The Modulating Role of Self-Referential Stimuli and Processes in the Effect of Stress and Negative Emotion on Inhibition Processes in Borderline Personality Disorder: Proposition of a Model to Integrate the Self-Concept and Inhibition Processes

Impulsivity is an important clinical and diagnostic feature of borderline personality disorder (BPD). Even though it has been reported that BPD individuals' inhibition performance is significantly reduced in the context of negative emotion or stress, this literature shows mixed results, raising questions about the possible role played by other factors. Winter (2016) proposed that negative emotion stimuli can be more disruptive for BPD individuals' attention control performance because they induce higher distractibility self-referential processes. This article aimed to systematically review the literature regarding the effect of stress and negative emotions on three main inhibition processesprepotent response inhibition, resistance to distractor interference, and resistance to proactive interferencein BPD and to verify the putative modulating role of self-referential stimuli and processes on these inhibition processes. All English and French experimental studies published until August 2018 were searched in PsychINFO and PubMED databases. The following keywords were used: borderline* AND inhibit* OR interference* OR forget* OR task* AND emotion* OR stress* OR affect*. A total of 1215 articles were included in the study. After full text revision, twenty-six papers were selected for review. The results of this review indicate that when stimuli or procedures involve self-reference stimuli or processes, BPD individuals' performance seems to be more disrupted in all three inhibition processes. A model based on Winter's and Kernberg's models is proposed with the aim of integrating the self-concept with inhibition processes in BPD.