Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral dysregulation.

Abstract

Theories of borderline personality disorder (BPD) have often considered it a disorder involving both emotional and behavioral dysregulation Keywords: borderline personality disorder, rumination, emotion dysregulation, nonsuicidal self-injury, dialectical behavior therapy The model presented in this article builds on Linehan's (1993) model, integrating findings from the field of emotion regulation with clinical research on behavioral dysregulation to better understand BPD. The Emotional Cascade Model posits that individuals with BPD undergo what is called an "emotional cascade," in which rumination on negative affect induces behavioral dysregulation. An emotional cascade is the result of a positive feedback loop where high levels of rumination on negative affect increase emotional intensity, and in response this increase in emotional intensity results in increased rumination. This cycle may generate an amplified emotional response to even minute amounts of emotional stimuli, and this cycle is self-perpetuating so that it may last for an extended amount of time. Furthermore, an emotional cascade may result in such an aversive emotional response that some of the most effective ways for individuals with BPD to reduce their negative affect involve behaviors that produce potent physical stimuli (such as the pain and visual sensations resulting from self-injurious behavior). Thus, dysregulated behaviors may serve as forms of distraction for individuals with BPD, allowing them to shift their attention from negative affective stimuli and in effect "shortcircuit" the emotional cascade. Other factors that may influence emotional cascades, such as catastrophizing, thought suppression, and low-distress tolerance, are discussed as well. BPD is then presented as an "emergent" phenomenon and the model is evaluated in light of other theories of and therapeutic traditions for BPD, resulting in a conclusion that this model may provide a unifying framework for differing theories and traditions. BPD BPD is a chronic and severe disorder characterized by chaotic interpersonal relationships, affective instability, anger control problems, identity diffusion, various forms of impulsive behaviors