The Role of Stress Generation in Emerging Borderline Personality Disorder
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Borderline Personality Disorder (BPD) is a debilitating disorder that is highly prevalent among clinical samples, and is associated with high levels of comorbidity with other Axis I conditions. Thus, identifying mechanisms that contribute to the negative impact of this disorder is of great value. Recent evidence suggests that stress generation may provide such an opportunity. Within the depression literature, the stress generation theory (Hammen, 1992) holds that depressed individuals experience more dependent life stress, (life stress that is dependent on the individual’s own contribution and interpersonal in nature) rather than independent, non-interpersonal life stress. Preliminary evidence in adolescent studies indicates that underlying Axis II cluster B pathology, and BPD are associated with stress generation initially; and this generated stress subsequently contributes to the development of depressive symptoms. However, very little is currently known about the links between depression, BPD, and stress generation in adolescent clinical samples. The aim of the current study was to address this gap in knowledge by assessing the role of BPD in relation to stress generation and depression utilizing developmentally appropriate measures in an inpatient sample of adolescents. Results indicated that BPD was not related to chronic, independent stress or stress perception, but bivariate level analyses suggest that adolescents with BPD report higher levels of dependent and interpersonal stress. At the same time, multivariate level analyses indicated that BPD only predicted the number of interpersonal episodic stressors after controlling for confounds. Interestingly, of all potential comorbid conditions, conduct problems was the most salient predictor of stress generation; significantly predicting chronic interpersonal stress and the number of dependent episodic events when controlling for BPD, age, and depression. Lastly, results suggested that chronic interpersonal stress, a component of stress generation, was not a significant mediator of the relation between BPD and depression, even though this trend had been reported in similar studies. All in all, these findings suggest that among inpatient adolescent samples, Axis II traits (BPD and conduct problems) predict stress generation above and beyond the influence of depression. This indicates that current conceptualizations of stress generation may need to be modified to gain a more comprehensive perspective of this phenomenon. Future research should assess the role of BPD; conduct problems, and depression in relation to stress generation within the context of a longitudinal design.