Stress Reactivity is Unique in Borderline Personality Disorder

The way in which a person reacts to stress can reveal a lot about their psychological state. Some theories exist that suggest that people with borderline personality (BPD) have an impaired reaction to stress, resulting in hyperactivity to stress and longer time to recover from stressful events. To test this theory, Lori N. Scott of the Department of Psychology at Pennsylvania State University led a study comparing stress reactivity in a group of female participants with BPD, traits similar to BPD (TM), and non-BPD traits (NTM). She measured the cortisol levels and the negative or positive affect of the women before and after they were exposed to stressors.

Scott found that the BPD women reacted less severely to stressors than the TM and NTM women. Although this finding was in contrast to some existing research, Scott believes there is a valid explanation for it. The BPD women had higher levels of stress, based on cortisol levels, and higher negative affect at baseline than the other women. Therefore, because their stress levels were elevated prior to being exposed to a stressor, their reaction to stress is less extreme than those with low baseline stress. Also, negative affect can dampen any reaction and weaken hyperactive stress responses.

When Scott looked at recovery time, she found that all the groups had similar rates of recovery from stress. Even though the BPD women experienced stress increases that were smaller in scale compared to the reactions of the other women, the time it took them to return to their elevated baseline stress levels was equal to that of the other women, whose stress increases were much steeper. “Our results provide some support for the high emotional intensity aspect, but not hyperreactivity and impaired recovery aspects, of current clinical theories of affective dysregulation in BPD,” said Scott. However, this study did not account for medication or comorbid conditions such as PTSD and substance use, all of which could influence stress reactivity in women with and without BPD. Future work may consider these issues when exploring the full range of reactions in women with BPD.

Reference:

Scott, L. N., Levy, K. N., and Granger, D. A. (2012). Biobehavioral reactivity to social evaluative stress in women with borderline personality disorder. Personality Disorders: Theory, Research, and Treatment. Advance online publication. doi: 10.1037/a0030117

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