Feelings of emptiness represent a common experience among individuals with borderline personality disorder (BPD) that are not well understood. Theoretical literature suggests that emptiness functions to downregulate intense emotional experiences in BPD, but this has not been tested. This study examines whether (1) emptiness at baseline and emptiness in response to stressors (i.e. emptiness reactivity) is elevated in BPD relative to clinical and healthy controls (HCs), and whether (2) emptiness reactivity predicts emotion reactivity across self-report, skin conductance response (SCR), and (...) respiratory sinus arrhythmia (RSA) indices of emotion. Participants (N = 120) with BPD, generalised anxiety disorder (GAD), or HCs provided measurements of emptiness, self-reported emotion, SCR, and RSA at baseline and following a rejection-themed stressor. Results revealed that baseline emptiness was highest in the BPD group compared to the HC group and the GAD group. There were no significant group differences for emptiness reactivity. Overall, increases in emptiness predicted increases and decreases in emotional reactivity via self-report and RSA, respectively. These results suggest that higher baseline emptiness rather than emptiness reactivity is characteristic of BPD. Future research using longitudinal and ecological momentary assessment designs is needed to examine the causes of emptiness and how it can be effectively reduced. (shrink)

Improving emotion regulation is central to borderline personality disorder (BPD) treatment, but little research indicates which emotion regulation strategies are optimally effective and when. Basic emotion science suggests that engagement emotion regulation strategies that process emotional content become less effective as emotional intensity increases, whereas disengagement strategies that disengage from it do not. This study examined whether emotional reactivity to emotional stimuli predicts the effectiveness of engagement and disengagement emotion regulation across self-report, general physiologic (heart rate), sympathetic (skin conductance responses), (...) and parasympathetic (respiratory sinus arrythmia) emotion in BPD, healthy, and clinical control (i.e. generalized anxiety disorder; GAD) groups. 120 participants (40 per group) were exposed to emotion inductions and then instructed to implement engagement (mindful awareness) and disengagement (distraction) strategies while self-report and physiological emotion measurements were taken. In the BPD and GAD groups, higher heart rate or respiratory sinus arrythmia reactivity, respectively, predicted improved mindful awareness effectiveness. Higher skin conductance reactivity predicted worsened distraction effectiveness in BPD. Higher reactivity may potentiate engagement emotion regulation, and exacerbate disengagement from emotional content, in BPD. Future research should examine other domains of emotion regulation that may be influenced by emotional intensity, and other forms of emotional intensity that may influence them. (shrink)