emotional cascades and understanding the chaos … · nificant (t" 1.44, p" .15). the...
TRANSCRIPT
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EMOTIONAL CASCADES AND UNDERSTANDING THE CHAOS AND
COMPLEXITY OF BORDERLINE PERSONALITY DISORDER
Edward A. Selby, Ph.D.
Assistant Professor Department of Psychology Rutgers, The State University of New Jersey Families for Borderline Personality Disorder Research Investigator Brain and Behavior Research Foundation
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Borderline Personality Disorder
TURBULENT EMOTIONS DYSREGULATED BEHAVIORS SUICIDAL BEHAVIOR/SELF-INJURY STORMY RELATIONSHIPS
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Vulnerability Psychopathology
Genetic Biological Social/Familial
Borderline Personality Disorder Self-Injury/Suicide Eating Disordered Behavior
? Emotional Mechanisms!
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Emotional Cascades
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Increased Emotional Intensity
EMOTIONAL CASCADE
Emotion
Rumination
Behavioral Dysregulation
Physical Sensations
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Increased Emotional Intensity
EMOTIONAL CASCADE
Emotion
Rumination
Behavioral Dysregulation
Physical Sensations
RELIEF
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Selby et al. (2009) J ABNORMAL PSY
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BPD Control
Neg
ati
ve
Em
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on
Group
Rumination Induction
Baseline
Post-Induction
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Selby et al. (2009) J ABNORMAL PSY
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BPD Control
Neg
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Em
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Group
Rumination Induction
Baseline
Post-Induction
p<.05 η^2 = .12
0
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Do Emotional Cascades Predict Future Dysregulated
Behaviors?
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Experience Sampling
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Number Reported % Sample Reporting Behavior
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High Lag-Rumination X High Lag- Negative Emotion
Predictive Validity
Immediate Future Dysregulated Behavior
Signal 1
Signal 2
γ = .18*
γ = .20*
γ = .=17*
Selby & Joiner, 2013, PDTRT
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3-Way Interaction Predicting Occurrence of a Dysregulated Behavior
The hypothesized three-way interaction betweenBPD symptoms, lag-rumination, and lag-negativeemotion prospectively predicting the occurrence ofa dysregulated behavior was significant (! " .13,SE " .06, OR " 1.14, p # .05). As demonstratedin Figure 1, those with high levels of BPD symp-toms, rumination, and negative emotion at onesignal had the highest probability of a subsequentbehavior. Tests of simple slopes indicated thatBPD symptoms, at high lag levels of lag-rumination and lag-negative emotion, signifi-cantly predicted increased probability of a behav-ior occurring (t " 3.39, p # .001). When theinteraction was examined at high BPD symptoms,with high levels of negative emotion and lowlevels of rumination, the interaction was not sig-nificant (t " 1.44, p " .15). The interaction forhigh BPD symptoms with low negative emotionand high rumination also was not significant (t "1.62, p " .11).
Discussion
Consistent with our predictions, a significantthree-way interaction was found, which indi-cated that at high levels of negative emotion and
rumination, those with BPD had an elevatedprobability of engaging in a dysregulated behaviorbeyond those with low levels of BPD symptoms.Importantly, this three-way interaction maintainedsignificance even when controlling for key co-variates. Findings provide support for an impor-tant part of the emotional cascade model andwarrant further research on emotional cascadesand dysregulated behaviors.
There were some limitations to note. First,these data were only able to address temporalprecedence of the model-relevant variables andcannot be used to test the potential causal ef-fects of emotional cascades on dysregulated be-havior. Similarly, these data are self-reportedand subject to the biases and perceptions of theparticipants, particularly with regard to whetherthe behaviors were difficult to control. Further,momentary measures of rumination and dys-regulated behaviors used here need additionalvalidation studies. Future studies should alsoexamine the distinct behaviors in this study todetermine if the behavior is actually difficult tocontrol, and to determine specific aspects ofnegative emotion and rumination that may beinvolved in the behavior. We also did not assess
Figure 1. Three-way interaction between borderline personality disorder (BPD) symptoms,lag-rumination, and lag-negative emotion to prospectively predict the probability of a dys-regulated behavior occurring in the next 2 to 3 hr. Note: High and low refer to 2 standarddeviations above or below mean for lag-rumination (Rum) and lag-negative emotion (NE),and P (behavior) refers to the percentile probability of a dysregulated behavior occurring.
8 SELBY AND JOINER
Selby & Joiner, 2013, PDTRT
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Instability of Rumination
Unstable Stable
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Butterfly Effect • Concept form Chaos Theory • More precisely known as, “Sensitive Dependence on
Initial Conditions” • Easier to think of as a “Compounding effect” • Even small differences can lead to very extreme
differences
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Butterfly Effect • Concept form Chaos Theory • More precisely known as, “Sensitive Dependence on
Initial Conditions” • Even small differences can lead to very extreme
differences • Easier to think of as a “Compounding effect” • In some people, we see an extremely strong and sensitive
connection between negative thought and negative emotion, particularly those with BPD
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Selby et al., in press, Journal of Personality
Butterfly Effect in Emotional Cascades
Signal 1 Signal 2
Lag-Rumination Lag-Negative Emotion
Rumination Negative Emotion
2-3 Hours Later
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Selby et al., in press, Journal of Personality
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Selby et al., in press, Journal of Personality
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Negative Emotion Effects
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Selby et al., in press, Journal of Personality
Butterfly Effect in Emotional Cascades
Signal 1 Signal 2
Lag-Rumination Lag-Negative Emotion
Dysregulated Behaviors
2-3 Hours Later
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Selby et al., in press, Journal of Personality
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Take Away • Demonstrated the Butterfly Effect with Emotional
Cascades • This same effect predicted dysregulated behaviors • Dysregulated behavior may serve as an “attractor” point
toward which dysregulated behaviors are drawn as emotional cascades progress
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Emergence
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Emergence
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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The Emotional Cascade Model
SELBY & JOINER (2009)
REV OF GEN PSY
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Treatment Implications
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Dialectical Behavior Therapy
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Mindfulness
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Activities
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Clinical Applications: Sleep • Poor Sleep Quality (Selby, 2013, JCCP)
• BPD symptoms predict problems with insomnia (initial, middle, and terminal) beyond relevant Axis I disorders
• Potentially due to rumination/emotional cascades?
• Nightmares • During ESM those with BPD reported more nightmares (Selby,
Ribeiro, & Joiner, 2013, Dreaming)
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What Can Family Members Do? • 1) Understand the emotion process of BPD
• Knowing what is going on reduces negative reactivity and improves empathy, even in challenging situations
• Even being able to give a process a name, such as “emotional cascade” can help
• 2) Help your loved one distract when upset • Work with them to come up with activities that they enjoy and are
willing to do when distressed • Develop a “coping card” of distracting activities, it is easy to forget
strategies when you are distressed
• 3) Try not to get frustrated • When we get frustrated, which can be easy at times, that can feed
into the emotion dysregulation process • Building emotion regulation skills takes time!
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Funding Acknowledgements: • Brain and Behavior Research Foundation
(NARSAD) • Families for Borderline Personality Disorder
Research • National Institute of Mental Health • Neil S. Jacobson Award for Outstanding and
Innovative Clinical Research
Contact: [email protected] Website: www.edwardaselby.com