(PS13-50) The Relationship Between Affective Variability and Variability of Suicidal Thoughts and Behaviors Among Adults with Borderline Personality Disorder

            It is estimated that around 75% of individuals with Borderline Personality Disorder (BPD) will make a suicide attempt in their lifetime and 10% of these individuals will die by suicide (Black et al., 2004). Individuals with BPD also frequently engage in non-suicidal self-injury (NSSI; Goodman et al., 2017). Given the high rates of self-injurious thoughts and behaviors (SITBs) among individuals with BPD, it is imperative that researchers improve methods for predicting who may be at an elevated risk of suicide to aid in prevention and intervention.

Affective instability, defined as repeated, rapid, and abrupt shifts in mood and a slow return to baseline is considered the core pathology in BPD (Nica & Links, 2009). Research has shown that SITBs may function to help manage affective instability. Despite previous research highlighting the relationship between affective instability, BPD, and SITBs, little research has examined the association between variability of SITBs and affective states over time within the context of BPD. Research investigating these constructs has only utilized data captured in brief timeframes, thus being limited in scope (i.e., Koenigsberg et al., 2002). For example, with a small sample of women with BPD, Rizk et al. (2019) utilized data from one week of ecological momentary assessment and found that affective instability predicted variability in suicidal ideation (SI). Therefore, preliminary research suggests that there may be a relationship between affective variability and variability of SITBs. While research to date has demonstrated a link between short-term affective instability and SITB variability, little to no research has investigated the relationship between long-term affective variability and SITB variability.

The present study will examine the relationship between variability of intensity of specific positive and negative affective states and intensity of SI and NSSI urges across six months of outpatient DBT treatment. Participants (n = 104) are adults all meeting criteria for BPD and have a mean age of 28.6 (SD = 8.81). The sample is 76% female, 73.1% white, and 4.8% Hispanic/Latinx. We hypothesize that (1) affect variability will be associated with SITB variability; and, (2) greater variability of specific negative emotions such as shame, anger, and sadness will be associated with greater variability of SITBs. Results from this study may provide a better understanding of how affective variability may impact variability of SITBs in a BPD sample and may further aid in suicide prevention.