Weekly Mind Reader: Emotion Deficits Link Borderline Personality and Eating Disorders?

This week features a deep dive into the link between borderline personality and eating disorders, managing treatment-resistant schizophrenia, and the announcement of a second FDA-approved Alzheimer’s treatment.

Could Shared Emotion Deficits Link Borderline Personality and Eating Disorders?

Borderline personality disorder (BPD) and eating disorders (EDs) remain persistent co-conspirators. Scientists have long suspected that shared emotion regulation deficits could explain their frequent comorbidity.

To test that, a group of researchers set out to investigate whether emotion regulation difficulties predict symptoms of BPD and EDs, both individually and together.

BPD, characterized by emotion regulation deficits, cognitive disturbances, and impaired relationships, haunts anywhere between 0.7 percent and 3.5 percent of the general population. Notably, it crops up frequently with EDs such as anorexia nervosa (AN) and bulimia nervosa (BN). Studies suggest a significant overlap, with 28 percent of people with BN and 25 percent of those with AN suffering a comorbid BPD diagnosis. It’s worse In inpatient settings as nearly 64 percent of BPD patients met the criteria for an ED.

Emotion dysregulation is central to BPD, leading to maladaptive strategies – like impulsive behaviors – to manage emotions. This typically exacerbates distress. 

In this particular study, involving 872 outpatients from the Rhode Island MIDAS project, researchers looked at BPD and ED diagnoses and emotion regulation using the Difficulties in Emotion Regulation Scale (DERS).

Results showed that BPD symptoms correlated with all emotion regulation deficits, whereas EDs showed differential relationships. For example, emotion regulation deficits showed a strong link to BN, while impulsivity and BPD total score appeared related to subthreshold AN. And while logistic regressions revealed that emotion regulation deficits significantly predicted BPD, they failed to forecast EDs.

The findings suggest that disordered eating in BPD might serve as a maladaptive strategy to manage emotions. This highlights the importance of targeting emotion regulation in treating comorbid BPD and EDs. Future research should explore the impact of other co-occurring psychiatric conditions and the effectiveness of emotion regulation-centered treatments.

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS

• If you’ve ever been uncertain about how to evaluate patients with a chronic psychotic illness or struggled with managing treatment-resistant schizophrenia, then this case study from the Primary Care Companion for CNS Disorders should prove useful.
• A JCP paper suggests that the offspring of parents with bipolar disorder, with lower socioeconomic status, and a personal history of mood disorders faced a greater risk of developing metabolic syndrome and its components.
• Another JCP article reviews evidence from multiple sources on the risks of major congenital malformation with untreated epilepsy and with exposure to antiepileptic drugs.
• Original research shows that resting-state activity of the VLPFC was altered in suicide attempters, possibly contributing to language impairment and poor decision-making and cognitive control.
• Finally, the FDA approved Eli Lilly’s new Alzheimer’s treatment, Kisunla, which is a monthly monoclonal antibody injection.