ISSN 2043-8087
Journal of Experimental Psychopathology
 Volume 6, Issue 4, 411-432, 2015
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Suppression, Acceptance, and Monitoring of Personally-Relevant Unwanted Thoughts in Women Diagnosed with Borderline Personality Disorder

Authors
  Jacqueline Pistorello - University of Nevada, Reno, Reno, NV
  Steven Hayes - University of Nevada, Reno, Reno, NV
  Ellen Costello - Butler Hospital, Providence, RI and Alpert Medical School of Brown University, Providence, RI
  Elizabeth Simpson - Harvard Medical School, Boston, MA
  Ann Begin - Private Practice, North Kingstown, RI
  Karen Rosen - Alpert Medical School of Brown University, Providence, RI
  Teri Pearlstein - Alpert Medical School of Brown University, Providence, RI and Women’s Medicine Collaborative, a Lifespan Partner, Providence, RI

Volume 6, Issue 4, 2015, Pages 411-432
DOI: http://dx.doi.org/10.5127/jep.042614

Abstract
Recent evidence suggests that patients with Borderline Personality Disorder (BPD) experience less immediate distress while suppressing unwanted thoughts, despite the negative long-term outcomes of that strategy longitudinally and in treatment settings. The present study investigated the impact of 8-minute audiotaped suppression/thought control, acceptance, and monitoring instructions on moderately distressing and personally relevant thoughts in women (N = 51; 17 per condition) diagnosed with BPD. Strategies were applied in a 5-minute think-aloud period, followed by a similar period without the strategy, and then a wind-down task. Those in the suppression condition reported less subjective distress throughout but showed evidence of attempts at distraction through increased talking in the second period. Participants in the suppression group with higher experiential avoidance showed more thought intrusions during the main task period and lower positive affect during the winddown task than those in other conditions. Suppression appears to produce some negative outcomes in this population despite resulting in less self-reported distress.

Table of Contents
Introduction
Method
 Recruitment, Screening, and Population
Procedure
 Think Aloud Training
 Selection of Personally Relevant Target Thought
 Interventions
 Think Aloud Tasks: Two 5-Minute Periods
  Manipulation Checks
  Measuring Potentially Delayed Effects
 Primary Outcomes
  Thought frequency.
  Subjective Units of Distress (SUDs).
  Number of words uttered.
  Pleasantness ratings.
 Individual Differences Self-Report Measures
Results
 Target Thought Content
 Manipulation Checks
 Data Analytic Plan for Intervention Effects
 Impact of Intervention on Outcomes
  Thought frequency.
  Subjective Units of Distress (SUDs).
  Number of words uttered.
  Pleasantness ratings.
 Correlations Between Individual Differences and Dependent Variables
 Impact of Self-Reported Experiential Avoidance (EA) on Outcomes
  Thought frequency.
  Subjective Units of Distress Scale (SUDs) and number of words uttered.
  Pleasantness ratings.
Discussion
 Suppression and Reduced Distress among BPD Patients
 Talking a Lot May Distract From Thinking
 Response Discordance as a Possible Mark of Suppression
 Limitations and Future Directions
Acknowledgements
References
Appendix A -- Condition Scripts
 Acceptance Condition
 Suppression / Thought Control Condition
 Monitoring Condition

Correspondence to
Jacqueline Pistorello, Ph.D., Counseling Services, Mail Stop 0080, University of Nevada,Reno, Reno, NV 89557.

Keywords
Borderline Personality Disorder, thought suppression, acceptance, experiential avoidance, psychological flexibility, Dialectical Behavior Therapy, word count, think aloud, monitoring

Dates
Received 7 Apr 2014; Revised 1 Jun 2015; Accepted 4 Nov 2015; In Press 30 Dec 2015









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