Borderline Kişilik Bozukluğu Özellikleri ile Duygusal Tepkisellik ve Pekiştireç Duyarlılık Sistemleri Arasındaki İlişkiler: Ağ ve Aracılık Analizi

Year 2025, Volume: 17 Issue: Supplement 1, 314 - 330

Gülşah Balaban , Yusuf Bilge

https://doi.org/10.18863/pgy.1766719

Abstract

Amaç: Bu çalışmanın amacı, borderline kişilik bozukluğu özellikleri ile duygusal tepkisellik ve pekiştireç duyarlılık sistemleri arasındaki ilişkileri çok boyutlu analizlerle incelemektir. Özellikle, davranışsal inhibisyon sistemi ve donma tepkisinin borderline kişilik bozukluğu özellikleri ile ilişkilerinde duygusal tepkisellik alt boyutlarının aracılık rollerinin değerlendirilmesi hedeflenmiştir.
Yöntem: Araştırmaya, yaşları 18 ile 53 arasında değişen (ortalama = 22,51, standart sapma = 4,11), %80’i kadın (n = 481) ve %20’si erkek (n = 120) olmak üzere toplam 601 yetişkin birey katılmıştır. Katılımcılardan elde edilen veriler doğrultusunda, kişilik bozukluğu boyutları, pekiştireç duyarlılık sistemleri (davranışsal inhibisyon sistemi, davranışsal aktivasyon sistemi ve dövüş–kaç–don sistemi) ve duygusal tepkisellik alt boyutları arasındaki ilişkiler Pearson korelasyon temelli ve Gaussian kısmi korelasyon temelli ağ analizleri ile değerlendirilmiştir. Ağ analizinden elde edilen merkeziyet ölçütlerine dayanarak en etkili değişkenler belirlenmiş, ardından borderline kişilik bozukluğu özellikleri ile davranışsal inhibisyon sistemi ve donma tepkisi arasındaki ilişkilerde duygusal tepkisellik alt boyutlarının aracılık rolleri PROCESS Macro Model 4 ile test edilmiştir.
Bulgular: Gaussian grafiksel model bulguları, borderline kişilik bozukluğu özelliklerinin ağ yapısı içerisinde merkezi bir konumda yer aldığını ve hem davranışsal inhibisyon sistemi hem de donma tepkisinin duygusal tepkisellik boyutlarıyla güçlü ilişkiler kurduğunu göstermiştir. Aracılık analizlerinde, negatif aktivasyon ve negatif yoğunluk alt boyutlarının, borderline kişilik bozukluğu özellikleri ile her iki motivasyonel sistem arasındaki ilişkide anlamlı düzeyde aracı role sahip olduğu tespit edilmiştir.
Sonuç: Elde edilen bulgular, borderline kişilik bozukluğunun ortaya çıkış ve sürdürülme süreçlerinde pekiştireç duyarlılık sistemleri ile olumsuz duygusal tepkisellik arasındaki etkileşimin dikkate alınmasının kuramsal ve klinik açıdan önemli olduğunu ortaya koymaktadır.

Keywords

Borderline Kişilik Bozukluğu , Duygusal Tepkisellik , Pekiştireç Duyarlılık Sistemleri

Ethical Statement

Bu çalışma için ……. Üniversitesi etik kurulundan 31.12.2021 tarihli ve 2021/12 sayılı onay alınmıştır.

Supporting Institution

TÜBİTAK Bilim İnsanı Destek Programları Başkanlığı (TÜBİTAK-BİDEB)

Thanks

Araştırma sürecine sağladığı burs desteğinden dolayı TÜBİTAK Bilim İnsanı Destek Programları Başkanlığı’na (TÜBİTAK-BİDEB, 2211-Yurt İçi Doktora Burs Programı) teşekkür ederiz.

Relationships Between Borderline Personality Disorder Traits and Emotional Reactivity and Reinforcement Sensitivity Systems: Network and Mediation Analysis

Abstract

Objective: This study aimed to examine the relationships between borderline personality disorder and emotional reactivity and reinforcement sensitivity systems through multidimensional analyses. Specifically, it was aimed to evaluate the mediating roles of the emotional reactivity in the relationships between borderline personality disorder and behavioral inhibition system and also the freeze.
Method: A total of 601 adults, 80% female (n = 481) and 20% male (n = 120), aged between 18 and 53 (M = 22.51, SD = 4.11), participated in the study. Based on the data obtained from the participants, the relationships among the personality disorder dimensions, reinforcement sensitivity systems (behavioral inhibition system, behavioral activation system, and fight-flight-freeze system), and emotional reactivity subdimensions were assessed using Pearson correlation-based and Gaussian partial correlation-based network analyses. Based on centrality measures obtained from the network analysis, the most influential variables were identified. Then, the mediating roles of the emotional reactivity subdimensions in the relationships between borderline personality disorder and the behavioral inhibition system and the freeze system were tested using PROCESS Macro Model 4.
Results: Gaussian graphical model findings indicated that borderline personality disorder occupies a central position within the network structure and that both the behavioral inhibition system and the freeze system established strong relationships with the emotional reactivity dimensions. Mediation analyses revealed that the negative activation and negative intensity subdimensions had a significant mediating role in the relationship between borderline personality disorder traits and both motivational systems.
Conclusion: The findings demonstrate the theoretical and clinical importance of considering the interaction between reinforcement sensitivity systems and negative emotional reactivity in the emergence and maintenance processes of borderline personality disorder.

Keywords

Borderline Personality Disorder , Emotional Reactivity , Reinforcement Sensitivity Systems

Ethical Statement

Ethical approval for this study was obtained from the Ethics Committee of ……. University on 31 December 2021 (Approval No: 2021/12).

Supporting Institution

TUBITAK Directorate of Scientist Support Programs (BİDEB)

Thanks

The authors would like to thank to the Scientific and Technological Research Council of Türkiye – Directorate of Science Fellowships and Grant Programs (TÜBİTAK-BİDEB, 2211-National PhD Scholarship Program) for the financial support provided during the research process.

References

• APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5). Washington DC, American Psychiatric Association.
• Balaban G (2023) Pekiştireç duyarlılığı ve duygusal tepkisellik:motivasyonel model temelinde kişilik bozuklukları ile çalışma belleği arasındaki ilişkinin incelenmesi (Doktora tezi). İstanbul, İstanbul Sabahattin Zaim Üniversitesi.
• Balaban G, Bilge Y (2021a) Study of validity and reliability of the reinforcement sensitivity questionnaire in Turkish community sample. Noro Psikiyatr Ars, 58:234-241.
• Balaban G, Bilge Y (2021b) The psychometric properties of Perth Emotional Reactivity Scale - Short Form in Turkish community sample. Psikiyatrie Güncel Yaklaşımlar, 13(Suppl 1):281-297.
• Becerra R, Campitelli G (2013) Emotional reactivity: critical analysis and proposal of a new scale. Int J Appl Psychol, 3:161-168.
• Bilge Y (2018) DSM-5 kişilik bozuklukları için kısa bir ölçek: Coolidge Eksen II Envanteri Plus Türkçe Kısa Formun geliştirilmesi. Anadolu Psikiyatri Derg, 19(Suppl 2):14-21.
• Bilge Y, Balaban G (2023) Moderated mediation models of emotion regulation and gender in the relationships between personality disorders and reinforcement sensitivity. Cyprus Turkish Journal of Psychiatry & Psychology, 5:292-302.
• Bilge Y, Emiral E (2022) The mediator role of BIS/BAS systems in the relationship between psychological symptoms and borderline personality features: confirmation from a non-western sample. Curr Psychol, 41:9008-9018.
• Bilge Y, Sertel Berk HÖ (2017) Coolidge Eksen II Envanteri Plus’ta (CATI+) yer alan DSM-III-R, DSM-IV-TR ve DSM-5 kişilik bozuklukları alt ölçeklerinin Türkçe güvenirlik ve geçerlik çalışması. J Int Soc Res, 10:459-474.
• Borsboom D, Cramer AO (2013) Network analysis: an integrative approach to the structure of psychopathology. Annu Rev Clin Psychol, 9:91-121.
• Bozzatello P, Rocca P, Baldassarri L, Bosia M, Bellino S (2021) The role of trauma in early onset borderline personality disorder: a biopsychosocial perspective. Front Psychiatry, 12:721361.
• Bozzatello P, Blua C, Brandellero D, Baldassarri L, Brasso C, Rocca P et al. (2024) Gender differences in borderline personality disorder: a narrative review. Front Psychiatry, 15:1320546.
• Bringmann LF, Elmer T, Epskamp S, Krause RW, Schoch D, Wichers M et al. (2019) What do centrality measures measure in psychological networks? J Abnorm Psychol, 128:892-903.
• Brody LR (1993) On understanding gender differences in the expression of emotion: gender roles, socialization, and language. In Human feelings: Explorations in Affect Development and Meaning, (Eds SL Ablon, D Brown, EJ Khantzian, JE Mack ):87-121. Hillsdale, Analytic Press.
• Campbell S, Osborn TL (2021) Adolescent psychopathology and psychological wellbeing: a network analysis approach. BMC Psychiatry, 21:333.
• Cardoso Melo RD, Schreuder MJ, Groen RN, Sarsembayeva D, Hartman CA (2023) Reward sensitivity across the lifespan in males and females and its associations with psychopathology. Pers Individ Dif, 204:1-8.
• Chaplin TM (2015) Gender and emotion expression: a developmental contextual perspective. Emot Rev, 7:14-21.
• Chavez Baldini U, Nieman DH, Keestra A, Lok A, Mocking RJT, de Koning P et al. (2023) The relationship between cognitive functioning and psychopathology in patients with psychiatric disorders: a transdiagnostic network analysis. Psychol Med, 53:476 485.
• Choate AM, Bornovalova MA, Hipwell AE, Chung T, Stepp SD (2023) Mutualistic processes in the development of psychopathology: the special case of borderline personality disorder. J Psychopathol Clin Sci, 132:185 197.
• Cooper R (2022) Reasons to expect psychopathy and antisocial personality disorder (ASPD) to vary across cultures. In Psychopathy: Its Uses, Validity and Status (Eds L Malatesti, J McMillan, P Šustar):253-268. Cham, Springer Nature..
• Corr PJ, DeYoung CG, McNaughton N (2013) Motivation and personality: a neuropsychological perspective. Soc Personal Psychol Compass, 7:158 175.
• Crotty K, Viswanathan M, Kennedy S, Edlund MJ, Ali R, Siddiqui M et al. (2024) Psychotherapies for the treatment of borderline personality disorder: a systematic review. J Consult Clin Psychol, 92:275 295.
• Davidson RJ (1998) Affective style and affective disorders: perspectives from affective neuroscience. Cogn Emot, 12:307 330.
• Defoe IN, Khurana A, Betancourt LM, Hurt H, Romer D (2022) Cascades from early adolescent impulsivity to late adolescent antisocial personality disorder and alcohol use disorder. J Adolesc Health, 71:579 586.
• Deyoung CG, Gray JR (2009). Personality neuroscience: Explaining individual differences in affect, behaviour and cognition. In The Cambridge Handbook of Personality Psychology (Eds PJ Corr, G Matthews):323-346. New York, Cambridge University Press.
• Epskamp S, Fried EI (2018) A tutorial on regularized partial correlation networks. Psychol Methods, 23:617 634.
• Erdfelder E, Faul F, Buchner A (1996) GPOWER: a general power analysis program. Behav Res Methods Instrum Comput, 28:1 11.
• Fahlgren MK, Cheung JC, Ciesinski NK, McCloskey MS, Coccaro EF (2022) Gender differences in the relationship between anger and aggressive behavior. J Interpers Violence, 37:NP12661 NP12670.
• Farhane Medina NZ, Luque B, Tabernero C, Castillo Mayén R (2022) Factors associated with gender and sex differences in anxiety prevalence and comorbidity: a systematic review. Sci Prog, 105:1-30.
• Fitzpatrick S, Dixon Gordon KL, Turner CJ, Chen SX, Chapman A (2023) Emotion dysregulation in personality disorders. Curr Psychiatry Rep, 25:223 231.
• Förster K, Kurtz M, Konrad A, Kanske P (2022) Emotionale reaktivität, emotionsregulation und soziale emotionen bei affektiven störungen: neuronale modelle als grundlage für behandlungsansätze.. Z Klin Psychol Psychot, 51:11 25.
• Freeman LC (1977) A set of measures of centrality based on betweenness. Sociometry, 40:35 41.
• Giannoulis E, Nousis C, Sula IJ, Georgitsi ME, Malogiannis I (2025) Understanding the borderline brain: a review of neurobiological findings in borderline personality disorder (BPD). Biomedicines, 13:1783.
• Gray JA (1981) A critique of Eysenck’s Theory of Personality. In A Model of Personality (Ed HJ Eysenck):246-276. Berlin, Springer.
• Gray JA, McNaughton N (2000) The Neuropsychology of Anxiety: An Enquiry in to the Functions of the Septo-Hippocampal System, 2nd ed. Oxford, Oxford University Press.
• Güreşen ÜA (2024) New method in psychopathology research: network analysis. Psdikiyatride Güncel Yaklaşımlar, 16:358 372.
• Hayes AF (2018) Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, 2nd ed. New York, Guilford Press.
• Johnson SL, Turner RJ, Iwata N (2003) BIS/BAS levels and psychiatric disorder: an epidemiological study. J Psychopathol Behav Assess, 25:25 36.
• Jones PJ, Ma R, McNally RJ (2021) Bridge centrality: a network approach to understanding comorbidity. Multivar Behav Res, 56:353 367.
• Klonsky ED, Jane JS, Turkheimer E, Oltmanns TF (2002) Gender role and personality disorders. J Pers Disord, 16:464 476.
• Krause-Utz A, Winter D, Niedtfeld I, Schmahl C. (2014) The latest neuroimaging findings in borderline personality disorder. Curr Psychiatry Rep, 16:438.
• Linehan MM (1993) Cognitive-Behavioral Treatment of Borderline Personality Disorder, 2nd ed. New York, Guilford Press.
• Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P et al. (2024) Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23:4 25.
• Löffler CS, Greitemeyer T (2023) Are women the more empathetic gender? the effects of gender role expectations. Curr Psychol, 42:220-231.
• Lucas RE, Baird BM (2004) Extraversion and emotional reactivity. J Pers Soc Psychol, 86:473 485.
• Massó Rodriguez A, Hogg B, Gardoki-Souto I, Valiente-Gómez A, Trabsa A, Mosquera D et al. (2021) Clinical features, neuropsychology and neuroimaging in bipolar and borderline personality disorder: a systematic review of cross-diagnostic studies. Front Psychiatry, 12:681876.
• McLaren V, Gallagher M, Hopwood CJ, Sharp C (2022) Hypermentalizing and borderline personality disorder: a meta analytic review. Am J Psychother, 75:21 31.
• McNally RJ (2021) Network analysis of psychopathology: controversies and challenges. Annu Rev Clin Psychol, 17:31 53.
• Mehrotra K, Raudales AM, Epshteyn G, Dixon-Gordon KL, Peters JR, Weiss NH (2025) Prospective relationships between positive emotion dysregulation and borderline personality disorder features among women experiencing intimate partner violence. Pers Disord Theory Res Treat, 16:184 192.
• Millon T, Grossman S, Millon C, Meagher S, Ramnath R (2004) Personality Disorders in Modern Life, 2nd ed. New York, Wiley.
• Paris J (2003) Personality disorders over time: precursors, course and outcome. J Pers Disord, 17:479 488.
• Pickering AD, Corr PJ (2008) J.A. Gray's reinforcement sensitivity theory (RST) of personality. In the SAGE Handbook of Personality Theory and Assessment, Vol. 1. Personality Theories and Models (Eds GJ Boyle, G Matthews, DH Saklofske):239-256. London, Sage.
• Preece D, Becerra R, Campitelli G (2019) Assessing emotional reactivity: psychometric properties of the Perth Emotional Reactivity Scale and the development of a short form. J Pers Assess, 101:589 597.
• Preece DA, Petrova K, Mehta A, Gross JJ (2023) The Emotion Regulation Questionnaire Short Form (ERQ S): a 6 item measure of cognitive reappraisal and expressive suppression. J Affect Disord, 340:855 861.
• Robinaugh DJ, Millner AJ, McNally RJ (2016) Identifying highly influential nodes in the complicated grief network. J Abnorm Psychol, 125:747 757.
• Rosenthal MZ, Gratz KL, Kosson DS, Cheavens JS, Lejuez CW, Lynch TR (2008) Borderline personality disorder and emotional responding: a review of the research literature. Clin Psychol Rev, 28:75 91.
• Selby EA, Joiner TE Jr. (2009) Cascades of emotion: the emergence of borderline personality disorder from emotional and behavioral dysregulation. Rev Gen Psychol, 13:219-229.
• Shapero BG, Farabaugh A, Terechina O, DeCross S, Cheung JC, Fava M, Holt DJ (2019) Understanding the effects of emotional reactivity on depression and suicidal thoughts and behaviors: moderating effects of childhood adversity and resilience. J Affect Disord, 245:419 427.
• Sharma R, Cameron A, Fang Z, Ismail N, Smith A (2021) The regulatory roles of progesterone and estradiol on emotion processing in women. Cogn Affect Behav Neurosci, 21:1026 1038.
• Sher L, Siever LJ, Goodman M, McNamara M, Hazlett EA, Koenigsberg HW et al. (2015) Gender differences in the clinical characteristics and psychiatric comorbidity in patients with antisocial personality disorder. Psychiatry Res, 229:685 689.
• Silbersweig D, Clarkin JF, Goldstein M, Kernberg OF, Tuescher O, Levy KN et al. (2007) Failure of frontolimbic inhibitory function in the context of negative emotion in borderline personality disorder. Am J Psychiatry, 164:1832 1841.
• Smederevac S, Mitrović D, Čolović P, Nikolašević Ž (2014) Validation of the measure of revised reinforcement sensitivity theory constructs. J Individ Differ, 35:12 21.
• Tully J, Pereira AC, Sethi A, Griem J, Cross B, Williams SC et al. (2024) Impaired striatal glutamate/GABA regulation in violent offenders with antisocial personality disorder and psychopathy. Mol Psychiatry, 29:1824 1832.
• Waite EE, DeFontes C, Weiss NH, Karnedy C, Woods SE., Haliczer LA et al. (2024) Borderline personality disorder and multidimensional impulsivity: the roles of positive and negative emotion dysregulation. J Affect Disord, 344:635-643.
• Wang Q, Li Z, Zhong J (2024) Network analysis of borderline personality features in adolescence using a screening tool in a Chinese community sample. Psychopathology, 57:182-191.
• Young G (2011) Broadening defense mechanisms: literature review and discussion. In: Causality and Neo-Stages in Development. London, Springer.
• Yun S, Jo SH, Jeon HJ, Kim HG, Cheon EJ, Koo BH (2024) The complexity of borderline personality disorder: network analysis of personality factors and defense styles in the context of borderline personality organization. Psychiatry Investig, 21:672-679.