Cognitive Reappraisal of Negative Emotional Images in Borderline Personality Disorder: Content Analysis, Perceived Effectiveness, and Diagnostic Specificity.

Individuals with borderline personality disorder (BPD) report using cognitive reappraisal less often than healthy individuals despite the long-term benefits of the emotion regulation strategy on emotional stability. Individuals with BPD, mixed anxiety and/or depressive disorders (MAD), and healthy controls (HC) completed an experimental task to investigate the tactics contained in cognitive reappraisal statements vocalized for high and low emotional intensity photographs. Self-reported effectiveness after using cognitive reappraisal to decrease negative emotions was also evaluated. Although BPD and MAD used a similar number of cognitive reappraisal tactics, they perceived themselves as less effective at reducing their negative emotions compared to HC. During cognitive reappraisal, BPD and MAD uttered fewer words versus HC, while BPD uttered fewer words versus MAD. Results suggest that individuals with BPD and MAD are less fluent and perceive themselves as less effective than HC when using cognitive reappraisal to lower negative emotions regardless of stimulus intensity.