Interpersonal Problems in Borderline Personality Disorder: Associations with Mentalizing, Emotion Regulation, and Impulsiveness

Interpersonal problems are a core symptom of borderline personality disorder (BPD). This study investigated the relationship between emotion dysregulation, impulsiveness, and impaired mentalizing in the context of predicting interpersonal problems in BPD. Two-hundred and ten patients with BPD completed the Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS-11), Reflective Functioning Questionnaire (RFQ), and Inventory of Interpersonal Problems (IIP-32). We conducted three path models, with either mentalizing, emotion regulation, or impulsiveness as the exogenous variable. Emotion dysregulation and attentional impulsiveness predicted interpersonal problems directly, whereas hypomentalizing predicted interpersonal problems only indirectly throughout emotion dysregulation and attentional impulsiveness. Our results suggest that these domains contribute significantly to interpersonal problems in BPD. Moreover, hypomentalizing might impact on interpersonal problems via its effect on impulsiveness and emotion regulation. The study argues that focussing on emotion regulation and mentalizing in BPD treatments might have inter-linked beneficial effects on interpersonal problems.