Emotion Dysregulation as a Core Feature of Borderline Personality Disorder: Associations with Impulsivity and Symptom...

Objectives: This study aimed to explore the relationship between emotion dysregulation (ED), impulsivity, and symptom severity in emerging adults (16-25 years) diagnosed with Borderline Personality Disorder (BPD). Specifically, it sought to determine which ED dimensions differentiate BPD from non-clinical, independently of anxiety and depression, and how these relate to clinical features of BPD. Methods: A total of 184 participants (BPD = 44, non-clinical group = 140) completed standardized assessments, including the DERS (ED), UPPS-P (impulsivity), DIB-R (BPD), BDI-II (depression), and STAI-T (trait anxiety). Analyses included Mann-Whitney tests, quantile and logistic regressions, and Spearman correlations, adjusting for clinical covariates. Results: BPD participants scored significantly higher on all DERS subscales (p < 0.001). Adjusted regressions identified Impulse, Awareness, and Clarity as key discriminators (ORs: 5.91, 3.56, 2.90), and a total DERS score >129 increased BPD likelihood twelvefold. ED dimensions were associated with DIB-R symptom severity, especially Impulse and Strategies. Only Clarity showed a negative correlation with suicide attempts, suggesting greater emotional confusion was linked to fewer reported attempts. ED also correlated with urgency traits on the UPPS-P. Conclusions: ED-particularly emotional impulsivity, poor awareness, and low clarity-emerges as a core marker of BPD in emerging adulthood. These findings underscore the importance of early intervention strategies targeting emotional identification, modulation, and impulsivity control to mitigate clinical severity and long-term risk.