title: Observer-rated coping associated with borderline personality disorder: an exploratory study.
abstract: BACKGROUND
  Little is known about coping specificities, as operationalization of the concept of affect regulation, in borderline personality disorder (BPD). It is most important to take into account methodological criticisms addressed to the self-report questionnaire approach and to compare BPD coping specificities to the ones of neighbouring diagnostic categories, such as bipolar disorder (BD).
  
  
  METHODS
  The present exploratory study compared the coping profiles of N = 25 patients presenting BPD to those of N = 25 patients presenting BD and to those of N = 25 healthy controls. All participants underwent a clinical interview that was transcribed and rated using the Coping Patterns observer-rater system.
  
  
  RESULTS
  Results partially confirmed study hypotheses and showed differences between BPD patients and healthy controls in all coping domains (competence, resources and autonomy), whereas the only coping domain presenting a BPD-specific lack of skills, compared with the BD patients, was autonomy, a set of coping strategies facing stress appraised as challenge. These coping processes were linked to general and BPD symptomatology.
  
  
  CONCLUSIONS
  These results extend conclusions of earlier studies on affect regulation processes in BPD and bear important clinical implications, in the context of dialectical behavior therapy and other therapeutic approaches. Limitations of this exploratory study, such as the small sample size, are acknowledged.
  
  
  CONCLUSIONS
  Coping can be reliably assessed in the narrative process in an non-structured interview frame. Patients with borderline personality disorder present with a specific lack of skills in affect regulation related to autonomy issues, compared to patients with bipolar disorder and healthy controls. Lack of skills in accommodation to distressing emotions in borderline personality disorder is related to symptom gravity and may be treated using radical acceptance strategies.
authors.affiliation: Institute of Psychotherapy and Section K. Jaspers, Department of Psychiatry-CHUV, University of Lausanne, Switzerland.
authors.forename: Ueli
authors.initials: U
authors.lastname: Kramer
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000339:Affect / Q000502:physiology; D001883:Borderline Personality Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Affect Regulation; Bipolar Disorder; Borderline Personality Disorder; Coping; Dialectical Behavior Therapy; Observer-rated Methodology