The course of dysphoric affective and cognitive states in borderline personality disorder: a 10-year follow-up study

The current study aimed to assess dysphoric states among 290 patients with borderline personality disorder (BPD) and 72 non-borderline axis II comparison subjects other personality disorders, (OPD) over a 10-year course of prospective follow-up. Additionally, we assessed the severity of these states among borderline patients who had and had not recovered both symptomatically and psychosocially. The Dysphoric Affect Scale (DAS) - a 50-item self-report measure of affective and cognitive states thought to be common among borderline patients and specific to the disorder - was administered at five waves of prospective follow-up. Affective and cognitive DAS items were separately analyzed, yielding respective subscores. Borderline patients reported more severe dysphoric states compared to OPD subjects at baseline. However, the severity of affective and cognitive states declined significantly for both groups taken together over 10 years of follow-up. Within the BPD group, recovered subjects reported less severe dysphoric states compared to non-recovered subjects at baseline. Results also showed a significant decline in DAS scores over time, but at a greater rate for recovered subjects. In sum, while the severity of dysphoric states declines significantly over time, inner distress remains an area of vulnerability for borderline subjects. Additionally, the severity and pervasiveness of these states may affect recovery over time.