Gentiana Sadikaj

Affect Dysregulation in Individuals With Borderline Personality Disorder: Persistence and Interpersonal Triggers

We hypothesized that affect dysregulation among individuals with borderline personality disorder (BPD) would involve greater persistence of negative affect between interpersonal events and heightened reactivity to stimuli indicating risk of rejection or disapproval, specifically perceptions of others’ communal (agreeable-quarrelsome) behaviors. A total of 38 participants with BPD and 31 controls collected information about affect and perceptions of the interaction partners behavior during interpersonal events for a 20-day period. Negative and positive affect persisted more across interpersonal events for individuals with BPD than for controls. In addition, individuals with BPD reported a greater increase in negative affect when they perceived less communal behavior and a smaller increase in positive affect when they perceived more communal behavior in others. Findings indicate the importance of interpersonal perceptions in the affect dysregulation of individuals with BPD.

Quarrelsome behavior in borderline personality disorder: influence of behavioral and affective reactivity to perceptions of others.

We examined how the amplification of 3 within-person processes (behavioral reactivity to interpersonal perceptions, affect reactivity to interpersonal perceptions, and behavioral reactivity to a persons own affect) accounts for greater quarrelsome behavior among individuals with borderline personality disorder (BPD). Using an event-contingent recording (ECR) methodology, individuals with BPD (N = 38) and community controls (N = 31) reported on their negative affect, quarrelsome behavior, and perceptions of the interaction partners agreeable-quarrelsome behavior in interpersonal events during a 20-day period. Behavioral reactivity to negative affect was similar in both groups. However, behavioral reactivity and affect reactivity to interpersonal perceptions were elevated in individuals with BPD relative to community controls; specifically, individuals with BPD reported more quarrelsome behavior and more negative affect during interactions in which they perceived others as more cold-quarrelsome. Greater negative affect reactivity to perceptions of others cold-quarrelsome behavior partly accounted for the increased quarrelsome behavior reported by individuals with BPD during these interactions. This pattern of results suggests a cycle in which the perception of cold-quarrelsome behavior in others triggers elevated negative affect and quarrelsome behavior in individuals with BPD, which subsequently led to more quarrelsome behavior from their interaction partners, which leads to perceptions of others as cold-quarrelsomeness, which begins the cycle anew.

Impact of male partner responses on sexual function in women with vulvodynia and their partners: a dyadic daily experience study.

OBJECTIVE There is a paucity of research investigating the role of interpersonal variables in vulvodynia--a prevalent, chronic, vulvo-vaginal pain condition that negatively affects many aspects of womens sexual health, emotional well-being and intimate relationships. Cross-sectional studies have shown that male partner responses to painful intercourse are associated with pain and sexual satisfaction in women with vulvodynia. Partner responses can be solicitous (attention and sympathy), negative (hostility and frustration), and facilitative (encouragement of adaptive coping). No research has assessed the influence of daily partner responses in this population. Further, there is limited knowledge regarding the impact of partner responses on sexual function, which is a key measure of impairment in vulvodynia. METHODS Using daily diaries, 66 women (M age = 27.91, SD = 5.94) diagnosed with vulvodynia and their cohabiting male partners (M age = 30.00, SD = 8.33) reported on male partner responses and sexual function on days when sexual intercourse occurred (M = 6.54, SD = 4.99). Drawing on the Actor-Partner Interdependence model (APIM), a multivariate multilevel modeling approach was adopted. RESULTS A womans sexual functioning improved on days when she perceived greater facilitative and lower solicitous and negative male partner responses, and when her male partner reported lower solicitous responses. A mans sexual functioning was poorer on days when he reported greater solicitous and negative responses. CONCLUSIONS Findings suggest that facilitative male partner responses may improve sexual functioning whereas solicitous and negative responses may be detrimental. Partner responses should be targeted in psychological interventions aimed to improve the sexual functioning of affected couples.

Relationship satisfaction moderates the associations between male partner responses and depression in women with vulvodynia : a dyadic daily experience study.

Summary Targeting male partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia. ABSTRACT Vulvodynia is a prevalent vulvovaginal pain condition that interferes with womens psychological health. Given the central role of sexuality and relationships in vulvodynia, relationship satisfaction may be an important moderator of daily partner responses to this pain and associated negative sequelae, such as depression. Sixty‐nine women (M age = 28.12 years, SD = 6.68) with vulvodynia and their cohabiting partners (M age = 29.67 years, SD = 8.10) reported their daily relationship satisfaction, and male partner responses on sexual intercourse days (M = 3.74, SD = 2.47) over 8 weeks. Women also reported their depressive symptoms. Relationship satisfaction on the preceding day moderated the associations between partner responses and womens depressive symptoms in several significant ways: (1) On days after women reported higher relationship satisfaction than usual, their perception of greater facilitative male partner responses was associated with their decreased depression; (2) on days after women reported lower relationship satisfaction than usual, their perception of greater negative male partner responses was associated with their increased depression; (3) on days after men reported higher relationship satisfaction than usual, their self‐reported higher negative responses were associated with decreased womens depression, and higher solicitous responses were associated with increased womens depression, whereas (4) on days after men reported lower relationship satisfaction than usual, their self‐reported higher negative responses were related to increased womens depression, and higher solicitous responses were associated with decreased womens depression. Targeting partner responses and relationship satisfaction may enhance the quality of interventions aimed at reducing depression in women with vulvodynia.

Attachment-related affective dynamics: differential reactivity to others' interpersonal behavior.

We examined the influences of attachment orientations on within-person changes in affect as a function of perceptions of the interaction partners agreeable behavior in interactions involving a romantic partner and other kinds of partners. Working adults reported affect, perceptions of the other persons behavior, and the relationship with the other in interpersonal events during 20 days. As expected, the within-person association between perceived partners agreeable behavior and negative affect was stronger for individuals higher on attachment anxiety and was weaker for individuals higher on attachment avoidance. These effects were more pronounced in interactions with a romantic partner than with other persons. Findings demonstrate that attachment orientations are associated with differing within-person processes and that these processes are sensitive to kind of interaction partner.

A prospective 2-year examination of cognitive and behavioral correlates of provoked vestibulodynia outcomes.

Background:Provoked vestibulodynia (PVD) is a common genital pain disorder in women that is associated with sexual dysfunction and lowered sexual satisfaction. A potentially applicable cognitive-behavioral model of chronic pain and disability is the fear-avoidance model (FAM) of pain. The FAM posits that cognitive variables, such as pain catastrophizing, fear, and anxiety lead to avoidance of pain-provoking behaviors (eg, intercourse), resulting in continued pain and disability. Although some of the FAM variables have been shown to be associated with PVD pain and sexuality outcomes, the model as a whole has never been tested in this population. An additional protective factor, pain self-efficacy (SE), is also associated with PVD, but has not been tested within the FAM model. Aims:Using a 2-year longitudinal design, we examine (1) whether initial levels (T1) of the independent FAM variables and pain SE were associated with changes in pain, sexual function, and sexual satisfaction over the 2-year time period; (2) the prospective contribution of changes in cognitive-affective (FAM) variables to changes in pain, and sexuality outcomes; and (3) whether these were mediated by behavioral change (avoidance of intercourse). Methods:A sample of 222 women with PVD completed self-report measures of FAM variables, SE, pain, sexual function, and sexual satisfaction at time 1 and at a 2-year follow-up. Structural equation modeling with Latent Difference Scores was used to examine changes and to examine mediation between variables. Main Outcomes:Questionnaires included the Pain Catastrophizing Scale, McGill Pain Questionnaire, Trait Anxiety Inventory, Pain Self-Efficacy Scale, and Global Measure of Sexual Satisfaction, Female Sexual Function Index. Results:Participants who reported higher SE at T1 reported greater declines in pain, greater increases in sexual satisfaction, and greater declines in sexual function over the 2 time points. The overall change model did not support the FAM using negative cognitive-affective variables. Only increases in pain SE were associated with reductions in pain intensity. The relationship between changes in SE and changes in pain was partially mediated through changes in avoidance (more intercourse attempts). The same pattern of results was found for changes in sexual satisfaction as the outcome, and a partial mediation effect was found. There were no significant predictors of changes in sexual function other than T1 SE. Discussion:Changes in both cognitive and behavioral variables were significantly associated with improved pain and sexual satisfaction outcomes. However, it was the positive changes in SE that better predicted changes in avoidance behavior, pain, and sexual satisfaction. Cognitive-behavior therapy is often focused on changing negative pain-related cognitions to reduce avoidance and pain, but the present results demonstrate the potential importance of bolstering positive self-beliefs as well. Indeed, before engaging in exposure therapies, SE beliefs should be assessed and potentially targeted to improve adherence to exposure strategies.

Consequences of interpersonal spin on couple-relevant goal progress and relationship satisfaction in romantic relationships.

Large fluctuations in a persons interpersonal behavior across situations and over time are thought to be associated with poor personal and interpersonal outcomes. This study examined 2 outcomes, relationship satisfaction and goal progress, that could be associated with individual differences in dispersion of interpersonal behavior (interpersonal spin) in romantic relationships. Need satisfaction and perceived autonomy support for goal pursuit from the partner were examined as mediator variables. Spin was measured using an event-contingent recording (ECR) methodology with a sample of 93 cohabiting couples who reported their interpersonal behavior in interactions with each other during a 20-day period. Relationship satisfaction and goal completion were measured at the end of the ECR procedure (T2) and approximately 7 months after the ECR (T3). Need satisfaction and perceived autonomy support were measured at T2. In both genders, higher spin was associated with lower T2 relationship satisfaction. There was also a decline in relationship satisfaction from T2 to T3 among men with high spin partners. In both genders, higher spin was associated with lower need satisfaction, and lower need satisfaction was associated with a decline in relationship satisfaction from T2 to T3. In both genders, higher spin was associated with lower perceived autonomy support, and lower support was associated with decreased progress in goal completion from T2 to T3. The effects of spin were independent of the effects of mean levels of behavior. These findings extend the understanding of the detrimental consequences of dispersion in interpersonal behavior to the disruption of the persons romantic relationships.

Negative affective reaction to partner’s dominant behavior influences satisfaction with romantic relationship:

Dominant behavior has been related to lower quality romantic relationships. The present study examined two processes through which dominant behavior affects the quality of romantic relationships: (1) the extent to which the partner’s dominance increases the person’s negative affect by thwarting the person’s sense of autonomy and (2) the degree to which the person’s negative affect in reaction to the partner’s dominant behavior affects relationship satisfaction. Using an event-contingent recording (ECR) methodology, 92 cohabiting couples reported their dominant behavior, negative affect, and autonomy in interactions with each other during 20 days. Relationship satisfaction was measured at the end of the ECR period. The results indicated that when a partner engages in dominant behavior, the person experiences greater negative affect in part due to a sense of thwarted autonomy and that greater negative affective reaction in association with the partner’s dominant behavior is related to lower relationship satisfaction in the person.

Abstract: Within-Person Processes Leading to Quarrelsome Behavior in Interactions Between Romantic Partners

This study used multilevel structural equation modeling (MSEM; Preacher, Zyphur, & Zhang, 2010) to examine within-person processes that give rise to quarrelsome behavior in interactions between romantic partners. Based on Interpersonal Theory and Adult Attachment Theory, we hypothesized that a persons quarrelsome behavior would be predicted by (a) the direct effect of the partners quarrelsome behavior, (b) an indirect effect mediated by the persons perceptions of the partners quarrelsome behavior, and (c) an indirect effect mediated by the persons felt security. Using an event-contingent recording methodology, both partners in 93 cohabiting community couples reported independently on their quarrelsome behavior, felt security, and perceptions of the partners quarrelsome behavior in interactions with each other during a 20-day period. Findings (see Figure 1) supported a direct effect of partners increases in quarrelsome behavior on persons increases in quarrelsome behavior. This association was partly accounted for by perceptions of partners behavior and felt security following these perceptions. The more a person perceived the partner as engaging in quarrelsome behavior, the more the person engaged in quarrelsome behavior [indirect effect = .016, 95% CI (.009 − .022)]. Furthermore, the persons perception of greater quarrelsomeness in the partners behavior was associated with decreases in the persons felt security, which in turn were related to increases in a persons quarrelsome behavior [indirect effect = .009, 95% CI (.005 − .013)]. No gender differences were found. Findings indicate that a partners increase in quarrelsome behavior is partly related to a persons increase in quarrelsome behavior in part to the extent that the person perceives the behavior as quarrelsome and consequently feels insecure during the interaction. Findings illustrate an application of MSEM for assessing multilevel mediation in the dyadic context. Moreover, the results suggest that theory and therapeutic interventions should consider interpersonal perceptions as the first link in the chain of affective and behavioral reactions to the interpersonal behaviors of others.

The Effects of If-Then Plans on Weight Loss: Results of the McGill CHIP Healthy Weight Program Randomized Controlled Trial: Effects of If-Then Plans

The NIH‐developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one‐on‐one. The group‐based DPP is less effective, with average weight losses of only 3.5%. The objective of this study was to increase weight loss outcomes of the group‐based DPP by integrating habit formation tools (i.e., if‐then plans). This two‐arm randomized controlled trial tested the efficacy of the habit formation–enhanced group‐based DPP compared with the standard group‐based DPP on changes in body weight (primary outcome). This study presents the 3‐ and 12‐month results of this 24‐month trial.