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The Temporal Relation of Arousal and Perceived Rejection in Patients with Borderline Personality Disorder and Depressive Disorders: An Experience Sampling Approach

Borderline personality disorder (BPD) is characterized by high levels of arousal and perceived rejection by others. The temporal relation between these constructs, however, remains largely unclear. Based on predictions derived from the dynamic affect model and the rejection sensitivity model, we expected increases in arousal and perceived rejection to predict subsequent increases in perceived rejection and arousal, respectively. To investigate this topic, we assessed current self-reported affective arousal and perceived rejection in patients with BPD (n = 42), patients with depressive disorders (DD; n = 43), and healthy controls (HC; n = 40) for 52 times within 13 hours (ca. every 15 min). In line with previous studies, dynamic structural equation model results indicate significantly higher trait levels of arousal and perceived rejection in patients with BPD compared to participants in the DD and HC groups. In addition, we found substantial autoregressive and cross-lagged effects for arousal and perceived rejection. Other than expected, the magnitude of these effects did not significantly differ across diagnostic groups. Our findings suggest close temporal relations between arousal and perceived rejection. In patients with BPD, these effects unfold against the background of substantially elevated trait levels of arousal and perceived rejection. Future ambulatory assessment studies should provide additional context information (e.g., through monitoring rejection events) to investigate how patients with BPD perceive rejection in everyday life and how this affects subsequent levels of arousal.