Do borderline personality disorder features and rejection sensitivity predict social network outcomes over time?

https://doi.org/10.1016/j.paid.2016.02.032Get rights and content

Highlights

  • BPD features were negatively related to social network quality one month later.

  • BPD features predicted aspects of social network composition one month later.

  • RS functions as both a mediator and a moderator of these relations.

  • This should be further examined in a clinical sample.

Abstract

Social functioning is routinely understood to be disrupted for those with BPD features; however there is little understanding of how BPD features and BPD-relevant traits impact social network characteristics over time. We hypothesized that BPD features negatively predict social network quality and composition and that rejection sensitivity (RS) would affect these relations. To examine this, a sample of female college students (N = 127) was recruited and followed over one month. BPD features predicted lower ratings of social network quality and aspects of network composition. BPD features exerted an indirect effect through one-week RS on perceived levels of conflict and criticism as well as on number of partners in the network at one-month follow-up. Moderation analyses revealed that BPD features predicted lower social network satisfaction and support at one month for those with high RS, but did not impact satisfaction or support for those with low RS. These results indicate that even non-clinical levels of BPD psychopathology are related to poor social network outcomes. These findings also highlight RS as a potential mechanism by which BPD features predict lower social support and satisfaction and a potential risk factor for higher conflict and criticism within social networks.

Introduction

Theoretical and empirical accounts point to difficult interpersonal relationships as a major source of distress for those with borderline personality disorder (BPD; Gunderson, 2007, Hilsenroth et al., 2007). There is increasing evidence that BPD features are related to both objective (e.g., composition of networks) and subjective (e.g., ratings of network quality) social network constructs. In terms of objective social network outcomes, BPD status is related to smaller social networks, measured by fewer interaction partners per day (Stepp, Pilkonis, Yaggi, Morse, & Feske, 2009), and more BPD features predict the generation of fewer partners available to fulfill the need for social support (Zielinski & Veilleux, 2014). BPD criteria are also related to an increased proportion of conflictual or romantic partners in one's social network (e.g., Clifton et al., 2007, Daley et al., 2000). Consistent with these compositional differences, BPD features have been associated with less satisfaction and support from romantic partners (Bouchard et al., 2009, Daley et al., 2000) and from social partners in general (Zielinski & Veilleux, 2014). However, there is increasing evidence that positive social relationships may result in lower levels of anger, a BPD criterion (Kuhlken, Robertson, Benson, & Nelson-Gray, 2013), and that marriage may positively predict overall global functioning and symptom status over time for those with BPD features (Links & Heslegrave, 2000). Thus, given the protective nature of stable, satisfying relationships and the likelihood that BPD features may interfere with forming or keeping such relationships, it is imperative to determine what predicts high quality relationships at high levels of BPD features.

A growing body of research indicates that problematic social network outcomes are associated with BPD features (e.g., Daley et al., 2000, Zielinski and Veilleux, 2014), even in samples not diagnosed with or selected for BPD status. Understanding social network dysfunction across the continuum of BPD features is important given evidence that even minimal levels of BPD pathology have clinical significance (Zimmerman, Chelminski, Young, Dalrymple, & Martinez, 2012) and subclinical BPD features are longitudinally associated with difficulties in academic achievement, mood, and interpersonal functioning (Trull, Useda, Conforti, & Doan, 1997).

To date, most existing research has examined the effects of BPD features on social network characteristics without considering the impact of vulnerabilities associated with BPD. Examining specific personality characteristics that may put those with BPD features at increased risk for poor social network outcomes or contribute to specific social network characteristics over time can give us a more precise understanding of the interplay between BPD features and disrupted social networks.

RS, defined as the tendency to anxiously expect, readily perceive, and react strongly to perceived rejection (Downey & Feldman, 1996), frequently characterizes BPD, yet the two constructs are not synonymous. The empirical association between BPD features and RS has been demonstrated in several studies (e.g., Berenson et al., 2011, Tragesser et al., 2008) and some researchers have investigated RS as a mechanism through which BPD results in problematic outcomes. Among those diagnosed with BPD, Selby, Ward, and Joiner (2010) found that BPD symptoms predicted RS, which predicted dysregulated emotions and eating behavior. In undergraduate samples, RS mediated the relation between BPD features and facial trust appraisal (Miano, Fertuck, Arntz, & Stanley, 2013) and between BPD features and number of social contacts (Zielinski & Veilleux, 2014). However, Zielinski and Veilleux (2014) found that RS did not mediate the relation between BPD features and social support satisfaction. These results can be interpreted to suggest that elevated fears of social rejection in BPD may decrease regulatory ability, leading to impulsive behaviors, less trust of others, and fewer social contacts but that the relation between BPD and satisfaction with one's social support may be a direct effect, not dependent on RS. While the association between BPD and RS across investigations suggests that RS may be important in understanding how and when BPD features predict social network characteristics, these meditational studies were all cross-sectional, limiting our understanding of temporal links.

Assessing the composition and quality of social networks can be a daunting task given the number of decisions that must be made to appropriately operationalize and define the construct. One of the first decisions is whether the social network should be examined at one time point or over time. The majority of compositional research to date has examined social network differences between those with BPD and various control participants either at one time point to assess how BPD features and social network qualities are concurrently related (e.g., Clifton et al. (2007)) or over relatively short time periods (e.g., one week; Stepp et al., 2009) to determine how particular interactions impact short-term outcomes such as mood. However, these designs do not permit an investigation of how social networks are affected by BPD features over time. Second, who is considered to be in one's social network is an important aspect of social network research. Some researchers have assessed specific relationships (e.g., romantic partners; Bouchard et al., 2009) while others have examined partners who might be available in particular contexts (e.g., Zielinski & Veilleux, 2014). While these designs are informative, it is also important to assess social networks more broadly, as those with whom the individual frequently interacts may impact their emotional functioning and available support.

We examined how BPD features impacted social network characteristics using ratings of social network relationships over time. Existing research provides some insight into specific characteristics of the social networks of those with BPD and BPD features using various methods, such as daily diary assessment and cross-sectional self-report. However, this research is limited and there is no consensus on the best methods to assess social networks. Given this, we developed a measure, described below, to assess relationships with all partners with whom individuals frequently interact. Based on previous findings, we assessed composition of the social networks (e.g., number of total partners, romantic partners, and partners to whom one had stopped speaking) as well as the quality of each relationship (i.e., satisfaction, support, conflict, and criticism). We tested whether BPD features predicted social network characteristics one month later.

We also assessed the influence of RS on these associations. While several studies have examined RS as a mediator of the relations between BPD and socially relevant outcomes (e.g., Miano et al., 2013, Zielinski and Veilleux, 2014), RS also has been tested as a moderator that amplifies risk for deficits in social functioning at higher levels of BPD features (Gardner, Qualter, Stylianou, & Robinson, 2010). We tested RS as both a moderator and a mediator of the relations between BPD features and social network outcomes to clarify whether RS is the mechanism through which these relations exist or a risk factor for poor social outcomes for those with BPD features. Examining interpersonal relationships in this manner allows for a more complete picture of social networks and BPD features and a better understanding of potential risk factors and mechanisms for disrupted network quality.

Section snippets

Participants and procedure

This study was open to all female introductory psychology students. Because BPD is primarily diagnosed in women (American Psychiatric Association, 2013) and there are tend to be differences in social networks (Kendler, Myers, & Prescott, 2005) and RS (Downey, Freitas, Michaelis, & Khouri, 1998) based on gender, we limited participation to female students. At baseline, participants completed consent forms and questionnaires assessing personality variables (i.e., BPD features, RS) and social

Baseline characteristics

At baseline, participants reported PAI-BOR scores that were consistent with other undergraduate samples (T-score = 48; Morey, 1991) with 6% of the sample scoring above 37 on the PAI-BOR, suggesting clinically relevant BPD features. RSQ scores were also comparable to those found in other undergraduate samples (Downey and Feldman, 1996, Zielinski and Veilleux, 2014). Table 1 includes the means, standard deviations, and correlations among variables at baseline.

Do baseline BPD features predict one-month social network outcomes?

BPD features at baseline predicted

Discussion

Taken together, these findings help characterize the relations between BPD features and social network outcomes and have implications for understanding the context in which interpersonal difficulties occur for those with heightened features of BPD. First, the results qualify the effect of BPD features on perceived social network quality. Although BPD features negatively predicted both perceived support from and satisfaction with one's social network, this effect was strongest at higher levels

Acknowledgments

The authors thank Star Hess and Victoria Alexander, the undergraduate research assistants who assisted with data collection.

References (25)

  • G. Downey et al.

    Implications of rejection sensitivity for intimate relationships

    Journal of Personality and Social Psychology

    (1996)
  • G. Downey et al.

    The self-fulfilling prophesy in close relationships: Rejection sensitivity and rejection by romantic partners

    Journal of Personality and Social Psychology

    (1998)
  • Cited by (28)

    • Borderline personality traits mediate the relationship between low perceived social support and non-suicidal self-injury in a clinical sample of adolescents

      2022, Journal of Affective Disorders
      Citation Excerpt :

      Congruently, recent research shows that adolescents with BPD perceive their caregivers to be less supportive and more invalidating than did controls without BPD, suggesting that their perceptions of caregiving behaviors are vital in the context of enduring borderline psychopathology (Bennett et al., 2019). Research in non-clinical adult samples also indicates that BPD features are associated with fewer supportive relationships and less satisfaction with social support (Beeney et al., 2018; Lazarus et al., 2016; Zielinski and Veilleux, 2014). Importantly, while BPD features are associated with low PSS, they are also closely associated with NSSI.

    • The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder

      2021, Clinical Psychology Review
      Citation Excerpt :

      A robust research literature suggests that individuals with BPD are also more likely to expect, perceive, and respond to, rejection (i.e., rejection sensitivity; Downey, Mougios, Ayduk, London, & Shoda, 2004). Several questionnaire-based studies suggest that rejection sensitivity is higher in individuals with BPD than HCs and clinical control groups (Berenson et al., 2016; Staebler, Helbing, Rosenbach, & Renneberg, 2011), predicts the presence of BPD in outpatients (Chesin, Fertuck, Goodman, Lichenstein, & Stanley, 2015), and is associated with higher BPD severity (e.g., De Panfilis, Meehan, Cain, & Clarkin, 2016; Goodman, Fertuck, Chesin, Lichenstein, & Stanley, 2014; Lazarus, Southward, & Cheavens, 2016; Miano et al., 2013; Peters, Smart, & Baer, 2015; Rosenbach & Renneberg, 2014; Sato, Fonagy, & Luyten, 2018; Selby, Ward, & Joiner, 2010; Zielinski & Veilleux, 2014). Although a minority of studies suggest that individuals with BPD do not exhibit statistically significant differences in rejection sensitivity to other clinical groups (Berenson et al., 2016), meta-analyses support that rejection sensitivity is hallmark to BPD and is associated with greater BPD severity (Cavicchioli & Maffei, 2019; Foxhall, Hamilton-Giachritsis, & Button, 2019).

    View all citing articles on Scopus

    This article is a Special issue article – “Young researcher award 2015".

    View full text