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First evidence of a prospective relation between avoidance of internal states and borderline personality disorder features in adolescents

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Abstract

At least two leading developmental models of borderline personality disorder (BPD) emphasize the role of accurate reflection and understanding of internal states as significant to the development of BPD features (Fonagy, Int J Psycho-Anal 72:639–656, 1991; Linehan, Cognitive-behavioral treatment of borderline personality disorder, 1993). The current study used the construct of experiential avoidance (EA) to operationalize avoidance of internal states and sought to examine (1) the concurrent relations between EA and borderline features in a large and diverse community sample; and (2) the prospective relation between EA and borderline features over a 1-year follow-up, controlling for baseline levels of borderline features. N = 881 adolescents recruited from public schools in a large metropolitan area participated in baseline assessments and N = 730 completed follow-up assessments. Two main findings were reported. First, EA was associated with borderline features, depressive, and anxiety symptoms at the bivariate level, but when all variables were considered together, depression and anxiety no longer remained significantly associated with borderline features, suggesting that the relations among these symptom clusters may be accounted for by EA as a cross-cutting underlying psychological process. Second, EA predicted levels of borderline symptoms at 1-year follow-up, controlling for baseline levels of borderline symptoms, and symptoms of anxiety and depression. Results are interpreted against the background of developmental theories of borderline personality disorder.

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Acknowledgments

This research was supported by Award Number K23HD059916 (PI: Temple) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and 2012-WG-BX-0005 (PI: Temple) from the National Institute of Justice. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIH or NIJ.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study has been approved by the appropriated ethics committee and was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All persons gave their informed consent prior of their inclusion in the study. Details that might disclose the identity of study participants have been omitted.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204-5022, USA

    Carla Sharp, Allison Kalpakci, William Mellick & Amanda Venta

  2. Department of Psychiatry, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555-0587, USA

    Jeff R. Temple

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  1. Carla Sharp
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Correspondence to Carla Sharp.

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Sharp, C., Kalpakci, A., Mellick, W. et al. First evidence of a prospective relation between avoidance of internal states and borderline personality disorder features in adolescents. Eur Child Adolesc Psychiatry 24, 283–290 (2015). https://doi.org/10.1007/s00787-014-0574-3

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