Cognitive Therapy and Research

, Volume 40, Issue 3, pp 314–327 | Cite as

Emotional Reactivity to Personally-Relevant and Standardized Sounds in Borderline Personality Disorder

  • M. Zachary RosenthalEmail author
  • Andrada D. Neacsiu
  • Paul J. Geiger
  • Caitlin Fang
  • Roianne Ahn
  • Jose Larrauri
Original Article


Theoretical conceptualizations highlight emotional reactivity as a core problem for borderline personality disorder (BPD); however, empirical work investigating emotional reactivity in BPD has produced mixed and inconclusive findings. The current study aimed to clarify emotional reactivity in adults diagnosed with BPD (N = 22) and healthy controls (HCs; N = 31) using a controlled, laboratory experiment that assessed multiple indices of emotional reactivity (i.e., subjective, psychophysiological, and facial expressive) in response to auditory stimuli (i.e., standardized vs. personally-relevant; pleasant vs. unpleasant sounds). The BPD group was characterized by higher self-reported arousal and lower valence to personally-relevant unpleasant sounds compared to HCs. Supporting study hypotheses, participants in the BPD group showed heightened skin conductance responses, specifically to unpleasant personally-relevant sounds, compared to HCs. No differences were found between BPD and HC groups on facial expressive responses. Findings replicate and extend previous studies on this topic, and highlight the need to further refine the characterization of emotional reactivity in BPD to include personally-relevant unpleasant stimuli.


Borderline personality disorder Emotion Emotional reactivity Emotion regulation Sensory processing 



This study was funded by the Brout Family Foundation.

Compliance with Ethical Standards

Conflict of Interest

M. Zachary Rosenthal, Andrada D. Neacsiu, Paul J. Geiger, Caitlin Fang, Roianne Ahn and Jose Larrauri declare that they have no conflict of interest.

Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.


  1. American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association (APA).Google Scholar
  2. Austin, M. A., Riniolo, T. C., & Porges, S. W. (2007). Borderline personality disorder and emotion regulation: Insights from the polyvagal theory. Brain and Cognition, 65, 69–76.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Ballinger, G. A. (2004). Using generalized estimating equations for longitudinal data analysis. Organizational Research Methods, 7, 127–150.CrossRefGoogle Scholar
  4. Baschnagel, J. S., Coffey, S. F., Hawk, L. W, Jr, Schumacher, J. A., & Holloman, G. (2013). Psychophysiological assessment of emotional processing in patients with borderline personality disorder with and without comorbid substance use. Personality Disorders: Theory, Research, and Treatment, 4(3), 203–213.CrossRefGoogle Scholar
  5. Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135(3), 495.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Bradley, M. M., & Lang, P. J. (1994). Measuring emotion: The self-assessment manikin and the semantic differential. Journal of Behavioral Therapy and Experimental Psychiatry, 25, 49–59.CrossRefGoogle Scholar
  7. Bradley, M. M., & Lang, P. J. (2000). Affective reactions to acoustic stimuli. Psychophysiology, 37, 204–215.CrossRefPubMedGoogle Scholar
  8. Chapman, A. L., Walters, K. N., & Gordon, K. L. D. (2014). Emotional reactivity to social rejection and negative evaluation among persons with borderline personality features. Journal of Personality Disorders, 28(5), 720–733.CrossRefPubMedGoogle Scholar
  9. Cheavens, J. S., Rosenthal, M. Z., Daughters, S. B., Nowak, J., Kosson, D., Lynch, T. R., & Lejuez, C. W. (2005). An analogue investigation of the relationships among perceived parental criticism, negative affect, and borderline personality disorder features: The role of thought suppression. Behaviour Research and Therapy, 43, 257–268.CrossRefPubMedGoogle Scholar
  10. Ebner-Premier, U. W., Welch, S. S., Grossman, P., Reisch, T., Linehan, M. M., & Bohus, M. (2007). Psychophysiological ambulatory assessment of affective dysregulation in borderline personality disorder. Psychiatry Research, 150, 265–275.CrossRefGoogle Scholar
  11. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured clinical interview for DSM-IV axis I disorders—patient edition (SCID-I/P, Version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
  12. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV Axis I disorders—Patient Edition (SCID-I/P, Version 2.0), Unpublished measure. New York: New York State Psychiatric Institute.Google Scholar
  13. Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6(4), 459–473.CrossRefGoogle Scholar
  14. Gibbons, R. D., Hedeker, D., & DuToit, S. (2010). Advances in analysis of longitudinal data. Annual Review of Clinical Psychology, 6, 79–107.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Gratz, K. L., Tull, M. T., Baruch, D. E., Bornovalova, M. A., & Lejuez, C. W. (2008). Factors associated with co-occurring borderline personality disorder among inner-city substance users: The roles of childhood maltreatment, negative affect intensity/reactivity, and emotion dysregulation. Comprehensive Psychiatry, 49, 603–615.CrossRefPubMedGoogle Scholar
  16. Herpertz, S. C., Kunert, H. J., Schwenger, U. B., & Sass, H. (1999). Affective responsiveness in borderline personality disorder: A psychophysiological approach. American Journal of Psychiatry, 156, 1550–1556.CrossRefPubMedGoogle Scholar
  17. Herpertz, S. C., Schwenger, U. B., Kunert, H. J., Lukas, G., Gretzer, U., Nutzmann, J., et al. (2000). Emotional responses in patients with borderline as compared with avoidant personality disorder. Journal of Personality Disorders, 14, 339–351.CrossRefPubMedGoogle Scholar
  18. Herpertz, S. C., Werth, U., Lucas, G., Qunaibi, M., Schuerkens, A., Kunert, H., et al. (2001). Emotion in criminal offenders with psychopathy and borderline personality disorders. Archives of General Psychiatry, 58, 737–745.CrossRefPubMedGoogle Scholar
  19. Khuri, A. I., Mathew, T., & Sinha, B. K. (1998). Statistical tests for linear mixed models. New York: Wiley.CrossRefGoogle Scholar
  20. Kring, A. M., & Sloan, D. M. (2007). The Facial Expression Coding System (FACES): Development, validation, and utility. Psychological Assessment, 19, 210–224.CrossRefPubMedGoogle Scholar
  21. Kuo, J. R., & Linehan, M. M. (2009). Disentangling emotion processes in borderline personality disorder: Physiological and self-reported assessment of biological vulnerability, baseline intensity, and reactivity to emotionally evocative stimuli. Journal of Abnormal Psychology, 118, 531–544.CrossRefPubMedPubMedCentralGoogle Scholar
  22. Kuo, J. R., Neacsiu, A. D., Fitzpatrick, S., & MacDonald, D. E. (2014). A methodological examination of emotion inductions in borderline personality disorder: A comparison of standardized versus idiographic stimuli. Journal of Psychopathology and Behavioral Assessment, 36(1), 155–164.CrossRefGoogle Scholar
  23. Lang, P. J. (1979). A bio-informational theory of emotional imagery. Psychophysiology, 16, 495–512.CrossRefPubMedGoogle Scholar
  24. LeDoux, J. (2012). Rethinking the emotional brain. Neuron, 73(4), 653–676.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Liang, K. Y., & Zeger, S. L. (1986). Longitudinal data analysis using generalized linear models. Biometrika, 73(1), 13–22.CrossRefGoogle Scholar
  26. Limberg, A., Barnow, S., Freyberger, H. J., & Hamm, A. O. (2011). Emotional vulnerability in borderline personality disorder is cue specific and modulated by traumatization. Biological Psychiatry, 69(6), 574–582.CrossRefPubMedGoogle Scholar
  27. Linehan, M. M. (1993). Cognitive–behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
  28. Merkl, A. M., Ammelburg, N., Aust, S., Roepke, S., Reinecker, H., Trahms, L., et al. (2010). Processing of visual stimuli in borderline personality disorder: A combined behavioural and magnetoencephalographic study. International Journal of Psychophysiology, 78, 257–264.CrossRefPubMedGoogle Scholar
  29. Minzenberg, M. J., Fan, J., New, A. S., Tang, C. Y., & Siever, L. J. (2008). Frontolimbic structural changes in borderline personality disorder. Journal of Psychiatric Research, 42(9), 727–733.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Pagura, J., Stein, M. B., Bolton, J. M., Cox, B. J., Grant, B., & Sareen, J. (2010). Comorbidity of borderline personality disorder and posttraumatic stress disorder in the US population. Journal of Psychiatric Research, 44(16), 1190–1198.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Renneberg, B., Heyn, K., Gebhard, R., & Bachmann, S. (2005). Facial expression of emotions in borderline personality disorder and depression. Journal of Behavior Therapy and Experimental Psychiatry, 36, 183–196.CrossRefPubMedGoogle Scholar
  32. Rosenthal, M. Z., Ahn, R., & Geiger, P. J. (2011). Reactivity to sensations in borderline personality disorder: A preliminary study. Journal of Personality Disorders, 25(5), 715–721.CrossRefPubMedGoogle Scholar
  33. Rosenthal, M. Z., Fang, C. M., & Chapman, A. L. (2015). Ambulatory measurement of emotional dysfunction in borderline personality disorder. Current Opinion in Psychology, 3, 75–79.CrossRefGoogle Scholar
  34. Rosenthal, M. Z., Gratz, K., Kosson, D. S., Lejuez, C. W., Cheavens, J. S., & Lynch, T. R. (2008). Borderline personality disorder and emotional functioning: A review of the research literature. Clinical Psychology Review, 28, 75–91.CrossRefPubMedGoogle Scholar
  35. Salavert, J., Gasol, M., Vieta, E., Cervantes, A., Trampal, C., & Gispert, J. D. (2011). Fronto-limbic dysfunction in borderline personality disorder: A 18F-FDG positron emission tomography study. Journal of Affective Disorders, 131(1), 260–267.CrossRefPubMedGoogle Scholar
  36. Schmahl, C., & Bremner, J. D. (2006). Neuroimaging in borderline personality disorder. Journal of Psychiatric Research, 40, 419–427.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Schmahl, C. G., Elzinga, B. M., Ebner, U. W., Simms, T., Sanislow, C., Vermetten, E., et al. (2004). Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: A preliminary report. Psychiatry Research, 126(1), 33–42.CrossRefPubMedGoogle Scholar
  38. Scott, L. N., Levy, K. N., & Granger, D. A. (2013). Biobehavioral reactivity to social evaluative stress in women with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 4(2), 91–100.CrossRefGoogle Scholar
  39. Stiglmayr, C. E., Grathwol, T., Linehan, M. M., Ihorst, G., Fahrenberg, J., & Bohus, M. (2005). Aversive tension in patients with borderline personality disorder: A computer-based controlled field study. Acta Psychiatrica, 111, 372–379.CrossRefGoogle Scholar
  40. Stiglmayr, C., Shapiro, D., Stieglitz, R., Limberger, M., & Bohus, M. (2001). Experience of aversive tension and dissociation in female patients with borderline personality disorder—a controlled study. Journal of Psychiatry Research, 35(2), 111–118.CrossRefGoogle Scholar
  41. Suvak, M. K., Sege, C. T., Sloan, D. M., Shea, M. T., Yen, S., & Litz, B. T. (2012). Emotional processing in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 3(3), 273–282.CrossRefGoogle Scholar
  42. Verbeke, G. (1997). Linear mixed models for longitudinal data. In G. Verbeke & G. Mohlenbergs (Eds.), Linear mixed models in practice (pp. 63–153). New York: Springer.Google Scholar
  43. Verona, E., Curtin, J. J., Patrick, C. J., Bradley, M. M., & Lang, P. J. (2004). Psychopathy and physiological response to emotionally evocative sounds. Journal of Abnormal Psychology, 113, 99–108.CrossRefPubMedGoogle Scholar
  44. Weinberg, A., Klonsky, E. D., & Hajcak, G. (2009). Autonomic impairment in borderline personality disorder: A laboratory investigation. Brain and Cognition, 71, 279–286.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • M. Zachary Rosenthal
    • 1
    • 2
    Email author
  • Andrada D. Neacsiu
    • 1
  • Paul J. Geiger
    • 3
  • Caitlin Fang
    • 2
  • Roianne Ahn
    • 4
  • Jose Larrauri
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamUSA
  2. 2.Duke UniversityDurhamUSA
  3. 3.University of KentuckyLexingtonUSA
  4. 4.Star CenterGreenwood VillageUSA

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