Proposition of a transdiagnostic processual approach of emotion dysregulation based on core triggers and interpersonal styles

Summary & key facts

The paper reviews research on emotion dysregulation (ED) and argues that ED is not only central to borderline personality disorder (BPD) but also appears across many other diagnoses. After looking at evidence for ED in eight conditions, the authors propose a transdiagnostic, process-focused model that groups typical emotional triggers and interpersonal styles. They say this model could help clinicians with diagnosis and treatment planning and could fit alongside dimensional systems like HiTOP and AMPD, but the paper presents a proposal based on a literature review rather than a tested clinical tool.

Key facts:

• Emotion dysregulation (ED) is described as an integral part of borderline personality disorder (BPD) but is also found across many other psychiatric disorders.
• The authors reviewed evidence for ED in eight conditions: borderline personality disorder; pathological narcissism with/without narcissistic personality disorder; obsessive-compulsive personality disorder; antisocial personality disorder; b
• The paper proposes a transdiagnostic, processual model of ED that is organized around core emotional triggers and interpersonal styles rather than diagnostic categories alone.
• The authors argue that the strong link between ED and BPD can make clinicians underestimate ED in other clinical contexts, which may complicate diagnosis and treatment planning, especially when patients have comorbid conditions.
• The proposed model is intended to complement existing dimensional approaches (for example, HiTOP and AMPD) and to help build more specific treatment frameworks for people with ED.
• The article presents a theoretical proposal based on a literature review; it does not report new clinical trial data or validation of the proposed model.

Abstract

Emotion dysregulation (ED) has primarily been described in patients suffering from borderline personality disorder (BPD) and is an integral part of this diagnosis, but it is also a transdiagnostic construct that can be found in several other psychiatric disorders. The strong relationships between ED and BPD may lead clinicians to underestimate ED associated to other clinical contexts. This can lead to difficulties in diagnostic and treatment orientation, especially in the context of comorbidities. In this article, after reviewing the literature on the development and functioning of emotion dysregulation, and on the evidence for emotion dysregulation in eight disorders (borderline personality disorder, pathological narcissism with/without narcissistic personality disorder, obsessive-compulsive personality disorder, antisocial personality disorder, bipolar disorder, autism spectrum disorder, complex post-traumatic stress disorder, and adult attention deficit hyperactivity disorder), we present a transdiagnostic processual model of emotion dysregulation based on core triggers and interpersonal styles to try to address this issue and to provide a simple but technical tool to help clinicians in their diagnostic assessment and treatment orientation. By focusing more on typical patterns and interpersonal dynamics than only on categories, we believe that this model may contribute to the actual need for improvement of our current psychiatric classifications, alongside other well-studied and under-used dimensional models of psychopathology (e.g., HiTOP, AMPD), and may be useful to build more specific treatment frameworks for patients suffering from ED.

Topics

Mental Health and Psychiatry Obsessive-Compulsive Spectrum Disorders Personality Disorders and Psychopathology

Categories

Clinical Psychology Psychology Social Sciences

Tags

Biology Borderline personality disorder Clinical psychology Context (archaeology) Emotional dysregulation Interpersonal communication Narcissistic personality disorder Paleontology Personality Personality disorders Personality pathology Psychiatry Psychology Psychopathology Psychotherapist Social psychology

Conditions & symptoms

ADHD PTSD