2026 ECNP Congress

PS03-3058

First results of the DynAMoND study: mapping distinct patterns of affective dysregulation in ADHD, bipolar disorder, and borderline personality disorder

Maximilian Bayas — T. Kockler, C. Bittendorf, S. Matura, M. Aichholzer, S. Fischer, C. Reif-Leonhard, J.A. Ramos-Quiroga, S. Munoz Caller, G. de Girolamo, L. Iozzino, M. D’Addazio, M. Bulgarini, J. Haavik, A. Halmøy, K. Schiøler Hellum, B. Osnes, A.J. Lundervold, J.N. Kolle, N. Perroud, R. Hasler, C. Rodriguez, J. Repple, U. Ebner-Priemer, A. Reif, F. Donno, S. Carucci · University Hospital Frankfurt-Goethe University, Department for Psychiatry- Psychosomatic Medicine and Psychotherapy, Frankfurt, Germany

2026 ECNP Congress

Background

Attention-deficit/hyperactivity disorder (ADHD), bipolar disorder (BD), and borderline personality disorder (BPD) are neurodevelopmental and early-onset personality disorders characterized by distinct patterns of affective fluctuations with a relevant degree of comorbidity (1–3). Whether this comorbidity reflects shared pathophysiological mechanisms remains unclear. The DynAMoND study investigates differential dynamics of affective and self-esteem regulation across these clinical groups.

Methods

DynAMoND is an international, prospective cohort study recruiting participants aged 14–50 across five European sites (Frankfurt, Barcelona, Bergen, Brescia, Geneva) (4). Diagnoses were confirmed using structured interviews (M.I.N.I., DIVA 2.0, SCID-5-PD). The present analyses are based on data from five measurement bursts of 363 participants (129 ADHD, 62 BD, 94 BPD, 78 HC).

During each five-day measurement burst, participants received 10 daily ecological momentary assessment (EMA) prompts via their own smartphone (pseudo-random time-sampling, ~72-minute intervals, 9h–21h). Affective state was assessed along three dimensions using visual analogue scales with opposing anchors: valence (“content–discontent”, “unwell–well”), tense arousal (“agitated–calm”, “relaxed–tense”), and energetic arousal (“full of energy–without energy”, “tired–awake”). Self-esteem was assessed using an adapted four-item Rosenberg Self-Esteem Scale. Additional items captured impulsivity, positive and negative daily life events, social interactions, and dysfunctional behavior. Participants concurrently wore wristband activity sensors (Move 4, movisens GmbH) to monitor physical activity.

Affect dynamics parameters - attractor (homebase), variability, and attractor strength - were estimated simultaneously using an advanced stochastic modeling approach, while accounting for positive and negative event reactivity, across all four affect dimensions.

Results

Affective Dysregulation: BPD and BD both exhibited significantly elevated affective variability in valence (p<.001), suggesting amplified moment-to-moment emotional fluctuations in both disorders.

Event Reactivity: BPD showed heightened sensitivity to positive events (p<.001), while ADHD demonstrated elevated negative event reactivity (p<.05), suggesting distinct reactive phenotypes.

Self-Esteem Homeostasis: BPD displayed a substantially lower self-esteem attractor (homebase) with pronounced variability (p<.001), indicating persistent low self-regard amplified by instability. Conversely, healthy controls demonstrated the strongest self-esteem attractor strength (p<.001), reflecting robust affective stability.

Arousal Dimensions: Group differences were most pronounced in energetic arousal and self-esteem domains, with only minimal effects in tense arousal.

Conclusions

These first results from the DynAMoND study reveal distinct affective phenotypes across disorders. BPD and BD share elevated affective variability but diverge markedly in event sensitivity and self-esteem regulation: Patients with BPD are characterized by a persistently low self-esteem homebase, high self-esteem variability, and heightened reactivity to positive events. Patients with ADHD exhibit a selective negative event reactivity profile without the broad affective variability characteristic of mood disorders. Healthy controls demonstrated the most robust self-esteem attractor strength, underscoring self-esteem instability as a transdiagnostic marker.

These differential profiles may help refine diagnostic boundaries or even establish transdiagnostic disease mechanism along the Research Domain Criteria (RDoC) concept and inform targeted interventions: emotion regulation strategies in BPD could address self-esteem instability and reactivity to positive events, while ADHD treatment may benefit from targeting negative event appraisal. Ongoing longitudinal analyses incorporating sleep, stress, and genetic data, will allow us to characterize the full temporal dynamics and predictors of affect dysregulation across these disorders.

References

  1. Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, et al. Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers. 2015 Aug 6;1:15020. doi:10.1038/nrdp.2015.20
  2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Vol. 5. 2013.
  3. Asherson P, Young AH, Eich-Höchli D, Moran P, Porsdal V, Deberdt W. Differential diagnosis, comorbidity, and treatment of attention-deficit/hyperactivity disorder in relation to bipolar disorder or borderline personality disorder in adults. Current Medical Research and Opinion. 2014 Aug 1;30(8):1657–72. doi:10.1185/03007995.2014.915800 PubMed PMID: 24804976.
  4. Bayas M, Kockler TD, Ramos-Quiroga JA, Caller SM, Fadeuilhe C, de Girolamo G, et al. Dynamics of affect modulation in neurodevelopmental disorders (DynAMoND) - study design of a prospective cohort study. Int J Bipolar Disord. 2024 Dec 28;12(1):44. doi:10.1186/s40345-024-00367-2 PubMed PMID: 39733204; PubMed Central PMCID: PMC11682027.