Daily shame and hostile irritability in adolescent girls with borderline personality disorder symptoms

Abstract

Recent theoretical and empirical work suggests that adults with borderline personality disorder (BPD) have difficulty regulating both shame and anger, and that these emotions may be functionally related in clinically relevant ways (e.g., Schoenleber & Berenbaum, 2012b). The covariation of shame with anger-related emotions has important clinical implications for interventions targeting shame and uncontrolled anger in BPD. However, no studies have examined shame, anger, and their covariation in adolescents who may be at risk for developing BPD. Therefore, this study focuses on associations between BPD symptoms and patterns of covariation between daily experiences of shame and anger-related affects (i.e., hostile irritability) in a community sample of adolescent girls using ecological momentary assessment. Multilevel models revealed that girls with greater BPD symptoms who reported greater mean levels of shame across the week also tended to report more hostile irritability, even after controlling for guilt. Additionally, examination of within-person variability showed that girls with greater BPD symptoms reported more hostile irritability on occasions when they also reported greater concurrent shame, but this was only the case in girls of average socioeconomic status (i.e., those not receiving public assistance). Unlike shame, guilt was not associated with hostile irritability in girls with greater BPD symptoms. Results suggest that shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms.

(PsycINFO Database Record (c) 2015 APA, all rights reserved).

Figures

Figure 1

Multilevel structural equation model illustrating within-person effects at level 1 and between-person effects at level 2. Filled circles represent random effects. s1 = slope of momentary hostile irritability regressed on momentary shame. s2 = slope of momentary hostile irritability regressed on momentary guilt. BPD = borderline personality disorder symptoms. Race, socioeconomic status (SES), and two-way interactions between level 2 covariates were also included in the model (see Table 3 for all regression coefficients), but are not included in the figure for ease of interpretation.

Figure 2

Within-person associations between momentary shame and concurrent momentary hostile irritability (log-transformed) as a function of borderline personality disorder (BPD) symptoms and socioeconomic status (SES). Lines represent model-estimated simple slopes at - 1SD and +1SD from the mean of BPD symptoms and at low (i.e., receiving public assistance) and average (i.e., not receiving public assistance) SES levels. The association between momentary shame (within-person deviations from individual means) and hostile irritability is only significant (i.e., different from zero, p < .05) among girls with high BPD symptoms and average SES (solid black line).