A contingency-oriented approach to understanding borderline personality disorder: Situational triggers and symptoms

Kelly Miskewicz, William Fleeson, Elizabeth Mayfield Arnold, Mary Kate Law, Malek Mneimne, R. Michael Furr

Research output: Contribution to journalArticle

29 Scopus citations


This article tested a contingency-oriented perspective to examine the dynamic relationships between in-the-moment borderline personality disorder (BPD) symptom events and in-the-moment triggers. An experience sampling study with 282 adults, including 77 participants with BPD, obtained reports of situational triggers and BPD symptom events five times daily for 2 weeks. Triggers included being rejected, betrayed, abandoned, offended, and disappointed; having one’s self-concept threatened; being in a boring situation; and being alone. BPD was associated with increased situational triggers. Multilevel models revealed significant within-person associations between situational triggers and BPD symptoms for the average participant in the study, with significant individual variance in the strength and direction of trigger-symptom contingencies. Most trigger-symptom contingencies were stronger for individuals with greater borderline symptomatology, suggesting that triggers are meaningfully related to BPD. These findings highlight possible proximal mechanisms that maintain BPD and help explain the course of a disorder often described as chaotic and unpredictable.

Original languageEnglish (US)
Pages (from-to)486-502
Number of pages17
JournalJournal of Personality Disorders
Issue number4
StatePublished - Aug 1 2015
Externally publishedYes


ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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