The association between anger rumination and emotional dysregulation in borderline personality disorder: A review

Borderline Personality Disorder (BPD) is characterized by impulsiveness, interpersonal difficulties, emotional instability and dysfunctional cognitive processes. In addition to these symptoms, anger rumination is a cognitive mechanism often prominent in BPD patients and it has been found to be associated with maladaptive outcomes, such as increasing anger feelings, aggressive and impulsive behaviors. In this context, the aim of our review is to synthesize results on the relationship between emotional dysregulation and anger rumination in BPD with the final goal to get more information about possible psychotherapeutic methods in the treatment of BPD. A comprehensive search on BPD and anger rumination was performed on PubMed, Embase and Scopus. The search identified 8 articles meeting our inclusion criteria. Most of the studies reported a correlation between BPD emotional instability and dyscontrolled behaviors, anger and depressive rumination. Specifically, from the reviewed studies, it emerged that the tendency to use dysfunctional cognitive strategies, such as anger rumination, predicted aggressive behavior above and beyond emotion dysregulation, ultimately suggesting that anger rumination mediates the relationship between emotional dysregulation and aggression proneness. The cross-sectional design and the inclusion of subjects without a definite diagnosis of BPD (e.g., university students), may have decreased the generalizability of the results to the clinical populations and limited the possibility to explore the effect of anger rumination over time in BPD. From the reviewed studies emerged that the identification of anger rumination as a proximal process with respect to BPD may have the potential to expand and support psychotherapeutic treatment.