(PS7-82) The Moderating Effects of Alexithymia on the Association Between Borderline Personality Disorder and Emotion Regulation Flexibility

Previous literature on emotion regulation (ER) and borderline personality disorder (BPD) suggests that BPD is associated with more dysfunctional ER strategy use (Daros & Williams, 2019). However, recent literature (e.g., Aldao et al., 2015) has begun to suggest that ER strategies are rarely implemented alone, and that ER flexibility – the association between ER strategy use variability and environmental changes – is associated with greater mental health. Few studies have examined ER flexibility and BPD features, and results indicate that BPD is associated with using fewer strategies (i.e., small repertoires), and less adaptability and persistence in using ER strategies. However, other emotional processes, such as alexithymia – difficulties identifying, describing, externally oriented thinking – may disrupt ER processes (Ridings & Lutz-Zois, 2014), and is associated with greater BPD features. Therefore, the present study examined the associations between ER flexibility, alexithymia, and BPD symptoms. Participants were 245 adults that primarily identified as women (53%), heterosexual (84.4%), and non-ethnic White (74%). Participants completed the Flexible Regulation of Emotional Expression (FREE; Burton & Bonanno, 2016) scale, the Clarity and Awareness subscales of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) and the Personality Assessment Inventory (PAI)-BPD (Morey 1991) to assess ER flexibility, alexithymia, and BPD symptoms. Mean centered variables were entered into hierarchical linear regression models. The additive effects of alexithymia and ER flexibility, controlling for sex and age, on BPD symptoms were tested in step 1 and the multiplicative effect of alexithymia and ER flexibility on BPD symptoms was tested in step 2. Results suggest that the omnibus test was significant in step 1 (F = 30.85, p < .001) and the additive effects accounted for 34% of the variance in BPD symptoms. There was a significant negative additive effect of age (B = -0.25, p < .001) and a significant positive additive effect of alexithymia (B = 3.54, p < .001) on BPD symptoms controlling for sex (p = .099) and ER flexibility (p = .318). When adding the interaction effect of alexithymia and ER flexibility in step 2 (B = 0.07, p = .001), the omnibus regression remained significant (F = 27.87, p < .001) and accounted for an additional 2.9% of the variance in BPD symptoms (p = .001). Simple slope analyses revealed that at low levels of alexithymia, the association between ER flexibility and BPD symptoms was significant and negative (B = -0.16, p = .005), whereas at high levels of alexithymia the association between ER flexibility and BPD symptoms was not significant (p = .182). By contrast the association between alexithymia and BPD symptoms were positive and significant at high and low levels of ER flexibility; however, the association was stronger at high levels of ER flexibility (B = 4.90, b = .65, p < .001). Results suggest that the beneficial effects of ER flexibility on BPD symptoms depend on one’s awareness of their emotions. Our findings and theory suggest that alexithymia may disrupt ER processes and thus, it is critical that interventions increase emotional awareness prior to increasing ER strategy use.