Abstract

Borderline Personality Disorder (BPD) is a serious mental illness characterized by a chronic pattern of instability in interpersonal relationships and self-image, along with a higher baseline of emotional sensitivity and marked impulsivity that begins by early adulthood and persists regardless of context. Emotion dysregulation, a cardinal feature of the disorder, is of high relevance to clinical and medical contexts since it has been correlated with greater risk of parasuicidal behaviors, co-occurring psychiatric illnesses and multiple hospitalizations. Less understood is the role of emotion dysregulation on somatization and medical comorbidity. Physiological correlates of emotion dysregulation, such as decreased heart rate variability (HRV) and cascades of pro-inflammatory cytokines associated to dysphoric mood can increase the risk of medical comorbidity in the BPD population. This mini review assesses and discusses how maladaptive emotion regulation strategies, such as emotional suppression, and BPD-endogenous traits like attachment-seeking behavior can potentiate detrimental health outcomes through physiological correlates and medical self-harm. Future research directions should assess the role of emotional suppression in somatization and medical comorbidity in both sociodemographic and medically diverse BPD populations. In the clinical setting, encouraging reappraisal instead of emotional suppression can help improve treatment outcomes in both psychiatric and medical domains.

Keywords

borderline personality disorder, emotion dysregulation, emotion suppression, somatization, medical comorbidity, metabolic syndrome