett, P., Ching, B. C. F., Hallam, B., Günak, M. M., Steare, T., Parker, J., Labovitch, S., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20962345
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Zhang, P., Zhao, Y., Qin, Y., Chen, A., He, C., He, S., Lin, Q., Ai, Z., Chen, F., & Shi, J. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10769-4
- Authors
- Ibraheim, M., Kalpakci, A., & Sharp, C.
- Affiliations
- University of Houston (US)
- Corresponding author
- Sharp, Carla
- Venue
- Borderline Personality Disorder and Emotion Dysregulation
- Published
- 2017-01-10
- Volume
- 4
- Issue
- 1
- Pages
- 1-1
- ISSN
- 2051-6673 (ISSN-L)
- PMC
- PMC5223469
- OpenAlex
- W2569026848
- Cited by
- 72
- References
- 77
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 11 · 2023: 11 · 2022: 18 · 2021: 9 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 3
- FWCI
- 5.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Borderline Personality Disorder and Emotion Dysregulation (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- McNair Family Foundation
- Duncan Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- emotional dysregulation, borderline personality disorder, adolescents, adolescent inpatients, behavioral regulation, impulse control, psychiatric symptom severity, borderline personality traits
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