Chapter 3 84 granularity,” “emotional intelligence,” or “emotion regulation.” All references in the included studies were reviewed to check for additional relevant articles. 2.2 Selection of studies The selection of studies occurred in two phases: (1) screening of title and abstract and (2) inspection of full texts. To prevent premature discarding of relevant articles, all articles were included for full-text inspection in the second phase when the title and abstract did not give sufficient information. We restricted our full-text inspection to studies published in English in peerreviewed journals. Two researchers (YD and GW) independently assessed the inclusion and exclusion criteria after an initial calibration. Using a random sample of 60 articles, there was an agreement between the two reviewers of 93% for the first phase (Cohen’s kappa = .81). Using a new random sample of 60 articles for the second phase, there was an agreement of 98% for inclusion or exclusion of the study (Cohen’s kappa = .96). Disagreements were resolved by consensus. 2.3 Inclusion criteria Next to a diagnosis of BPD or a measure of borderline personality symptoms, studies had to empirically measure emotional awareness or alexithymia. We included studies that measured aspects of emotional awareness by means of subscales of broader psychological instruments—such as difficulties in emotion regulation (DERS) [7], emotional intelligence (SEIS) [57], or meta-mood (Trait Meta-Mood Scale; TMMS) [65] —and studies that used instruments assessing alexithymia, such as the TAS-20 [39, 40] or the BVAQ [58, 66, 67]. We included studies if they compared the level of emotional awareness or alexithymia in a borderline personality group to a healthy or non-alexithymic psychiatric control group, or if the studies examined the association between the level of emotional awareness or alexithymia and the level of borderline traits in a clinical or nonclinical sample. 2.4 Exclusion criteria A study was excluded if it did not empirically assess BPP or emotional awareness or alexithymia (e.g., awareness of the feelings of others rather than one’s own; awareness of cognitions or bodily signals rather than emotions). Studies were also excluded if they used the same data as previous studies, if they did not have an appropriate research design to compare or relate BPP to alexithymia, or compared BPP to a patient group that was also supposed to have lowered emotional awareness or alexithymia (e.g., other personality or eating disorders). When articles presented too little usable data for inclusion in the analysis, efforts were made to contact the author(s) to acquire the missing data. In the end, four studies had to be excluded because of missing data.
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