Electronic Thesis and Dissertation Repository

Thesis Format



Master of Clinical Science




Erin A. Kaufman


Borderline personality disorder (BPD) is associated with significant impairment in interpersonal functioning and risk of suicidal ideation (SI). One mechanism underlying interpersonal problems in BPD is deficits in social problem-solving. Using ecological momentary assessment, this study investigated how acute interpersonal problems (conflict, social isolation, lack of support, and rejection) were associated with daily SI in adolescents presenting with BPD features. Perceived rejection (β = 0.05, SE = 0.02, p = .03), support (β = 0.09, SE = 0.02, p < .001), and conflict (β = 6.07, SE = 1.30, p < .001) were associated with SI concurrently. Those with weaker social problem-solving abilities were more likely to experience SI in response to perceived rejection (β = -0.3, SE = 0.01, p = .04). This study contributes to the growing literature on advancing near-term prediction of SI, and highlights a potentially modifiable skill that is important for understanding suicide risk.

Summary for Lay Audience

Borderline personality disorder (BPD) is a mental condition that is marked by interpersonal difficulties and elevated risk of having suicidal thoughts. Adolescents and adults with features of BPD often report experiencing high rates of social isolation, conflict, and lack of social support, and are highly sensitive to feeling rejected by others. These same interpersonal experiences also put individuals at greater risk of suicide, more generally. Having a weaker capacity to solve social problems may be one reason why people with BPD features face difficulties maintaining healthy relationships. Social problem-solving encompasses skills that help individuals solve and cope with interpersonal problems and stressors that occur in everyday life. Prior research suggests having poor social problem-solving abilities is linked with both BPD and suicide risk. The current study examined whether interpersonal problems (i.e., conflict, lack of support, social isolation, and rejection) were associated with suicidal thoughts in everyday life among adolescents presenting with BPD features. Results suggest that adolescents who argued with another person and felt rejected by others were simultaneously more likely to think about suicide. I also investigated how social problem-solving related to these experiences, and found that those who had weaker social problem-solving abilities were more likely to think about suicide after feeling rejected. Finally, this study shows that daily experiences of interpersonal problems and suicidal thoughts can fluctuate dramatically over even several hours. This is important given that most prior research does not capture changes in these experiences over such short periods of time. Overall, this study demonstrates that interpersonal problems are linked with elevated suicide risk in everyday life, and the ability to solve social problems is a skillset that should be targeted to prevent escalations in suicidal thoughts—particularly among those vulnerable to rejection.