Correlates of affective instability in borderline personality disorder : an assessment using the electronically activated recorder (EAR)

Abstract

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] Affective instability (AI) is a key feature of borderline personality disorder (BPD). Given the dynamic nature of affective instability, it is ideally studied using ambulatory assessment (AA). Recently, several major studies have examined affective instability via momentary self-report, using electronic diaries, which participants can use throughout their daily routine. However, all of these studies are based on the assumption that an individual is an accurate reporter of his/her emotional experience. In the present study, an Electronically Activated Recorder (EAR) designed to capture ambient sounds and interpersonal interactions was worn by 25 participants with BPD who also met the specific AI criterion as well as 13 participants with major depressive disorder (who did not meet criteria for AI or BPD) for three days. After listening to the recordings, trained coders rated the affect of each participant across three days in various social contexts. We found little to no agreement between traditional self-report measures of BPD and EAR ratings of affect. Also, there were no significant differences between the BPD group and depressed group on EAR measures of negative affect and affective instability. However, there were significant associations between being in the presence of other people and negative affect, which varied by group status. The EAR offers an alternative to self-report and gives us insight into the expression of emotions in BPD. Given that the EAR provides new information, this may supplement our knowledge of BPD and affective instability.