Affect Dysregulation in Borderline Personality Disorder and Somatoform Disorder: Differentiating Under- and Over-Regulation
Abstract
Although affect dysregulation is considered a core component of borderline personality disorder (BPD) and somatoform disorders (SoD), remarkably little research has focused on prevalence and nature of affect dysregulation in these disorders. BPD and SoD diagnoses were confirmed or ruled out in 472 psychiatric inpatients using clinical interviews. Three qualitatively different forms of affect dysregulation were identified: under-regulation, over-regulation of affect and combined under- and over-regulation of affect. BPD was associated with under-regulation of affect, and SoD was associated with over-regulation of affect. However, one in five patients with BPD also reported substantial over-regulation, and one in six patients with SoD reported clinically significant under-regulation, and the comorbid BPD and SoD group reported more frequently both over- and under-regulation than patients diagnosed with BPD or SoD alone or those with other psychiatric disorders.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Cites
(1992) · Cited by 5,228 · see citing works
Davis, H. S. (1966) · JAMA · doi:10.1001/jama.1966.03100200106038 · Cited by 1,719 · see citing works
Kirk, J., & Miller, M. L. (1986) · Sage eBooks · doi:10.4135/9781412985659.n2 · Cited by 1,376 · see citing works
Emotional processing in posttraumatic stress disorder.
Litz, B. T., Orsillo, S. M., Kaloupek, D. G., & Weathers, F. W. (2000) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.109.1.26 · Cited by 284 · see citing works
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 · see citing works
van Dijke, A., Ford Julian, D., van der Hart, O., Van Son Maarten, J. M., van der Heijden, P. G. M., & Bühring, M. E. F. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.5628 · Cited by 54 · see citing works
Self-citationDysfunctional affect regulation in borderline personality disorder and in somatoform disorder
van Dijke, A. (2012) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v3i0.19566 · Cited by 27 · see citing works
Borderline Personality Disorder
(2014) · Routledge eBooks · doi:10.4324/9781315821726-15 · Cited by 11 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities
Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000014 · Cited by 698 · see citing works
Self-citationThe Emotion Regulation Questionnaire: Psychometric properties in general community samples
Preece, D. A., Becerra, R., Robinson, K., & Gross, J. J. (2020) · Journal of Personality Assessment · doi:10.1080/00223891.2018.1564319 · Cited by 237 · see citing works
Preece, D. A., Becerra, R., Robinson, K., Dandy, J., & Allan, A. (2018) · Personality and Individual Differences · doi:10.1016/j.paid.2018.05.011 · Cited by 227 · see citing works
Complex PTSD and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00155-9 · Cited by 209 · see citing works
“hood victimization and adult BPD and cPTSD, have been investigated in a series of studies with a cohort of adult psychiatric inpatients who met criteria for BPD with or without a comorbid somatoform disorder, or with a somatoform or other severe Axis I disorder without BPD [175, 177, 179].”
BackgroundSelf-citationComplex PTSD, affect dysregulation, and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-9 · Cited by 182 · see citing works
Self-citationCattane, N., Rossi, R., Lanfredi, M., & Cattaneo, A. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1383-2 · Cited by 177 · see citing works
The Role of Trauma in Early Onset Borderline Personality Disorder: A Biopsychosocial Perspective
Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M., & Bellino, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.721361 · Cited by 111 · see citing works
Preece, D. A., Becerra, R., Robinson, K., Dandy, J., & Allan, A. (2018) · Personality and Individual Differences · doi:10.1016/j.paid.2018.07.025 · Cited by 116 · see citing works
Preece, D. A., Becerra, R., Robinson, K., & Dandy, J. (2017) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-017-9634-6 · Cited by 96 · see citing works
MacIntosh, H. B., Godbout, N., & Dubash, N. (2015) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000028 · Cited by 100 · see citing works
Giourou, E., Σκώκου, Μ., Andrew, S. P., Alexopoulou, K. I., Gourzis, P., & Jelastopulu, E. (2018) · World Journal of Psychiatry · doi:10.5498/wjp.v8.i1.12 · Cited by 95 · see citing works
van Dijke, A., Hopman, J. A. B., & Ford, J. D. (2018) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1400878 · Cited by 80 · see citing works
Self-citationWeiner, L., Perroud, N. A., & Weibel, S. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s192871 · Cited by 76 · see citing works
van Dijke, A., van der Hart, O., Ford, J. D., van Son, M. J. M., van der Heijden, P. G. M., & Bühring, M. E. F. (2010) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2010.496140 · Cited by 70 · see citing works
Self-citationIncreased attempts to suppress negative and positive emotions in Borderline Personality Disorder
Beblo, T., Fernando, S. C., Kamper, P., Griepenstroh, J., Aschenbrenner, S., Pastuszak, A., Schlosser, N., & Drießen, M. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.06.036 · Cited by 64 · see citing works
van Dijke, A., Ford, J. D., Frank, L. E., & van der Hart, O. (2015) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2015.1016253 · Cited by 53 · see citing works
Self-citationvan Dijke, A., Ford Julian, D., van der Hart, O., Van Son Maarten, J. M., van der Heijden, P. G. M., & Bühring, M. E. F. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.5628 · Cited by 54 · see citing works
Self-citationAdult attachment and emotion dysregulation in borderline personality and somatoform disorders
van Dijke, A., & Ford, J. D. (2015) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-015-0026-9 · Cited by 46 · see citing works
Self-citationEvren, C., Çınar, Ö. G., & Evren, B. (2012) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2011.11.009 · Cited by 42 · see citing works
van Dijke, A., Ford, J. D., van Son, M., Frank, L., & van der Hart, O. (2013) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/a0027256 · Cited by 41 · see citing works
Self-citationSteffen, A., Fiess, J., Schmidt, R., & Rockstroh, B. S. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0514-x · Cited by 40 · see citing works
Suicidality in patients with somatoform disorder – the speechless expression of anger?
Kämpfer, N., Staufenbiel, S. M., Wegener, I., Rambau, S., Urbach, A. S., Mücke, M., Geiser, F., & Conrad, R. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.10.022 · Cited by 40 · see citing works
Deficits in Degraded Facial Affect Labeling in Schizophrenia and Borderline Personality Disorder
van Dijke, A., Wout‐Frank, M. V. ‘., Ford, J. D., & Aleman, A. (2016) · PLoS ONE · doi:10.1371/journal.pone.0154145 · Cited by 37 · see citing works
Self-citationFossati, A., Gratz, K. L., Somma, A., Maffei, C., & Borroni, S. (2016) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_222 · Cited by 33 · see citing works
del Río-Casanova, L., González, A., Páramo, M., Van Dijke, A., & Brenlla, J. (2016) · Reviews in the Neurosciences · doi:10.1515/revneuro-2015-0045 · Cited by 32 · see citing works
Lamela, D. J. P. D. V., & Figueiredo, B. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.04.001 · Cited by 29 · see citing works
Toward a Definition of Affective Instability
Renaud, S., & Zacchia, C. (2012) · Harvard Review of Psychiatry · doi:10.3109/10673229.2012.747798 · Cited by 31 · see citing works
Dysfunctional affect regulation in borderline personality disorder and in somatoform disorder
van Dijke, A. (2012) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v3i0.19566 · Cited by 27 · see citing works
Childhood risk factors for personality disorder symptoms related to violence
Reising, K., Farrington, D. P., Ttofi, M. M., Piquero, A. R., & Coid, J. (2019) · Aggression and Violent Behavior · doi:10.1016/j.avb.2019.07.010 · Cited by 26 · see citing works
Morales‐Muñoz, I., Upthegrove, R., Mallikarjun, P. K., Broome, M. R., & Marwaha, S. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.4724 · Cited by 25 · see citing works
Cheavens, J. S., Strunk, D. R., & Chriki, L. S. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.20870 · Cited by 24 · see citing works
Dragan, M. (2018) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2018.12.001 · Cited by 22 · see citing works
Emotional Reactivity, Emotion Regulation, and Regulatory Choice in Somatic Symptom Disorder
Schnabel, K., Schulz, S. M., & Witthöft, M. (2022) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001118 · Cited by 21 · see citing works
Schmaling, K. B., & Fales, J. L. (2018) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12244 · Cited by 17 · see citing works
Punamäki, R., Flykt, M. S., Belt, R. H., & Lindblom, J. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e06728 · Cited by 19 · see citing works
van Dijke, A., Hopman, J. A. B., & Ford, J. D. (2018) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.11.002 · Cited by 15 · see citing works
Self-citationvan Dijke, A., van der Hart, O., van Son, M. J. M., Bühring, M. E. F., van der Heijden, P. G. M., & Ford, J. D. (2012) · Psychopathology · doi:10.1159/000338832 · Cited by 14 · see citing works
Self-citationPériard, I. A.-C., Dierolf, A. M., Lutz, A., Vögele, C., Voderholzer, U., Koch, S., Bach, M., Asenstorfer, C., Michaux, G., Mertens, V., et al. (2024) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2024.112342 · Cited by 12 · see citing works
Ford, J. D. (2018) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12243 · Cited by 11 · see citing works
Self-citationDemystifying borderline personality disorder in primary care
Wu, T., Hu, J. J., Davydow, D. S., Huang, H., Spottswood, M., & Huang, H. Y. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.1024022 · Cited by 12 · see citing works
Treatment for Borderline Personality Disorder and Secondary Effects on Somatization
Schmaling, K. B., Fales, J. L., & Linehan, M. M. (2020) · Journal of Personality Disorders · doi:10.1521/pedi_2020_34_469 · Cited by 8 · see citing works
Wegen, K. S., van Dijke, A., Aalbers, A., & Zedlitz, A. M. E. E. (2017) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2017.06.001 · Cited by 7 · see citing works
BEERTEN-DUIJKERS, J. C. L. M., Vissers, C., Verbeeck, W., Arntz, A. R., & Egger, J. I. M. (2014) · UvA-DARE (University of Amsterdam) · Cited by 6 · see citing works
Evren, C., Karabulut, V., Alnıak, İ., Evren, B., Carkci, O. H., Cengel, H. Y., Menekseoglu, P. O., Cetin, T., Bozkurt, M., & Umut, G. (2019) · Psychiatry and Clinical Psychopharmacology · doi:10.1080/24750573.2019.1595271 · Cited by 5 · see citing works
van Dijke, A., & Lenstra, S. (2016) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000271 · Cited by 4 · see citing works
Do Patients with Somatoform Disorders Present with Illusory Mental Health?
Eurelings, J. W. E., Dijke, B. A. V., & Gool, F. M. A. V. (2015) · Journal of Psychology & Psychotherapy · doi:10.4172/2161-0487.1000213 · Cited by 4 · see citing works
Heidari, S., & Aliloo, M. M. (2015) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2015.03.434 · Cited by 4 · see citing works
Mersin, S., Kuş, İ., & Mercan, N. (2025) · Perspectives In Psychiatric Care · doi:10.1155/ppc/8533257 · Cited by 2 · see citing works
The Role of Trauma in the Therapeutic Relationship
Pievani, L., Mapelli, C., & Fernández, I. (2024) · Springer eBooks · doi:10.1007/978-3-031-71904-2_9 · Cited by 1 · see citing works
Childhood risk factors, emotion awareness and regulation in borderline personality disorder
Vickers, L. (2014) · Bangor University Research Portal (Bangor University)
Corcos, M., Loisel, Y., & Jeammet, P. (2016)
Reising, K. (2020) · Apollo (University of Cambridge) · doi:10.17863/cam.72834
Steele, K., Boon, S., & van der Hart, O. (2018) · De Boeck Supérieur eBooks · doi:10.3917/dbu.steel.2018.01.0565
Shang, V., Parle, S., & Kitamura, H. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4855623
Attention-Deficit/Hyperactivity Disorder (ADHD) and Borderline Personality Disorder
Salavati, M., & Selby, E. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-75503-3_15
Leonardi, J., Gazzillo, F., & Kealy, D. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100645
Fernandez, V. A. (2019) · theses.fr (ABES) · doi:10.70675/25b8c91azd0fcz4680z8a83zdfd3d067a92c
Abargil, M., Rubinstein, D., Lerner, A., Basol, E. Z., Maynard, J., Davydovska, T., & Harpaz‐Rotem, I. (2026) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001885
- Authors
- van Dijke, A., Ford, J. D., van der Hart, O., van Son, M., van der Heijden, P., & Bühring, M.
- Affiliations
- University of Connecticut (US)
- Venue
- Journal of Personality Disorders
- Publisher
- Guilford Publications
- Published
- 2010-06
- Volume
- 24
- Issue
- 3
- Pages
- 296-311
- ISSN
- 0885-579X (ISSN-L)
- OpenAlex
- W2064970989
- Cited by
- 58
- References
- 8
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 5 · 2018: 8 · 2017: 4 · 2016: 5 · 2015: 7 · 2014: 4 · 2013: 2 · 2012: 6
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- affect dysregulation, borderline personality disorder, somatoform disorders, comorbidities, psychiatric inpatients
- MeSH terms
- Adult, Affect, Analysis of Variance, Borderline Personality Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Regression Analysis, Somatoform Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review