Psychotic-like experiences in adolescents with borderline personality traits: associations with emotion regulation and socio-cognitive functioning

Psychotic-like experiences (PLEs) are commonly observed among individuals with Borderline Personality Disorder and are associated with poorer prognosis. It is unclear whether adolescents with elevated borderline personality traits (BPTs) experience more PLEs than non-clinical peers and which factors are associated with them. In this cross-sectional study, 50 adolescent girls with elevated BPTs and 50 age-matched non-clinical controls completed measures of PLEs, emotion regulation, and executive and social-cognitive functioning. In the full sample ( N = 100), exploratory indirect-effect and hierarchical regression analyses examined PLE frequency. Adolescents with elevated BPTs reported more frequent (d = 1.61) and distressing (d = 1.45) PLEs than controls. They also showed greater emotion regulation difficulties and impairments in neuro-socio-cognitive functioning, and most differences remained after adjustment for family background. Exploratory analyses identified a positive indirect statistical association through emotion regulation difficulties (indirect effect = 0.21, 95% CI 0.07–0.37), while the direct association between BPT severity and PLE frequency remained significant (c′ = 0.25, p = .011). Our findings underscore the importance of assessing PLEs and addressing emotion regulation in adolescents with BPTs, alongside their cognitive and social-cognitive difficulties. Although causality cannot be established, these associations warrant longitudinal investigation.