Rumination in Borderline Personality Disorder: A Meta-analytic Review

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability, specifically rumination. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in BPD. Taking this into consideration, a meta-analysis was performed to look at how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, comorbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of rumination domains for the entire sample revealed a medium correlation between BPD symptoms and rumination. When types of rumination were assessed, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/impulsivity. Demographic variables showed no significance. Clinical implications and further therapeutic interventions are discussed considering rumination.