Emotional responsiveness in borderline personality disorder: The role of basal hyperarousal and self-reported emotional regulation

The present study aims to test the hypothesis of biological hyperarousal and hyperreactivity underpinning the dysfunctional emotional processes of borderline personality disorder (BPD). Self-reported (quality and intensity of emotions) and physiological (respiratory sinus arrhythmia [RSA] and heart rate) data were collected in 14 clinical subjects with BPD and in 14 control subjects (healthy controls [HCs]), during the administration of six video clips with different emotional contents. Our findings showed a constant hyperarousal state (lower RSA) in the clinical group, supporting the hypothesis of a biological vulnerability to emotional dysregulation. BPD patients showed lower self-reported happiness in positive stimuli compared with HCs and a significant association between emotional dysregulation and physiological hyperreactivity to neutral stimuli. Our data support the hypothesis of a constant condition of physiological preparedness to threat and danger in BPD subjects. Moreover, our results highlight the influence of self-reported ability in regulating emotions in explaining BPD responses to specific emotional situations.