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Borderline Personality Disorder and Emotion Dysregulation

Impulsivity and addiction

This section is edited by Tim Trull.

"Major theories of substance use disorder (including alcohol and other substances) implicate both emotional dysregulation and impulsivity. For example, the self-medication (or drive-reduction) perspective suggests that substance use is an attempt to regulate or alleviate negative affect, and thus may become negatively reinforcing. Furthermore, individuals higher in impulsivity report greater stress-reduction from substance use, making repeated use more likely.

Substance use may also be an attempt to heighten positive affect and may become positively reinforcing. The pharmacological effects of substance use can also influence affect and impulsivity. For example, substance use may increase positive affect and arousal in small doses, decrease negative affect in small to moderate doses, increase negative affect after prolonged heavy consumption and withdrawal, and increase disinhibition.

Supporting these theories, there are many examples in the literature of the comorbidity between substance use disorders and disorders characterized by emotional dysregulation and behavioral disinhibition, including: borderline personality disorder, other personality disorders, and a range of other psychiatric conditions (e.g., mood disorders, anxiety disorders, externalizing disorders).

This new section of the journal will highlight current and cutting-edge work elucidating the interplay between both emotion dysregulation and impulsivity and substance use disorder, as well as implications for the prevention and treatment of substance use disorders."

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