Louisiana Tech University Louisiana Tech Digital Commons Doctoral Dissertations Graduate School Spring 2014 The effect of state orientation on emotion dysregulation, borderline personality disorder, and nonsuicidal self-injury Desiree LeBoeuf-Davis Follow this and additional works at: https://digitalcommons.latech.edu/dissertations Part of the Counseling Psychology Commons, Personality and Social Contexts Commons, and the Quantitative Psychology Commons THE EFFECT OF STATE ORIENTATION ON EMOTION DYSREGULATION, BORDERLINE PERSONALITY DISORDER, AND NONSUICIDAL SELF-INJURY by Desiree LeBoeuf-Davis, B.S., M.A. A Dissertation Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy COLLEGE OF EDUCATION LOUISIANA TECH UNIVERSITY May 2014 UMI Number: 3662220 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. 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Box 1346 Ann Arbor, Ml 48106-1346 LOUISIANA TECH UNIVERSITY THE GRADUATE SCHOOL April 11, 2014 Date We hereby recommend that the dissertation prepared under our supervision Desiree LeBoeuf-Davis entitled__________________________________________________________________________________ The Effect of State Orientation on Emotion Dysregulation, Borderline Personality Disorder, and Nonsuicidal Self-injury be accepted in partial fulfillment of the requirements for the Degree of Doctor of Philosophy itipervisor of Dissertation Research Head of Department Department of Psychology Department Recommendation concurred in: Advisory Committee Approved: Approved: Director of/Graquate Studies Dean of the Graduate School Dean of the College" GS Form 13a (6/07) ABSTRACT The current study extends the application of Personality Systems Interactions (PSI) theory (Kuhl, 2000b) to the distinction between Nonsuicidal Self-injury (NSSI) and Borderline Personality Disorder (BPD) by examining the effect of State Orientation (Kuhl, 1994) on emotion dysregulation, BPD, and NSSI. Participants were recruited using social media and internet-based snowball techniques. Participants were directed to a web-based survey consisting of a demographic questionnaire, the Action Control Scale -24 (ACS-24; Kuhl, 1994; Kuhl & Fuhrmann, 1998), the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004; Gratz and Roemer, 2008), the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD; Zanarini et al., 2003), and the Inventory of Statements About Self-injury (ISAS; Klonsky & Glenn, 2009; Klonsky & Olino, 2008). Path analysis was used to test a mediation model in which State Orientation had direct effects on emotion dysregulation, BPD symptoms, and NSSI behaviors, and indirect effects on BPD symptoms and NSSI behaviors through emotion dysregulation. The hypothesized model suggested the relationship between BPD symptoms and NSSI behaviors is mediated by the total effects specified in the model. Results indicated that the specified model demonstrated marginal model-data correspondence and was not supported. The retained model (a theory consistent model) depicted direct effects of State Orientation on emotion dysregulation, but not on BPD symptoms or NSSI behaviors. However, results indicated an indirect effect of State Orientation on BPD symptoms and NSSI behaviors. These findings are consistent with previous research suggesting that NSSI may be a distinct disorder, specifically, separate from BPD. Future research should attempt to replicate the findings of the current study and/or test the originally proposed model with alternate populations (e.g., undergraduate college students, clinical samples of various ages, and youth). Additionally, future research should incorporate other aspects of PSI theory into the NSSI and BPD literature Clinical implications include early identification and subsequent intervention, as well as improved conceptualization of client characteristics. APPROVAL FOR SCHOLARLY DISSEMINATION The author grants to the Prescott Memorial Library of Louisiana Tech University the right to reproduce, by appropriate methods, upon request, any or all portions of this Dissertation. It is understood that “proper request” consists of the agreement, on the part of the requesting party, that said reproduction is for his personal use and that subsequent reproduction will not occur without written approval of the author of this Dissertation. Further, any portions of the Dissertation used in books, papers, and other works must be appropriately referenced to this Dissertation. Finally, the author of this Dissertation reserves the right to publish freely, in the literature, at any time, any or all portions of this Dissertation. Author ________________ °ate Lij//j/ y ______ GS Form 14 (5/03) DEDICATION This dissertation is dedicated to my mother, Barbara J. Davis, who has supported and encouraged me throughout my life as well as my academic career. I would never have accomplished my goals without her support. I am eternally grateful for the sacrifices she has made so that I could become a scholar. Thank you. TABLE OF CONTENTS ABSTRACT.................................................................................................................................. iii DEDICATION.............................................................................................................................. vi LIST OF TABLES...................................................................................................................... xii LIST OF FIGURES................................................................................................................... xiii ACKNOWLEDGEMENTS......................................................................................................xiv CHAPTER 1 INTRODUCTION.................................................................................................1 Personality Systems Interactions Theory .............................................................................3 Systems Conditioning......................................................................................................4 The Development of Disposition.......................................................................................... 6 Cognitive Macrosystems..................................................................................................9 Higher Level Macrosystems......................................................................................... 10 Two Modulation Assumptions...................................................................................... 11 State Orientation............................................................................................................. 15 Emotion Dysregulation .........................................................................................................17 The Development of Self-Control................................................................................19 Modes of Volition...........................................................................................................20 Diagnostic and Statistical Manual of Mental Disorders ..................................................24 DSM-IV-TR Axis I Disorders......................................................................................25 DSM-IV-TR Axis II Disorders.....................................................................................25 Relevant DSM-5 Changes............................................................................................ 26 Borderline Personality Disorder.................................................................................. 28 Comorbidity ...........................................................................................................................33 Nonsuicidal Self-Injury ........................................................................................................36 Rates of Self-Injury ........................................................................................................39 Methods of Self-Injury ...................................................................................................39 Functions of Self-Injury ................................................................................................ 40 Contextual Features of Self-Injury..............................................................................42 Risk Factors for Self-Injury ................................................................................................ 44 Borderline Personality Disorder.................................................................................. 44 Theories Explaining Self-Injury.................................................................................. 48 Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM-5)...................................................................................................52 DSM-5 NSSI Criteria.....................................................................................................54