The Emotional Bank Account and the Four Horsemen of the Apocalypse in Romantic Relationships of People With Borderline Personality Disorder: A Dyadic Observational Study

Abstract

Few studies have examined behaviors in romantic relationships associated with borderline personality disorder (BPD). We assessed critical variables from marital research: the emotional bank account (positive-to-negative behaviors) and the four horsemen of the apocalypse (criticism, defensiveness, contempt, and stonewalling). Couples (N = 130, or 260 participants) engaged in a conflict task and reported relationship satisfaction at intake and 12 months. Clinician-rated BPD and avoidant PD (APD) criteria were examined. People with more BPD symptoms and their partners were less satisfied, which worsened by follow-up. Conflict behaviors partially explained these associations. Partners of people with more BPD symptoms had a worse emotional bank account, which then predicted (a) poorer satisfaction for both members and (b) worsening partner satisfaction. People with more BPD symptoms criticized more; their partners defended and stonewalled more. APD predicted worsening satisfaction. BPD appears to link specifically with relationship dysfunction, partly through associations with partner behavior.