Higher baseline emotion dysregulation predicts treatment dropout in outpatients with borderline personality disorder.

Treatment dropout is high among outpatients with borderline personality disorder (BPD) and is associated with myriad negative therapeutic and psychosocial outcomes. Identifying predictors of treatment dropout can inform treatment provision for this population. The present study investigated whether symptom profiles of static and dynamic factors could predict treatment dropout. Treatment-seeking outpatients with BPD (N = 102) completed pre-treatment measures of BPD symptom severity, emotion dysregulation, impulsivity, motivation, self-harm, and attachment style to determine their collective impact on dropout prior to 6 months of treatment. Discriminant function analysis was used to classify group membership (treatment dropout vs. nondropout) but did not produce a statistically significant function. Groups were distinguished by baseline levels of emotion dysregulation with higher dysregulation predicting premature treatment dropout. Clinicians working with outpatients with BPD might benefit from optimizing emotion regulation and distress tolerance strategies earlier in treatment to reduce premature dropout. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Relations Between Anxiety Sensitivity and Attachment in Outpatients With Borderline Personality Disorder.

Borderline personality disorder (BPD) is characterized by dysregulated emotion, interpersonal relationships, and impulsivity, and is putatively linked to a known transdiagnostic risk factor, anxiety sensitivity (AS). AS is a dispositional fear of the physical, cognitive, and/or social consequences of arousal-related somatic sensations. Gratz et al. (2008) demonstrated significantly higher AS in outpatients with BPD and a predictive value of AS over and above emotion dysregulation and impulsivity. The present study sought to extend these findings with a larger sample of outpatients with BPD by investigating predictive value of AS dimensions; relations between AS and attachment style; and impact of BPD treatment on AS. Participants completed measures at three time points: pretreatment and 6 and 12 months posttreatment. AS social was the best predictor; attachment anxiety correlated positively with AS global and AS physical. AS levels significantly decreased from pretreatment to 6 months posttreatment. Clinical implications discussed include targeting AS in BPD treatment.

Occupational Stress and Anger: Mediating Effects of Resiliency in First Responders.

First responders experience substantial stress due to the nature of their work (Carleton et al. 2017). Occupational stress (OS) results from a myriad of employment conditions (e.g., ambiguous work expectations, unreasonable workload; Osipow 1998). OS can lead to maladaptive anger, which negatively impacts personal well-being and work performance (Velichkovsky 2009). In contrast, resilience to demanding working conditions is associated with lower state and trait anger (Wilson et al. 2001); thus, resilience may serve a protective 'buffer' role against anger in the face of stress. Thus, we hypothesized that resiliency would mediate relations between dimensions of OS and anger. The current study included 201 first responders (male = 77.6%; M age = 43.73 years (SD = 10.97); police officers = 64.2%) who completed measures of OS (OSI-R; Osipow 1998), Anger (DSM-5 CC Anger; APA 2013), and Resiliency (CD-RISC; Connor and Davidson 2003). Results indicated that resiliency mediated relations between five components of OS and anger: Role Overload (p < .001); Insufficiency (p < .001); Role Boundary (p < .001); Role Ambiguity (p < .001); and Role Responsibility (p < .001). Results support the importance of resiliency-enhancing interventions to offset the experience of anger when confronted with occupational stress in first responders.