Background: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While...Show moreBackground: Dissociation is a prevalent symptom of borderline personality disorder (BPD) that has been associated with impaired psychological functions, such as working memory (WM) deficits. While previous studies have shown a link between dissociation and WM deficits, the influence of (mal)adaptive skills on this relationship remains unexplored. A core component of BPD treatment is practicing emotional regulation, which has been found to be associated with dissociation and WM capacity. Exploring these associations may be of clinical importance since practicing emotional regulation during treatment may additionally improve WM capacity in people with dissociation. This cross-sectional study examined how adaptive coping skills and maladaptive coping (self-harm) impact the relationship between dissociation and WM in 57 female BPD patients. Methods: An emotional working memory task (EWMT, adapted Sternberg recognition task), assessed WM in terms of accuracy and reaction time (RT) during distraction. Participants self-reported dissociation (Dissociation Stress Scale acute), self-harming behavior (Borderline Symptom List Supplement) and the use of (mal)adaptive skills (Dialectical Behavior Therapy-Revised Ways of Coping Checklist). Baseline characteristics were compared to a healthy control group (HC, n = 28) using a one-way Multivariate Analysis of Variance (MANOVA). Within the BPD group, simple and hierarchical linear regression analyses and correlation analyses were conducted to assess associations between clinical variables and WM. Results: BPD patients reported increased dissociation and self-harm, and less adaptive coping skills compared to HC, while they did not differ regarding WM. Within the BPD group, both pre-task dissociation and adaptive skills significantly predicted accuracy but not RT on the EWMT. Self-harm and adaptive skills were found to influence the association between dissociation and WM performance. These findings emphasize the importance of assessing dissociative symptoms prior to and during treatment. Strengthening adaptive skills and reducing self-harm remains an important treatment avenue that may enhance WM through better emotional regulation capacities.Show less
