Weekly links among irritability and suicidal thoughts and behaviors in high-risk youth.

BACKGROUND: Previous studies demonstrate a link between irritability and suicidal thoughts and behaviors (STBs) in youth samples. However, they have mostly assessed irritability in community samples and as a largely dispositional (i.e. trait-like) construct. Thus, it remains unclear to what extent links between irritability and STBs reflect within-person processes of elevated risk in clinically meaningful time periods. METHODS: The present study used clinical data from 689 adolescents aged 12-19 years attending a total of 6,128 visits at a specialty Intensive Outpatient Program for depressed and suicidal youth to examine patterns in weekly assessments of irritability and STBs throughout treatment, including associations among trends and fluctuations departing from these trends via multilevel structural equation modeling. Youth completed self-report measures of irritability, depression, and STBs weekly as part of standard IOP clinical care. RESULTS: Overall, two-thirds of variance in weekly irritable mood was accounted for by between-person differences and the remaining portion by weekly fluctuations. After controlling for depression, during weeks when youth were more irritable they experienced increased STBs. Rates of change in irritability and STBs tended to track together at early stages of treatment, but these effects were generally accounted for by depression severity. CONCLUSIONS: Our results suggest that although changes in STBs are best accounted for by depression, irritability can be understood as a specific, proximal risk factor for youth STBs that exacerbates youth STBs in clinically informative timeframes above and beyond depression.

A Longitudinal Network of Borderline-Related Trait Vulnerabilities from Childhood to Adolescence.

Early maladaptive traits are predictive of later borderline personality pathology (BPP), but little is known about their dynamic interplay over time. This is an important issue to address, however, as significant differences in the 'clinical weight' of various traits constituting the early BPP trait phenotype may inform the field on important target constructs from an early intervention perspective. Therefore, the current study aims to uncover the complex dependencies between BPP traits across the crucial developmental period of childhood and adolescence, by using longitudinal network analysis. Both between- and within-person networks were constructed to identify how early mother-reported borderline-related traits are connected across a timespan of six years (ntime 1 = 718, Mtime1 = 10.73 years, SDtime1 = 1.39, 55.1% girls). Overall, the temporal network suggested various trait interdependencies, with internalizing traits being particularly influential in the development of the BPP trait network structure. At the same time, externalizing traits likely inhibit the negative effects of these core traits. In addition, results also revealed that internalizing and externalizing clusters of early borderline-related traits are linked through emotional lability. Implications of these findings are discussed in view of the change mechanisms at play and potential targets for early intervention.

The development of personality-From metatraits to facets-Across adolescence and into adulthood in a sample of Mexican-origin youth.

The time between adolescence and adulthood is a transformative period of development. During these years, youth are exploring work, relationships, and worldviews while gaining the capacities needed to take on adult roles. These social and psychological processes are reflected in how personality develops across this period. Most youth personality development research has focused on the Big Five domains, ignoring the hierarchical structure of personality and missing broader, higher order processes and more specific, lower order processes. Toward a more comprehensive account, this study examines how personality develops from adolescence into the early years of adulthood at the metatrait (stability, plasticity), domain (Big Five), and facet levels. Data come from a longitudinal study of Mexican-origin youth (N = 645) with few socioeconomic resources who were assessed 5 times from Ages 14 to 23. We used latent growth curve models to investigate mean-level change, rank-order consistency, and the maintenance of trajectories for self-reported personality metatraits, domains, and facets. We found distinct developmental processes unfolding at each level of the hierarchy, including (a) mean-level changes in the metatraits and domains indicating increases in exploratory tendencies (i.e., plasticity) and maturity (i.e., increases in agreeableness and conscientiousness, decreases in neuroticism), and divergent change patterns between facets within each domain indicating nuanced maturational processes; (b) comparable levels of rank-order consistency for metatraits, domains, and facets; and (c) evidence that deviations from youth's developmental trajectories did not persist over time. Our findings offer insights into personality development that would be impossible to glean from the domain-level alone and adds needed sociocultural diversity to the literature. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily manifestations of caregiver- and self-reported maladaptive personality traits in adolescent girls.

Establishing maladaptive personality traits at a younger age in a developmentally appropriate and clinically tangible way may alert clinicians to dysfunction earlier, and thus reduce the risk of significant impairment later in life. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Alternative Model for Personality Disorders (AMPD) provides a set of traits useful for organizing behavioral and experiential patterns central to daily personality functioning. The goal of the present study was to evaluate manifestations indicative of AMPD traits via ambulatory assessments in the daily lives of adolescent girls. Caregivers and girls (N = 129; age: M = 12.27, SD = 0.80) provided baseline assessments of girls' trait vulnerabilities (negative affectivity, detachment, antagonism, disinhibition, psychoticism) and girls additionally completed a 16-day ecological momentary assessment protocol (N = 5,036 observations), rating social behaviors and experiences in their daily lives. Multilevel structural equation models revealed that trait vulnerabilities were linked to more extreme shifts in interpersonal experiences and behaviors from one moment to the next, suggesting that maladaptive personality traits were linked to greater variability. Furthermore, AMPD traits were positively and strongly related to negative affect in daily interpersonal situations. More specifically, girls' trait ratings were associated with elevated mean-levels of boredom, as well as interpersonal tension. Caregiver-reports complemented this perspective of dissatisfying social interactions, suggesting that especially detachment and antagonism accounted for lower levels of social connectedness and more variability in social activities in girls' daily lives. Results are discussed in terms of the short-term dynamics and related intervention targets of developmental personality pathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Suicidal urges and attempted suicide at multiple time scales in borderline personality disorder.

BACKGROUND: There is strong evidence for an enduring suicidal diathesis among individuals with a history of suicide attempts, particularly among people diagnosed with borderline personality disorder (BPD). However, the progression of suicidal crises among people predisposed to suicidal behavior remains poorly understood. METHODS: Via multilevel structural equation modeling we tested the hypothesis that a history of attempted suicide predicts a stronger dynamic link between affect and impulsivity with suicidal ideation (i.e., suicidal urges) - both moment-to-moment and day-to-day. 153 patients diagnosed with BPD, 105 of whom had a history of medically serious suicide attempts completed a 21-day ecological momentary assessment protocol (17,926 total assessments). RESULTS: Individuals with higher average levels of negative affect reported more suicidal thoughts. Moments characterized by more negative affect, hostility, impulsivity, and less positive affect were also characterized by elevated suicidal ideation. For hostility and positive affect, these significant links generalized to the daily level. At the same time, for negative affect and hostility the within-person coupling was stronger among attempters in comparison to non-attempters, and these effects did not significantly differ across timescales. LIMITATIONS: Follow-up studies replicating our findings of the dysregulation-suicidality nexus in clinically more diverse samples are needed. CONCLUSIONS: The diathesis for suicidal behavior manifests in tighter dynamic links between negative affect or hostility and suicidal ideation. Because these within-person links were amplified in attempters compared to non-attempters, differential coupling patterns may index potentially lethal processes that generalize beyond BPD reflecting distinct diathesis components.

Studying personality pathology with ecological momentary assessment: Harmonizing theory and method.

Over the past 20 years, ecological momentary assessment (EMA) has become a vital part of the methods repertoire used to study personality pathology. This is because EMA facilitates modeling (dys)function consistent with clinical theory as an ensemble of contextualized dynamic within-person processes, such as when and how relevant socio-affective responses may become disrupted in daily life. Despite its popularity, there is little systematic work on the conceptual adequacy and cross-study consistency in the design choices and reporting standards of EMA studies on personality disorders. EMA protocol design choices impact the reliability and validity of conclusions, and variability in choices affect replicability and thus credibility of the conclusions drawn. We provide an overview of the core decisions researchers face in designing an EMA study organized around the "three Ds": density (frequency of surveys), depth (length of surveys), and duration (number of days in a protocol). To identify the typical and range of used study designs, including what personality disorder researchers view as important and where there are gaps in our knowledge, we reviewed relevant studies published over the years 2000 to 2021. Of 66 identified unique EMA protocols, studies scheduled ~6.5 assessments per day with an average of ~21 items, lasted for ~13 days, and obtained a compliance of ~75%. Generally, denser studies had less depth and shorter duration, whereas protocols with longer duration tended to be deeper. We offer recommendations on how valid research on personality disorders can be organized around these considerations with the goal of reliably uncovering temporal dynamics in personality (dys)functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The personality meta-trait of stability and carotid artery atherosclerosis.

BACKGROUND: Several personality traits increase the risk for atherosclerotic cardiovascular disease. Because many of these traits are correlated, their associations with disease risk could reflect shared variance, rather than unique contributions of each trait. We examined a higher-order personality trait of Stability as related to preclinical atherosclerosis and tested whether any such relationship might be explained by correlated variation in cardiometabolic risk factors. METHOD: Among 798 community volunteers, lower-order traits of Neuroticism, Agreeableness, and Conscientiousness were modeled as latent variables (from self- and informant ratings) and used to estimate the second-order factor, Stability. Cardiometabolic risk was similarly modeled from indicators of glycemic control, blood pressure, adiposity, and lipids. Carotid artery atherosclerosis was measured as intima-media thickness (IMT) by duplex ultrasonography. RESULT: A structural equation model incorporating direct and indirect effects showed lower Stability associated with greater IMT, and this relationship was accounted for by the indirect pathway via cardiometabolic risk. Secondary analyses showed that: (1) Neuroticism, Agreeableness, and Conscientiousness were unrelated to IMT independent of Stability; and (2) Stability predicted variation in IMT when estimated from informant-, but not self-rated, traits. CONCLUSION: Personality traits may associate with atherosclerotic burden through their shared, rather than unique, variance, as reflected in Stability.

Attachment Manifestations in Daily Interpersonal Interactions.

The predominant focus in attachment research on trait-like individual differences has overshadowed investigation of the ways in which working models of attachment represent dynamic, interpersonally responsive socio-affective systems. Intensive longitudinal designs extend previous work by evaluating to what extent attachment varies over social interactions and the functional processes that underlie its fluctuation. We examined momentary activation of attachment orientations in the stream of peoples' daily lives and how those patterns were linked to interpersonal behavior. Based on an event-contingent, ambulatory 7-day assessment protocol (N=263; 3,971 interactions) operationalized using Contemporary Integrative Interpersonal Theory, we examined whether contextually activated working models accounted for patterns of interpersonal (anti-)complementarity. Our analyses revealed that the situational activation of working models varied as a function of interpersonal perceptions of warmth, which were linked to greater state security and lower levels of anxious or avoidant expectations. These reactivity patterns, in turn, accounted for interpersonal complementarity. Avoidant attachment was linked to diminished and secure attachment to enhanced expressions of warmth. The analyses were robust even when controlling for momentary positive and negative affect and closeness of the relationship. Attachment expectations wax and wane across daily social interactions, and such fluctuations are reflective primarily of a process in which perceptions of others' warmth activate secure attachment expectations and lower insecure ones. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00117-6.

Functional Somatic Symptoms and Emotion Regulation in Children and Adolescents.

Background: Functional Somatic Symptoms (FSS; i.e. symptoms without sufficient organic explanation) often begin in childhood and adolescence and are common to this developmental period. Emotion regulation and parental factors seem to play a relevant role in the development and maintenance of FSS. So far, little systematic research has been conducted in childhood and adolescence on the importance of specific emotion regulation strategies and their links with parental factors. Method: In two studies, children and adolescents (Study 1/Study 2: N = 46/68; 65%/60% female, Age M = 10.0/13.1) and their parents completed questionnaires on children's FSS and adaptive and maladaptive emotional regulation (in Study 2, additionally parental somatization and child/parental alexithymia). Results: In both studies, child-reported FSS were negatively associated with children's adaptive emotion regulation (r = -.34/-.31, p < .03; especially acceptance) and positively with children's maladaptive emotion regulation and alexithymia (r = .53/.46, p < .001). Moreover, children's maladaptive emotion regulation (ß = .34, p = .02) explained incremental variance in child-reported FSS beyond children's age/sex, parental somatization and emotion regulation. In contrast, parental somatization was the only significant predictor (ß = .44, p < .001) of parent-reported FSS in children/adolescents. Conclusion: Our results suggest that particularly rumination and alexithymia and parental somatization are important predictors of FSS in children/adolescents. Overall, the results showed a dependence on the person reporting children's FSS (i.e., method-variance). So, for future studies it is relevant to continue using the multi-informant approach.

Modeling sensitivity to social threat in adolescent girls: A psychoneurometric approach.

The Research Domain Criteria (RDoC) project's success rests on the assumption that constructs and data can be integrated across units of analysis and developmental stages. We adopted a psychoneurometric approach to establish biobehavioral liability models of sensitivity to social threat, a key component of potential threat that is particularly salient to the development of adolescent affective psychopathology. Models were derived from measures across four units of analysis in a community sample (n = 129) of 11- to 13-year-old girls oversampled for shy/fearful temperament. To test the ecological validity of derived factors, they were then related to real-world socioaffective processes in peer interactions over a 16-day ecological momentary assessment (EMA) protocol. Our results indicate that measures (i.e., amygdala reactivity to negative social feedback, eye-tracking bias toward social threat, parent- and adolescent-reports of social threat sensitivity) formed unit-specific factors, rather than one unified factor. These findings suggest that these factors were largely unrelated. Amygdala response to social punishment and attention bias toward threatening faces predicted real-world experiences with peers, suggesting that vigilance toward potentially threatening social information could be a mechanism through which vulnerable youth come to experience their peer interactions more negatively. We discuss measurement challenges confronting efforts to quantify developmentally sensitive RDoC constructs across units of analysis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Protective effects of reasons for living against suicidal ideation in daily life.

How do individuals resist suicidal urges in a crisis? Deterrents for suicide can be conceptualized as reasons for living (RFL), but our understanding of their protective effects is predominantly informed by cross-sectional research. We examined the protective effects of RFL on suicidal ideation (SI) in daily life in a high-risk sample. We also tested whether personality traits moderated the strength of the dynamic RFL-SI link. Adults with a borderline personality disorder diagnosis (N = 153, nsuicide attempters = 105) completed a 21-day ambulatory assessment protocol. Daily endorsements of RFL were negatively linked to SI at the within-person but not the between-person level. Whereas suicide attempters endorsed RFL less frequently than non-attempters, the protective effect of RFL was undiminished in this group. Furthermore, RFL's protective effect was particularly pronounced in those with higher average levels of suicidal ideation. While people high on extraversion endorsed RFL more often, this increase was not protective against SI, indicating that RFL reflect heterogeneous underlying psychological processes, only some of which protect against SI.

Integrating a functional view on suicide risk into idiographic statistical models.

Acute risk of death by suicide manifests in heightened suicidal ideation in certain contexts and time periods. These increases are thought to emerge from complex and mutually reinforcing relationships between dispositional vulnerability factors and individually suicidogenic short-term stressors. Together, these processes inform clinical safety planning and our therapeutic tools accommodate a reasonable degree of idiosyncrasy when we individualize interventions. Unraveling these multifaceted factors and processes on a quantitative level, however, requires estimation frameworks capable of representing idiosyncrasies relevant to intervention and psychotherapy. Using, data from a 21-day ambulatory assessment protocol that included six random prompts per day, we developed personalized (i.e., idiographic) models of interacting risk factors and suicidal ideation via Group Iterative Multiple Model Estimation (GIMME) in a sample of people diagnosed with borderline personality disorder (N = 95) stratified for a history of high lethality suicide attempts. Our models revealed high levels of heterogeneity in state risk factors related to suicidal ideation, with no features shared among the majority of participants or even among relatively homogenous clusters of participants (i.e., empirically derived subgroups). We discuss steps toward clinical implementation of personalized models, which can eventually capture suicidogenic changes in proximal risk factors and inform safety planning and interventions.

Sleep and next-day negative affect and suicidal ideation in borderline personality disorder.

Sleep disturbance is associated with elevated suicidal ideation and negative affect. To date, however, no study has investigated the temporal relationship between sleep and suicidality among those diagnosed with borderline personality disorder (BPD). This preregistered (https://osf.io/4vugk) study tested whether nightly sleep (self-reported sleep duration, sleep onset latency, and subjective sleep quality) represents a (within-person) short-term risk factor for affective dysregulation and increases in suicide risk from day-to-day, as well as whether between-person differences in sleep, negative affect, and suicidality were associated. We used a 21-day ecological momentary assessment protocol in a sample of 153 people diagnosed with BPD, 105 of which had a history of serious suicide attempts, and 52 healthy controls (N = 4076 days). We found a within-person association between worse subjective sleep quality and greater next-day negative affect. At the between-person level, we found positive relationships between sleep latency and suicidal ideation, and a negative association between subjective sleep quality and negative affect. BPD severity did not significantly moderate the strength of any within-person associations, although BPD was positively associated with average levels of suicidal ideation, sleep latency, and negative affect, and negatively related to subjective sleep quality. These findings suggest that the association of sleep with suicidal ideation and BPD exists largely at the between-persons rather than the within-person level. Disturbed sleep, therefore, seems to largely coincide, rather than specifically contribute to, the exacerbation of suicidal crises in BPD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Momentary interpersonal processes of suicidal surges in borderline personality disorder.

BACKGROUND: Suicide rates are high in borderline personality disorder (BPD) where interpersonal problems trigger intense affective dysregulation and impulses to act on suicidal thoughts. To date, however, no study has examined how interpersonal stressors contribute to momentary within-person links among affect and impulsivity with suicidal ideation (SI), and how those links vary over time in people's daily lives. METHODS: A total of 153 individuals diagnosed with BPD and 52 healthy controls completed a 21-day ecological momentary assessment protocol. Of these 153 individuals with BPD, 105 had a history of suicide attempts. Multilevel structural equation modeling was used to examine dynamic links among interpersonal perceptions, affect, state impulsivity, and suicidal intent. RESULTS: Aggregated across interactions, lower perceived warmth in others was associated with SI. This direct relationship, however, did not extend to momentary within-person associations. Instead, interpersonal conflicts were linked to SI indirectly via greater negative affect and lower positive affect. While a robust within-person link between interpersonal perceptions and impulsivity emerged, impulsivity did not account for the relationship between interpersonal perceptions and SI. CONCLUSION: This intensive longitudinal study illustrates momentary interpersonal signatures of an emerging suicidal crisis. Among people with BPD at high risk for suicide, interpersonal triggers initiate a cascade of affective dysregulation, which in turn gives rise to SI.

Displays of negative facial affect during parent-adolescent conflict and the bidirectional transmission of social anxiety.

BACKGROUND: Symptoms of social anxiety rise rapidly during adolescence, particularly for girls. Pervasive displays of parental negative affect may increase adolescents' fear of negative evaluation (FNE), thereby increasing risk for social anxiety symptoms. Adolescent displays of negative affect may also exacerbate parents' social anxiety symptoms (via FNE of their child or their parenting skills), yet little research has tested transactional pathways of transmission in families. By early adolescence, rates of parent-child conflict rise, and offspring become increasingly independent in their own displays of negative affect, increasing opportunities for hypothesized transactional pathways between parent-adolescent displays of negative affect and social anxiety symptoms. METHODS: This study included 129 parents and daughters (11-13; no baseline social anxiety disorder), two-thirds of whom were at high risk for social anxiety due to a shy/fearful temperament. We used actor-partner interdependence models (APIM) to test whether displays of negative facial affect, assessed individually for each parent and daughter during a conflict discussion, would predict their partner's social anxiety symptoms two years later. Automated facial affect coding assessed the frequency of negative affect during the discussion. Clinician ratings of social anxiety symptoms were completed at baseline and two-year follow-up. RESULTS: Both parents and daughters who displayed more frequent negative facial affect at baseline had partners with higher follow-up social anxiety symptoms, an effect that was maintained after accounting for actors' and partners' baseline symptoms. CONCLUSIONS: Findings are consistent with intergenerational models positing that parental negative affective behaviors increase risk for adolescent social anxiety symptoms but also suggest that adolescent negative facial affect may exacerbate parental social anxiety symptoms. These bidirectional effects improve understanding of how social anxiety is maintained within a transactional family structure and highlight that displays of negative affect during parent-adolescent interaction may warrant future examination as a potential treatment target for adolescent social anxiety.

Daily stress reactivity: The unique roles of personality and social support.

BACKGROUND: The processes through which social support exerts its influence in daily life are not well understood. Arguably, its salutary effects as an environmental variable might be construed as shared effects of personality. METHOD: To test this possibility, we investigated the unique and shared effects of personality and social support on daily stressor exposure (social conflict, task strain) and on the within-person association of stressor exposure with perceived stress. A community-sample of N = 391 adults completed an ambulatory assessment protocol for two 2-day periods with fixed hourly intervals spread across 16 hr. RESULTS: Consistent with our preregistered hypotheses, multilevel structural equation models returned that both, personality and perceived social support, predicted daily stressor exposure and moderated within-person effects of daily stressors on perceived stress. In contrast to our hypotheses, received social support had no effect on daily stress processes. When Extraversion, Neuroticism, and social support were added as joint predictors, Neuroticism and Extraversion were related to stressor exposure, and further moderated the within-person link between stressor exposure and stress experience, while perceived social support had an incremental beneficial effect on social conflict exposure and stress appraisal. CONCLUSION: Social support does not increment the well-established relationships between Neuroticism or Extraversion and stress reactivity.

Integrating Structure and Function in Conceptualizing and Assessing Pathological Traits.

The Diagnostic and Statistical Manual of Mental Disorders' (5th Edition) Alternative Model of Personality Disorders includes a dimensional trait model to describe individual differences in the manifestation of personality pathology. Empirically derived quantitative trait models of psychopathology address many of the structural problems of classical diagnostic schemes (e.g., nonbinary distributions, excessive comorbidity, and diagnostic heterogeneity). However, they are largely based on the structure of individual differences in the manifestation of psychopathology. In contrast, clinical theories of personality disorder, which are the foundation of intervention efforts, are based on the function of maladaptive behavior. This distinction is akin to the difference between morphology and physiology in the broader biological sciences. A structure-function divide in the focus of empirical and clinical work contributes to a lack of integration and difficulties with translation. Here we discuss this tension and argue for the need to bridge this divide and adopt research efforts that integrate structure and function of personality traits. Specifically, we suggest that between-person structure identifies the principal domains of functioning, but to understand dysfunction personality must be conceptualized and studied as an ensemble of contextualized dynamic processes.

Self-Distancing as a Strategy to Regulate Affect and Aggressive Behavior in Athletes: An Experimental Approach to Explore Emotion Regulation in the Laboratory.

Self-regulation, especially the regulation of emotion, is an important component of athletic performance. In our study, we tested the effect of a self-distancing strategy on athletes' performance in an aggression-inducing experimental task in the laboratory. To this end, we modified an established paradigm of interpersonal provocation [Taylor Aggression Paradigm (TAP)], which has the potential to complement field studies in order to increase our understanding of effective emotion regulation of athletes in critical situations in competitions. In our experimental setting, we first tested the applicability of the self-distancing perspective and the athletes' ability to dynamically adapt besides the self-distanced perspective a self-immersed perspective to provocation in the TAP. Secondly, we investigated how this altered perspective modulated regulatory abilities of negative affectivity, anger, and aggression. The experiment consisted of two conditions in which the participant adopted either a self-immersed or a self-distanced perspective. Forty athletes (female: 23; male: 17) from different team (n = 27) and individual sports (n = 13) with a mean age of 23.83 years (SD = 3.41) competed individually in a reaction-time task against a (fictitious) opponent. Results show that athletes are equally able to adopt both perspectives. In addition, within-person analyses indicate that self-distancing decreased aggressive behavior and negative affect compared to the self-immersed perspective. Our results suggest that self-distancing modulates different levels of athletes' experience (i.e., affect and anger) and behavior. Furthermore, this demonstrates the feasibility of testing self-regulation of emotion in athletes in a laboratory setting and allows for further application in research in sports and exercise psychology.

Attachment and Borderline Personality Disorder: Differential Effects on Situational Socio-Affective Processes.

Insecure attachment and borderline personality disorder (BPD) are defined by similar affective and interpersonal processes. Individuals diagnosed with BPD, however, represent only a subset of those described as insecurely attached, suggesting that attachment may hold broader relevance for socio-affective functioning. Based on a 21-day ecological momentary assessment protocol in a mixed clinical and community sample (N = 207) oversampled for BPD, we evaluate the discriminant validity of each construct as it influences daily interpersonal interactions. We find that insecure attachment is associated with elevated perceptions of interpersonal disaffiliation and maladaptive strategies for affect regulation, whereas enacted interpersonal hostility is more distinctive for BPD. In a series of sensitivity analyses, we further highlight potential caveats to these findings when studying both constructs concurrently. Together, our results suggest that both insecure attachment and BPD contribute to problematic affective and interpersonal processes, but that they do so at different stages of the unfolding social interaction, which has important implications for their maintenance and treatment.