Dysregulated eating behaviors in borderline personality disorder: are rejection sensitivity and emotion dysregulation linking mechanisms?

OBJECTIVE: Individuals with borderline personality disorder (BPD) often engage in dysregulated eating behaviors, such as binge-eating and purging. Rejection sensitivity, or the tendency to worry about and expect rejection in most situations, may be involved in this relationship by increasing the intensity and frequency of emotion dysregulation.
METHOD: Using a sample which included individuals diagnosed with BPD, a structural equation model was constructed using BPD symptoms and measures of rejection sensitivity, emotion dysregulation, and dysregulated eating behaviors.
RESULTS: The hypothesized model was supported in which BPD symptoms predicted high levels of rejection sensitivity, which then led to increased problems with emotion dysregulation and subsequent dysregulated eating behaviors. A significant indirect effect for rejection sensitivity on dysregulated eating behaviors, through emotion dysregulation, was found. This model also provided better fit than alternative models. DISCUSSION: The results of this study indicate that those with BPD may be more sensitive to rejection, and these fears of rejection may result in increased emotion dysregulation and subsequent dysregulated eating behaviors. Appearance-relevant rejection sensitivity may be an important factor to explore in future research.