Projects in Development

Borderline personality disorder (BPD) is a complex and disabling disorder that presents significant challenges for service delivery in drug and alcohol treatment services, other behavioral health care, and the criminal justice system. One of the central features of BPD is ongoing dysregulation of emotion, particularly negative affect, which can lead to self harming behavior and may be one of the core processes producing an increased risk of violence toward others in those with BPD. Although advances have been made in the treatment of repetitive self-harm in BPD, little treatment development effort has been directed toward addressing the problem of repetitive violence toward others in individuals with BPD including those who also have substance use problems. Building on their prior work developing a reliable and valid measure of emotion dysregulation, the proposed study lays the groundwork for developing an intervention for reducing repetitive violence toward others in individuals with BPD and substance use problems.

The study will interview 126 individuals with BPD, using structured and semi-structured instruments to assess the constructs of interest. First, researchers will examine whether emotion dysregulation elevates risk for violence and influences two of the most robust established risk markers for future violence—substance use and psychopathy. If supported, this establishes empirical justification for expecting that an intervention targeting emotion dysregulation will have a sizable effect on involvement in violence. Second, researchers will examine the potentially moderating influences of race and gender on the relationship between emotion dysregulation and violence and identify the types of situational contexts that trigger such incidents. This provides guidance about whether specialized interventions for different high risk groups are needed. Finally, researchers will address feasibility issues by soliciting consumer input regarding factors that may enhance or undermine the likelihood of successfully recruiting, engaging, and retaining repetitively violent individuals with BPD and substance use problems in psychosocial treatment. The information gained from this project will be used to support and guide an R21 application to develop and test a culturally competent violence reduction treatment for repetitively violent patients with BPD and substance abuse problems