Negative bias in fast emotion discrimination in borderline personality disorder

Perception and memory-based representations of facial emotions: Associations with personality functioning, affective states and recognition abilities

Personality traits and affective states are associated with biases in facial emotion perception. However, the precise personality impairments and affective states that underlie these biases remain largely unknown. To investigate how relevant factors influence facial emotion perception and recollection, Experiment 1 employed an image reconstruction approach in which community-dwelling adults (N = 89) rated the similarity of pairs of facial expressions, including those recalled from memory. Subsequently, perception- and memory-based expression representations derived from such ratings were assessed across participants and related to measures of personality impairment, state affect, and visual recognition abilities. Impairment in self-direction and level of positive affect accounted for the largest components of individual variability in perception and memory representations, respectively. Additionally, individual differences in these representations were impacted by face recognition ability. In Experiment 2, adult participants (N = 81) rated facial image reconstructions derived in Experiment 1, revealing that individual variability was associated with specific visual face properties, such as expressiveness, representation accuracy, and positivity/negativity. These findings highlight and clarify the influence of personality, affective state, and recognition abilities on individual differences in the perception and recollection of facial expressions.

Facial emotion processing in patients with borderline personality disorder as compared with healthy controls: an fMRI and ECG study

BACKGROUND

Maladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls.

METHODS

The study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the "faces" task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition).

RESULTS

We found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms.

CONCLUSION

The results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.

The Hypothalamus-Pituitary-Adrenal Axis and Social Cognition in Borderline Personality Disorder

Borderline personality disorder (BPD) is characterized by emotional instability, impulsivity and unstable interpersonal relationships. Patients experience discomforting levels of distress, inducing symptoms like dissociation, aggression or withdrawal. Social situations are particularly challenging, and acute social stress can reduce patients' cognitive and social functioning. In patients with Major Depressive Disorder or Posttraumatic Stress Disorder, which show high comorbidity with BPD, the endocrine stress response is characterized by Hypothalamus-Pituitary-Adrenal (HPA) axis dysfunction, which affects cognitive functioning. Compared to these clinical groups, research on HPA-axis function in BPD is relatively scarce, but evidence points towards a blunted cortisol reactivity to acute stress. Since BPD patients are particularly prone to social stress and experience high subjective difficulties in these situations, it seems plausible that HPA-axis dysregulation might contribute to decreased social cognition in BPD. The present review summarizes findings on the HPA-axis function in BPD and its association with social cognition following acute social stress. For this purpose, we review literature that employed a widely used social stressor (Trier Social Stress Test, TSST) to study the effects of acute social stress on social cognition and the HPA-axis response. We contrast these findings with studies on social cognition that employed Cyberball, another widely used social stressor that lacks HPA-axis involvement. We conclude that research on social cognition in BPD reveals heterogeneous results with no clear relationship between social functioning and HPA-axis response. More research is needed to better understand the psychophysiological underpinnings of impaired social cognition in BPD.

Developing and Validating a Facial Emotion Recognition Task With Graded Intensity

Facial emotion recognition (FER) tasks are often digitally altered to vary expression intensity; however, such tasks have unknown psychometric properties. In these studies, an FER task was developed and validated-the Graded Emotional Face Task (GEFT)-which provided an opportunity to examine the psychometric properties of such tasks. Facial expressions were altered to produce five intensity levels for six emotions (e.g., 40% anger). In Study 1, 224 undergraduates viewed subsets of these faces and labeled the expressions. An item selection algorithm was used to maximize internal consistency and balance gender and ethnicity. In Study 2, 219 undergraduates completed the final GEFT and a multimethod battery of validity measures. Finally, in Study 3, 407 undergraduates oversampled for borderline personality disorder (BPD) completed the GEFT and a self-report BPD measure. Broad FER scales (e.g., overall anger) demonstrated evidence of reliability and validity; however, more specific subscales (e.g., 40% anger) had more variable psychometric properties. Notably, ceiling/floor effects appeared to decrease both internal consistency and limit external validity correlations. The findings are discussed from the perspective of measurement issues in the social cognition literature.

Does Self-Silencing Behavior Mediate the Relation Between Rejection Sensitivity and Sexual Violence Victimization?

Previous research reveals that rejection sensitivity is associated with both sexual violence victimization and self-silencing behavior, yet the association among these variables has not been examined. As the foundation for this study, we propose a theoretical model that integrates these constructs. Using mediational analyses with bootstrapping, the results from a sample of 241 heterosexual college women revealed that consistent with the proposed model, self-silencing mediated the link between rejection sensitivity and reports of unwanted sexual contact and rape. The implications of the findings for the prevention of victimization/revictimization and interventions with victimized women are discussed.

Borderline personality disorder traits and mentalising ability: The self-other social cognition paradox

Objective

Borderline personality disorder (BPD) is a psychiatric condition characterised by a pervasive pattern of impulsivity, low self-image, and interpersonal conflicts. Previous findings indicate a mixed relationship between BPD and social cognition; little research as investigated whether BPD traits influence performance on specific elements of social cognitive tasks, i.e., positive/negative valence.

Method

Community-based typical controls (n = 151; 51% female) were recruited through an online survey. Participants completed aspects of the Personality Assessment Inventory pertaining to BPD traits, the Interpersonal Reactivity Index, and measures of both emotion recognition and mentalising.

Results

Following group stratification into high/low BPD traits, participants with high BPD traits were observed to perform significantly better when identifying negative valence stimuli. Furthermore, high levels of affect instability was found to significantly influence negative valence recognition.

Conclusion

This research highlights previous research which shows a paradox between higher performance on measures of social cognition, with a group of individuals who report significant interpersonal and relational difficulties. This research supports the assessment of social cognitive processes for people with BPD and/or high BPD traits to support clinical formulation of strengths and difficulties.

Altered psychobiological reactivity but no impairment of emotion recognition following stress in adolescents with non-suicidal self-injury

Impairments in both stress regulation and emotion recognition have been associated with borderline personality disorder (BPD) and non-suicidal self-injury (NSSI). Although it has been proposed that emotion recognition deficits particularly emerge during stress, this hypothesis has not been fully investigated. Adolescents with and without NSSI performed emotion recognition tasks before and after the employment of the Trier Social Stress Test (TSST). The psychobiological stress response was captured with psychological self-reports (affect, stress and dissociation), physiological recordings (heart rate, HR, and heart rate variability, HRV) and endocrinological sampling of saliva (cortisol and alpha-amylase). Mixed-linear models were applied to analyze stress-induced changes in emotion recognition performance and respective stress response measures. The TSST elicited altered psychobiological stress responses in adolescents with NSSI: A more pronounced decrease in positive affect, a more pronounced increase in negative affect, a less pronounced increase in HR, a less pronounced decrease in HRV and a more pronounced increase in alpha-amylase throughout the stress induction than adolescents without NSSI. Stress responses (dissociation, negative affect, cortisol and HR) differed as a function of BPD severity on a continuum, illustrating greater reactivity on self-reports but decreased biological responsiveness in those with greater BPD severity. Stress induction had similar effects on emotion recognition in adolescents with and without NSSI. Recognition sensitivity and recognition speed equally increased, in the absence of any differences in recognition accuracy. In contrast to prominent propositions, psychosocial stress does not appear to account for impaired emotion recognition across the BPD spectrum.

Expectation of Selfishness From Others in Borderline Personality Disorder

Social difficulties are apparent in borderline personality disorder (BPD). Behavior in BPD is characterized by mistrust and expectations of malevolence from others. We examined whether there is an asymmetry between their social behavior and their belief about other people’s social motivations. Subjects completed a task where they had to allocate money between themselves and an imagined other they will not meet and interact with. In addition they also had to report their expectations about how the imagined other would solve the task. We hypothesized that even though BPD patients will act in a prosocial way, they will expect selfish behavior from the other. We used the Slider Measure of social value orientation (SVO) and also created a modified version of the measure to examine the discrepancy between the subjects’ own SVO and their expectations from other people. We compared the results of thirty clinically diagnosed BPD patients to a matched sample of healthy participants. Our results show that the BPD group’s selfishness expectations significantly outweigh the expectations of selfishness in the HC group (U = 269, p = 0.007). This result further supports the mistrust and negativity bias observed in various aspects of social interactions in BPD.

Impaired impulse inhibition of emotional stimuli in patients with borderline personality disorder

This study was aimed to investigate whether BPD patients showed impaired impulse inhibition of emotional and non-emotional stimuli and to explore relevant neuroelectrophysiological mechanisms. A total of 32 BPD patients and 32 matched healthy controls were recruited. Self-reported scales were used to measure psychiatric symptoms. The event-related potentials (ERPs) were recorded when subjects were performing neutral and emotional Stop Signal Task (SST). Group differences in self-reported scores, behavioral variables and ERPs were compared. The BPD group scored significantly higher on impulsivity, severity of BPD symptoms, levels of depression and anxiety than the control group. In neutral SST, no significant group differences were detected in the amplitude and latency of ERPs components induced. In emotional SST, the P2 amplitude of negative emotion was significantly larger than that of neutral emotion in Go trials. In Stop trials, the P2 amplitude of BPD group was significantly smaller than that of control group, and the N2 amplitude of BPD group was significantly greater than that of control group. BPD patients showed impaired inhibition of emotional stimuli rather than non-emotional stimuli. The deficits of emotional impulse control mainly exhibit at the early attention, stimulus evaluation and conflict detection stages.

Emotional working memory updating in individuals with borderline personality features

BACKGROUND AND OBJECTIVES

Individuals with features of borderline personality disorder (BPD) are highly sensitive to social rejection. Working memory (WM) may play a critical role in processing emotional interpersonal information in BPD. Yet, little is known about how emotional WM operations are related to sensitivity to rejection cues and BPD features. Therefore, this study examined relationships among emotional WM operations, rejection sensitivity, and BPD features.

METHODS

Participants with BPD features (n = 39 with non-suicidal self-injury history; n = 47 without non-suicidal self-injury history) and healthy participants (n = 46) completed an emotional two-back task before and after a social exclusion induction (the Cyberball game).

RESULTS

Results showed that participants with BPD features were slower at discarding faces expressing anger and pain from WM compared to healthy individuals before the social exclusion induction. Participants with BPD features and a history of self-injury were also slower at entering happy faces into WM compared to the other participants. Moreover, across participants, slower WM discarding of angry and pain faces was associated with higher levels of rejection sensitivity. Finally, no group differences emerged with respect to WM entering and discarding operations for emotional faces in response to social exclusion.

LIMITATIONS

This study was conducted in a sample of undergraduate students and did not consider comorbidity with other forms of psychopathology.

CONCLUSIONS

These findings cast light on how emotional WM difficulties may be involved in how individuals with BPD process emotional interpersonal information.

A systematic review and meta-analysis of 'Systems for Social Processes' in borderline personality and substance use disorders

Deficits in social processing (SP) have been proposed to underpin interpersonal dysfunction in both Borderline Personality Disorder (BPD) and Substance Use Disorders (SUD). This study aimed to explore potential transdiagnostic cognitive and behavioral phenotypes of these disorders utilizing the NIMH Research Domain Criteria 'Systems for Social Processes'. A systematic review and meta-analysis of the published research was conducted on 134 studies identified through our database searches. Four meta-analyses were conducted, which revealed significant overlapping deficits in the ability to identify facial emotions and infer the mental states of others in both BPD and SUD. Further, people with BPD displayed a higher ostracism effect following perceived social exclusion. Systematically reviewed studies also revealed significant dysfunction amongst individuals with BPD and SUD across both self and other SP constructs, which were broadly similar in magnitude. Taken together, these results support the proposition that SP dysfunction may be considered a core transdiagnostic phenotype of BPD and SUD.

Facial Emotion Perception in Borderline Personality Disorder: Differential Neural Activation to Ambiguous and Threatening Expressions and Links to Impairments in Self and Interpersonal Functioning

BACKGROUND

Many individuals with borderline personality disorder (BPD) perceive emotional expressions in faces intended to convey no emotion and display a heightened sensitivity to facial expressions conveying threat, such as fear. In BPD, the amygdala activates in response to ambiguous and threatening facial expressions, although the differential sensitivity of this brain region to higher and lower intensities of fearful expressions and the relationship of this neural activity to personality impairments have not yet been investigated.

METHODS

In the present study, we examined brain activation during an implicit facial emotion task with neutral faces and fearful expressions displayed at 50% and 100% intensity in patients with BPD (n=45) and healthy controls (HC; n=25).

RESULTS

On neutral faces, higher brain activation was found in BPD compared to HC in the right temporal pole, amygdala, hippocampus, pallidum, and orbitofrontal cortex, whereas no significant whole-brain group differences were observed for either intensity of fearful expressions. A region-of-interest analysis focused on the amygdala-hippocampal complex showed greater activation for neutral and 50%-intensity fearful faces in BPD. Severity of personality impairment in the domains of empathy and identity were associated with higher precuneus activity during neutral and 100%-fearful face processing.

LIMITATIONS

Brain activation differences of this naturalistic severely ill inpatient sample may be influenced by comorbid Axis-I disorders often seen in samples of BPD.

CONCLUSIONS

These findings suggest a heightened amygdala-hippocampal response to neutral faces and moderate-intensity fearful expressions in BPD, while self and interpersonal impairments are associated with task-based activations in regions implicated in self-referential processes.

The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder

Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.

Facial Emotion Perception in Families Affected With Borderline Personality Disorder

Emotion perception biases may precipitate problematic interpersonal interactions in families affected with borderline personality disorder (BPD) and lead to conflictual relationships. In the present study, the authors investigated the familial aggregation of facial emotion recognition biases for neutral, happy, sad, fearful, and angry expressions in probands with BPD (n = 89), first-degree biological relatives (n = 67), and healthy controls (n = 87). Relatives showed comparable accuracy and response times to controls in recognizing negative emotions in aggregate and most discrete emotions. For sad expressions, both probands and relatives displayed slower response latencies, and they were more likely than controls to perceive sad expressions as fearful. Nonpsychiatrically affected relatives were slower than controls in responding to negative emotional expressions in aggregate, and fearful and sad facial expressions more specifically. These findings uncover potential biases in perceiving sad and fearful facial expressions that may be transmitted in families affected with BPD.

Social distance modulates outcome processing when comparing abilities with others

Social comparison occurs when individuals evaluate themselves in comparison with others. Social distance can influence the effect of social comparison. Using event-related potentials, this study examined how social distance affects the time course of outcome processing when individuals compare themselves with others in terms of ability. Participants were asked to perform a dot estimation task with a friend and a stranger. The results showed the effect of social distance on the N1, feedback-related negativity (FRN), and P300, such that the N1 and P300 were greater for the outcome when pairing with the stranger than when pairing with the friend, whereas the FRN was more negative for the outcome when pairing with the friend than when pairing with the stranger, suggesting that participants allocated more attention resources to the stranger's outcome during the early, automatic (the N1) and later, controlled processing stage (the P300). In addition, the FRN was sensitive to the valence of both self- and other-outcomes, and the FRN valence effect of self-outcome was modulated by friends' outcomes but not by strangers' outcomes, indicating that at the semi-automatic processing stage, closer social distance increases the likelihood of individuals being affected by the comparison targets. These results suggest that when comparing with others in the ability dimension, social distance plays a different role in different stages of outcome processing. At the primary stage of outcome processing, individuals are more likely to compare with close others in the ability dimension.

Negative bias and reduced visual information processing of socio-emotional context in borderline Personality Disorder: A support for the hypersensitivity hypothesis

BACKGROUND AND OBJECTIVES

Current studies on emotional dysregulation in BPD suggest that it might be manifested by altered appraisal and biased attentional mechanisms, rather than by hyperreactivity. The aim of this study was to acquire more evidence on this topic by testing the hypothesis that BPD patients are characterized by a negative evaluation bias and reduced visual exploration in response to socio-emotional content. Moreover, the association between the previous conceptualizations and typical dysfunctional processes in BPD were evaluated.

METHODS

Fifty-four socio-emotional pictures were administered to 20 female BPD patients and 20 healthy controls (HCs) divided into three blocks characterized by different stimulus durations (500 ms, 3s, 18s). Self-reported and eye-tracking data were collected during the experiment.

RESULTS

BPD patients showed lower valence ratings and reduced visual exploration of socio-emotional pictures compared to HCs. Visual exploration in BPD was affected by exposure time with reduced exploration in response to prolonged stimuli presentation. Dysfunctional features and pre-task negative affectivity level in BPD were correlated with self-reported evaluations and eye-tracking data.

LIMITATIONS

Possible effects of gender on emotional responsivity could not be addressed given the female composition of our sample. Moreover, the role of psychiatric symptoms and medications should be addressed in future research.

CONCLUSIONS

This study presented evidence on dysfunctional mechanisms sustaining emotional dysregulation in BPD. This construct seemed supported by a well-established negative bias towards emotional stimuli together with a reduced processing of social information as manifestations of emotional hypersensitivity.

Social cognition in adolescent females with borderline personality traits

OBJECTIVES

Social cognitive impairment is considered to be a psychopathological cornerstone in adolescent females with borderline personality disorder. The aim is to compare the social cognitive performance in adolescent females with borderline personality traits and healthy adolescent females, and to assess the social cognitive performance in relation to the severity of borderline personality features.

DESIGN

A case-control study was conducted on 30 adolescent females who fulfilled the diagnostic criteria of DSM-IV of borderline personality traits, compared to 30 matched healthy volunteer adolescent females.

METHODS

Borderline Personality Questionnaire (BPQ) was used to rate borderline personality features. Reading the Mind in the Eyes test (RMET) and Movie for the Assessment of Social Cognition (MASC) were applied to assess social cognitive abilities.

RESULTS

The scores of RMET and some domains of MASC showed a highly significant difference between the patient and control groups. Scores of RMET and some domains of MASC showed significant correlation with impulsiveness, emptiness, relationship patterns, and quasi-psychotic states subscales of BPQ.

CONCLUSIONS

Adolescent females with borderline personality traits had lower social cognitive performance compared to healthy adolescent females. The intensity of this social cognitive deficit was evident to be related to impulsivity, emptiness, pattern of relationships, and quasi-psychotic states.

Evidence for Altered Neural Processing in Patients With Borderline Personality Disorder

Abstract. Borderline personality disorder (BPD) is characterized by difficulties in emotion regulation, self-identity disturbances, self-injurious behavior, and reduced inhibitory control. Event-related potential (ERP) studies have sought to reveal the neural correlates of cognitive distortions and behavioral alterations in BPD. The article presents an overview of the existing ERP literature pertaining to BPD and discusses whether any one of the electrophysiological findings could serve as a reliable and specific marker for BPD. In short, ERP studies investigating P300 tentatively suggest impaired inhibitory control. Moreover, reduced error- and feedback-related processing and impaired response inhibition seem to be associated with impulsivity and risk-taking behavior in BPD patients. However, these findings are not specific for BPD. Regarding emotional and self-referential information processing, individuals with BPD display heightened vigilance toward social threat impacting their cognitive performance in various social-cognitive tasks demonstrating alterations of early negative and late positive potentials. These multifaceted electrophysiological alterations may be attributed to dysfunctional activity and connectivity of frontal brain regions and the limbic system.

Women With Borderline Personality Disorder Show Reduced Identification of Emotional Facial Expressions and a Heightened Negativity Bias

Individuals with borderline personality disorder (BPD) frequently display impairments in the identification of emotional facial expressions paralleled by a negativity bias. However, it remains unclear whether misperception of facial expressions is a key psychopathological marker of BPD. To address this question, the authors examined 43 women diagnosed with BPD and 56 healthy female controls using an emotion face identification task and a face dot-probe task together with measures on psychopathology. Compared to controls, women with BPD showed impaired identification of disgusted and angry faces concurrent with a bias to misclassify faces as angry, and a faster preconscious vigilance for fearful relative to happy facial expressions. Increased severity of borderline symptoms and global psychopathology in BPD patients were associated with reduced ability to identify angry facial expressions and a stronger negativity bias to anger. The findings indicate that BPD patients who misperceive face emotions have the greatest mental health issues.

Disrupted Relationship between Hippocampal Activation and Subsequent Memory Performance in Borderline Personality Disorder

BACKGROUND

Borderline personality disorder (BPD) is associated with subjective reports of forgetfulness and deficits on tests of memory performance. However, it is not yet known whether individuals with BPD show different patterns of activation in the hippocampus during episodic memory encoding, especially for materials that are not emotionally-valenced.

METHODS

Participants with BPD (n = 20) and non-psychiatric controls (n = 21) completed a memory encoding task in which they viewed scenes without emotional content during functional magnetic resonance imaging scans. Subsequently, they completed a recognition memory test outside of the scanner and neural activation during the presentation of successfully remembered scenes was contrasted with scenes that were subsequently forgotten.

RESULTS

Controls exhibited significant left hippocampal activation during successful memory encoding, displaying greater activity during the presentation of subsequently remembered versus forgotten scenes, and the strength of this activation was related to their recognition memory performance. Although hippocampal activation was observed for the BPD group during successful memory encoding, it did not reach significance when implementing a non-parametric statistical approach. Additionally, individual hippocampal recruitment was not significantly correlated with recognition memory performance in the BPD group. The strength of this correlation, but not the overall magnitude of hippocampal activation, was significantly different between the groups.

LIMITATIONS

Participants with BPD had comorbid psychiatric diagnoses and varied treatment histories. Whether patients and controls differentially perceived emotional content in the neutral scene memoranda was not tested.

CONCLUSIONS

Memory problems in BPD may be partially explained by a disrupted relationship between hippocampal activation and successful memory encoding.

Elucidating the relationship between borderline personality disorder and intimate partner violence

This study examined the established association between borderline personality disorder (BPD) and intimate partner violence (IPV). More specifically, it compared the DSM-5 traditional categorical personality disorder (PD) model with the DSM-5 Alternative Model of PD (AMPD) operationalizations of BPD in their relative associations with IPV. The effects of gender, as well as the associations between BPD and different forms of IPV were also considered. Additionally, we investigated the specific BPD-relevant AMPD personality traits that influence the BPD-IPV association. The study sample were 250 community-dwelling men and women recruited through an established crowdsourcing platform. Results revealed that both the 'traditional' and AMPD operationalizations of BPD were approximately equally associated with IPV perpetration, although the traditional BPD operationalization demonstrated some minor advantages in this regard. The AMPD trait facets of hostility (negative affectivity), suspiciousness (negative affectivity) and risk taking (disinhibition) were most strongly associated with IPV perpetration for the total sample, and additional negative affectivity trait facets were also associated with IPV for men only. Implications for these findings are discussed. © 2020 John Wiley & Sons, Ltd.

Patients with borderline personality disorder and comorbid PTSD show biased attention for threat in the facial dot-probe task

BACKGROUND AND OBJECTIVES

Biased attention to threat is likely to play a crucial role in the dysfunctional emotion-related information processing in borderline personality disorder (BPD). However, the role of comorbid posttraumatic stress disorder (PTSD) has not yet been fully disentangled.

METHODS

BPD patients with (n = 24) and without (n = 46) PTSD, 35 patients with Cluster-C personality disorder and 52 non-patients participated in the facial dot-probe task with angry, happy and neutral faces during automatic (100 ms), controlled (600 ms), and later (1200 ms) stages of information processing.

RESULTS

BPD patients showed a greater congruency effect to angry faces during the controlled stage of processing than controls. Specifically, in BPD with PTSD compared to controls, this effect was due to difficulties disengaging from threat, indicated by slower reaction times to incongruent angry targets compared to neutral trials. Regarding automatic and later stages of information processing, there was no attentional bias (AB) in BPD. None of the groups revealed biased attention for happy faces at any stages of information processing.

LIMITATIONS

We did not include a control group of PTSD patients without BPD. Therefore, we cannot rule out that the present AB in BPD is mainly due to PTSD-specific psychopathology.

CONCLUSIONS

These findings provide first evidence for an AB towards angry faces and difficulties disengaging from these threat-related social cues in adult BPD patients. Although BPD patients in general demonstrated an AB when compared with controls, this effect was especially pronounced for BPD with PTSD, suggesting a significant effect of trauma-related psychopathology on social attention in BPD.

A Meta-analysis and Systematic Review of Emotion-Regulation Strategies in Borderline Personality Disorder

Emotion dysregulation is often considered a core characteristic of individuals with borderline personality disorder (BPD). With the development and strength of a contemporary affective-science model that encompasses both healthy emotion regulation (ER) and emotion dysregulation, this model has increasingly been used to understand the affective experiences of people with BPD. In this meta-analysis and review, we systematically review six of the most commonly studied ER strategies and determine their relative endorsement in individuals with elevated symptoms of BPD compared to individuals with low symptoms of BPD and healthy controls, as well as to individuals with other mental disorders. Results from 93 unique studies and 213 different effect-size estimates indicated that symptoms of BPD were associated with less frequent use of ER strategies that would be considered more effective at reducing negative affect (i.e., cognitive reappraisal, problem solving, and acceptance) and more frequent use of ER strategies considered less effective at reducing negative affect (i.e., suppression, rumination, and avoidance). When compared to individuals with other mental disorders, people with BPD endorsed higher rates of rumination and avoidance, and lower rates of problem solving and acceptance. We also review important contributions from studies of ER in BPD that we were unable to incorporate into our meta-analysis. We conclude by discussing how the pattern of using ER strategies in BPD contributes to emotion dysregulation and also the potential reasons for this pattern, integrating both Gross's extended process model of ER and Linehan's updated theoretical account on the development of emotion dysregulation.

Characterizing Couple Dysfunction in Borderline Personality Disorder

Relationship dysfunction is a key criterion of borderline personality disorder (BPD). Nevertheless, little is known about the characteristics of romantic relationship functioning in BPD. In this study, couples in which the women were diagnosed with BPD (BPD couples) and healthy control couples (HC) were compared in their perceived relationship characteristics (e.g., relationship quality) and interpersonal experience variables (e.g., attachment). The hypothesis was tested that insecure attachment styles account for group differences in relationship characteristics. Variables were measured by self-report. Romantic relationships were appraised as more negative and conflictual by both members of BPD couples compared to HC. The perception of women with BPD was often more negative than that of their male partners, indicating potential biases in BPD patients' relationship evaluation. Insecure attachment styles only partially explained group differences in relationship characteristics, showing that attachment style is one, but not the only predictor of decreased relationship functioning in BPD couples.

Emotional Reactivity in Borderline Personality Disorder: Theoretical Considerations Based on a Meta-Analytic Review of Laboratory Studies

Emotional hyperreactivity (Linehan, 1993) is the most investigated construct in borderline personality disorder (BPD). However, experimental studies revealed mixed results on the topic. Our main objective is to comprehensively summarize the results on emotional reactivity in BPD compared to healthy controls (HCs), using a meta-analytic approach, considering different emotional response systems (physiology, behavior, self-report). We included 31 experimental studies (1,675 subjects). We observed null to small effect sizes for several physiological and behavioral outcomes. Conversely, BPD subjects revealed a moderate to large difference in valence attributed to emotional stimuli and a small difference in self-reported arousal. Significant differences in pooled effect sizes were found between self-report and physiological outcomes. Several sources of heterogeneity were explored. In general, the hyperreactivity hypothesis was not supported. Additional dysfunctional processes should be taken into consideration to understand BPD emotional responsiveness.

Biased Attention to Facial Expressions of Ambiguous Emotions in Borderline Personality Disorder: An Eye-Tracking Study

Preliminary evidence suggests that biased attention could be crucial in fostering the emotion recognition abnormalities in borderline personality disorder (BPD). We compared BPD patients to Cluster-C personality disorder (CC) patients and non-patients (NP) regarding emotion recognition in ambiguous faces and their visual attention allocation to the eyes. The role of comorbid posttraumatic stress disorder (PTSD) in BPD regarding emotion recognition and visual attention was explored. BPD patients fixated the eyes of angry/happy, sad/happy, and fearful/sad blends longer than non-patients. This visual attention pattern was mainly driven by BPD patients with PTSD. This subgroup also demonstrated longer fixations than CC patients and a trend towards longer fixations than BPD patients without PTSD for the angry/happy and fearful/sad blends. Emotion recognition was not altered in BPD. Biased visual attention towards the eyes of ambiguous facial expressions in BPD might be due to trauma-related attentional bias rather than to impairments in facial emotion recognition.

Heart rate variability during a cognitive reappraisal task in female patients with borderline personality disorder: the role of comorbid posttraumatic stress disorder and dissociation

BACKGROUND

Emotion dysregulation is a core feature of borderline personality disorder (BPD), which often co-occurs with posttraumatic stress disorder (PTSD). Difficulties in emotion regulation (ER) have been linked to lower high-frequency heart rate variability (HF-HRV), a measure of autonomous nervous system functioning. However, previous research on vagally-mediated heart rate in BPD revealed heterogeneous findings and the effects of comorbid PTSD and dissociation on HF-HRV are not yet completely understood. This study aim to investigate HF-HRV during resting-state and an ER task in female BPD patients with comorbid PTSD (BPD + PTSD), patients without this comorbidity (BPD), and healthy controls (HC).

METHODS

57 BPD patients (BPD: n = 37, BPD + PTSD: n = 20) and 27 HC performed an ER task with neutral, positive, and negative images. Participants were instructed to either attend these pictures or to down-regulate their upcoming emotions using cognitive reappraisal. Subjective arousal and wellbeing, self-reported dissociation, and electrocardiogram data were assessed.

RESULTS

Independent of ER instruction and picture valence, both patient groups (BPD and BPD + PTSD) reported higher subjective arousal and lower wellbeing; patients with BPD + PTSD further exhibited significantly lower HF-HRV compared with the other groups. Higher self-reported state dissociation predicted higher HF-HRV during down-regulating v. attending negative pictures in BPD + PTSD.

CONCLUSIONS

Findings suggest increased emotional reactivity to negative, positive, and neutral pictures, but do not provide evidence for deficits in instructed ER in BPD. Reduced HF-HRV appears to be particularly linked to comorbid PTSD, while dissociation may underlie attempts to increase ER and HF-HRV in BPD patients with this comorbidity.

Mentalization in Adolescents With Borderline Personality Disorder: A Comparison With Healthy Controls

Mentalization is proposed to underlie the disturbed interpersonal relatedness that is a hallmark of borderline personality disorder (BPD). Despite growing evidence of BPD in adolescents, studies examining mentalization in relation to adolescent BPD have remained limited. Given contradictory findings of this relationship, particularly with adults, further research of mentalization in adolescents with BPD is warranted. The current study further clarifies the nature of mentalizing impairments, related to BPD, by examining different aspects of mentalization between adolescents with BPD (n = 26) and a group of healthy controls (n = 25). Findings support studies that suggest that mentalization may be an important treatment target, influencing BPD symptoms and interpersonal functioning in adolescents with BPD. They also support the importance of examining mentalizing abilities in relation to varying levels of complexity, interpersonal contexts, and levels of arousal. Limitations and further research are discussed.

Effect of negative valence on assessment of self-relevance in female patients with borderline personality disorder

Background

A disturbed self-image is central to the characteristic symptoms of borderline personality disorder (BPD). Evaluations of self-relevance (SR) are highly important in cognitive and emotional processing of information and adaptive behavior.

Method

In the current study, we used affective statements to investigate if SR is altered in patients with higher scores on Borderline Symptom List (BSL-95). Forthyfemale adults with BPD and 20 healthy participants assessed a set of stimuli consisting of sentences in third-person for relevance to self.

Results

BPD patients exhibited a higher SR for negative contents as compared to healthy controls (p < .001). Furthermore, a significant positive correlation coefficient was found between the increased bias in evaluating the SR of stimuli and borderline symptom severity scores, as measured by BSL-95 questionnaire (r = 0.67, p < .001). This effect persisted after controlling for depressive symptoms by a partial correlation analysis.

Conclusion

Our results revealed an enhanced SR for negative statements, which was related to the severity of individuals’ BPD symptoms. These findings add to the diagnostic information regarding the disturbed organization of self in this clinical population. We suggest the maladaptive evaluation of SR offers an important treatment target for therapeutic approaches to BPD.

A comprehensive evaluation of emotional responsiveness in borderline personality disorder: a support for hypersensitivity hypothesis

BACKGROUND

Many experimental studies have evaluated Linehan's biological emotional vulnerability in Borderline Personality Disorder (BPD). However, some inconsistencies were observed in operationalizing and supporting its components. This study aims at clarifying which aspects of Linehan's model are altered in BPD, considering a multimodal evaluation of processes concerned with emotional responsiveness (self-report, psychophysiology and eye-tracking).

METHODS

Forty-eight socio-emotional pictures were administered to 28 participants (14 BPD, 14 Healthy Controls, HCs), gender- and age-matched, by employing two different lengths of stimuli exposure (5 s and 15 s).

RESULTS

Our results supported the hypersensitivity hypothesis in terms of faster physiological responses and altered visual processing. Furthermore, hypersensitivity was associated with detailed socio-emotional contents. Hyperreactivity assumption was not experimentally sustained by physiological and self-report data. Ultimately, the slow return to emotional baseline was demonstrated as an impaired emotional modulation.

CONCLUSIONS

Our data alternatively supported the hypersensitivity and the slow return to emotional baseline hypotheses, postulated by Linehan's Biosocial model, rather than the hyperreactivity assumption. Results have been discussed in light of other BPD core psychopathological processes.

Social Cognition and Borderline Personality Disorder: Splitting and Trust Impairment Findings

The Borderline personality disorder (BPD) diagnosis has its origins in the concept of borderline personality organization (BPO). BPO is rooted in psychoanalytic object relations theory (ORT) which conceptualizes BPD and BPO to exhibit a propensity to view significant others as either idealized or persecutory (splitting) and a trait-like paranoid view of interpersonal relations. From the ORT model, those with BPD think that they will ultimately be betrayed, abandoned, or neglected by significant others, despite periodic idealizations. This article synthesizes the extant literature splitting and trust impairments in BPD, identifies avenues for further investigation, and discusses the relative promise of different methods to evaluate these clinical processes.

Theory of mind disturbances in borderline personality disorder: A meta-analysis

Impairments of theory of mind (ToM) are widely accepted underlying factors of disturbed relatedness in borderline personality disorder (BPD). The aim of this meta-analysis a was to assess the weighted mean effect sizes of ToM performances in BPD compared to healthy controls (HC), and to investigate the effect of demographic variables and comorbidities on the variability of effect sizes across the studies. Seventeen studies involving 585 BPD patients and 501 HC were selected after literature search. Effect sizes for overall ToM, mental state decoding and reasoning, cognitive and affective ToM, and for task types were calculated. BPD patients significantly underperformed HC in overall ToM, mental state reasoning, and cognitive ToM, but had no deficits in mental state decoding. Affective ToM performance was largely task dependent in BPD. Comorbid anxiety disorders had a positive moderating effect on overall and affective ToM in BPD. Our results support the notion that BPD patients' have specific ToM impairments. Further research is necessary to evaluate the role of confounding factors, especially those of clinical comorbidities, neurocognitive functions, and adverse childhood life events. Complex ToM tasks with high contextual demands seem to be the most appropriate tests to assess ToM in patients with BPD.

Rejection sensitivity and borderline personality disorder features: A mediation model of effortful control and intolerance of ambiguity

Although past research suggests that borderline personality disorder (BPD) patients' rejection hypersensitivity may be an important factor underlying these patients' interpersonal problems, the role of cognitive factors in this association is still not well understood. The present study examined whether cognitive factors such as effortful control and intolerance of ambiguity mediated the association between rejection sensitivity and BPD features. A sample of 256 young adults completed self-report questionnaires assessing rejection sensitivity, effortful control, intolerance of ambiguity, and BPD features. Results showed that effortful control and intolerance of ambiguity mediated the association between rejection sensitivity and BPD features. The present study showed the role of cognitive aspects including both effortful control and intolerance of ambiguity in the relationship between rejection sensitivity and BPD features. However, there is a need for further research to experimentally investigate how rejection sensitivity may impact cognitive capacities in interpersonal contexts among individuals with BPD features.

Corticolimbic Connectivity Mediates the Relationship between Adverse Childhood Experiences and Symptom Severity in Borderline Personality Disorder

The interaction between biological and environmental factors (especially adverse childhood experiences, ACEs) plays a crucial role in the development and maintenance of borderline personality disorder (BPD). These factors act influencing BPD core features such as pervasive instability in affect regulation, impulse control, social cognition, and interpersonal relationships. In line with this perspective, abnormalities in social cognition and related neurobiological underpinnings could mediate the relationship between ACEs and psychopathological manifestations in adulthood. In a sample of 14 females, functional connectivity (FC) analyses were performed modeling the interaction between ACEs and corticolimbic dysregulation during emotional processing and its relationship with BPD symptom severity. ACEs were associated with a dampening of the negative FC between (1) the right amygdala (Amy) and right dorsolateral prefrontal cortex (DLPFC) and between (2) the left Amy and bilateral DLPFC, right precuneus, left cerebellum and left dorsomedial prefrontal cortex during emotional processing. The connectivity between right Amy and DLPFC mediates the relationship between childhood adversities and BPD symptomatology. Furthermore, the negative FC between Amy and DLPFC, postcentral gyrus, the vermis of cerebellum and precuneus was also associated with BPD symptom severity, with a weaker negative coupling between Amy and these regions being related to a worse BPD psychopathology. Our results confirm the role of ACEs in contributing to social cognition impairments in BPD and related symptomatology from a neurobiological perspective.

Divergent effects of oxytocin on (para-)limbic reactivity to emotional and neutral scenes in females with and without borderline personality disorder

Borderline personality disorder (BPD) patients’ hypersensitivity for emotionally relevant stimuli has been suggested be due to abnormal activity and connectivity in (para-)limbic and prefrontal brain regions during stimulus processing. The neuropeptide oxytocin has been shown to modulate activity and functional connectivity in these brain regions, thereby optimizing the processing of emotional and neutral stimuli. To investigate whether oxytocin would be capable of attenuating BPD patients’ hypersensitivity for such stimuli, we recorded brain activity and gaze behavior during the processing of complex scenes in 51 females with and 48 without BPD after intranasal application of either oxytocin or placebo. We found divergent effects of oxytocin on BPD and healthy control (HC) participants’ (para-)limbic reactivity to emotional and neutral scenes: Oxytocin decreased amygdala and insula reactivity in BPD participants but increased it in HC participants, indicating an oxytocin-induced normalization of amygdala and insula activity during scene processing. In addition, oxytocin normalized the abnormal coupling between amygdala activity and gaze behavior across all scenes in BPD participants. Overall, these findings suggest that oxytocin may be capable of attenuating BPD patients’ hypersensitivity for complex scenes, irrespective of their valence.

Explicit and Implicit Components of the Emotional Processing in Non-organic Vision Loss: Behavioral Evidence About the Role of Fear in Functional Blindness

Non-organic vision loss (NOVL), a functional partial or global vision loss, might be considered a manifestation of conversion disorder. The few previous studies focused on investigating the relationship between cerebral activity and subjective symptoms in NOVL; however, the emotional processing is still neglected. In the present case-controls study, we investigated the capability of two individuals diagnosed with NOVL to recognize implicitly the emotions of fear and anger; this was assessed through a facial emotion recognition task based on the redundant target effect. In addition, the level of alexithymia was measured by asking them to judge explicitly their ability to identify and describe emotions. Both individuals showed selective difficulties in recognizing the emotion of fear when their performance was contrasted with a matched control sample; they also mislabeled other emotional stimuli, judging them as fearful, when they were not. However, they did not report alexithymia when measured using a standard questionnaire. This preliminary investigation reports a mismatch between the implicit (i.e., the behavior in the experimental paradigm) and the explicit (i.e., the subjective evaluation of one’s own emotional capability) components of the emotional processing in NOVL. Moreover, fear seems to represent a critical emotion in this condition, as has been reported in other psychiatric disorders. However, possible difficulties in the emotional processing of fear would emerge only when they are inferred from an implicit behavior, instead of a subjective evaluation of one’s own emotional processing capability.

Face and gaze perception in borderline personality disorder: An electrical neuroimaging study

Humans are sensitive to gaze direction from early life, and gaze has social and affective values. Borderline personality disorder (BPD) is a clinical condition characterized by emotional dysregulation and enhanced sensitivity to affective and social cues. In this study we wanted to investigate the temporal-spatial dynamics of spontaneous gaze processing in BPD. We used a 2-back-working-memory task, in which neutral faces with direct and averted gaze were presented. Gaze was used as an emotional modulator of event-related-potentials to faces. High density EEG data were acquired in 19 females with BPD and 19 healthy women, and analyzed with a spatio-temporal microstates analysis approach. Independently of gaze direction, BPD patients showed altered N170 and P200 topographies for neutral faces. Source localization revealed that the anterior cingulate and other prefrontal regions were abnormally activated during the N170 component related to face encoding, while middle temporal deactivations were observed during the P200 component. Post-task affective ratings showed that BPD patients had difficulty to disambiguate neutral gaze. This study provides first evidence for an early neural bias toward neutral faces in BPD independent of gaze direction and also suggests the importance of considering basic aspects of social cognition in identifying biological risk factors of BPD.

Interpersonal Threat Sensitivity in Borderline Personality Disorder: An Eye-Tracking Study

Threat sensitivity is a prominent predictor of interpersonal dysfunctions in borderline personality disorder (BPD), leading to intense, aversive feelings of threat and eventually dysfunctional behaviors, such as aggression. In the present study, BPD patients and healthy volunteers classified angry, fearful, neutral, and happy faces presented for 150 ms or 5,000 ms to investigate initial saccades and facial scanning. Patients more often wrongly identified anger, responded slower to all faces, and made faster saccades towards the eyes of briefly presented neutral faces and slower saccades away from fearful eyes compared with healthy volunteers. Latency of initial saccades and fixation duration correlated negatively with the patients' aggressiveness. Supporting previous results, BPD patients did not experience general deficits in facial emotion processing, but a specific hypersensitivity for and deficits in detailed evaluation of threat cues, which was particularly enhanced in aggressive patients. Interventions might benefit from relocating attention towards positive information and detailed evaluation of social cues.

Facial emotion recognition and borderline personality pathology

The impact of borderline personality pathology on facial emotion recognition has been in dispute; with impaired, comparable, and enhanced accuracy found in high borderline personality groups. Discrepancies are likely driven by variations in facial emotion recognition tasks across studies (stimuli type/intensity) and heterogeneity in borderline personality pathology. This study evaluates facial emotion recognition for neutral and negative emotions (fear/sadness/disgust/anger) presented at varying intensities. Effortful control was evaluated as a moderator of facial emotion recognition in borderline personality. Non-clinical multicultural undergraduates (n = 132) completed a morphed facial emotion recognition task of neutral and negative emotional expressions across different intensities (100% Neutral; 25%/50%/75% Emotion) and self-reported borderline personality features and effortful control. Greater borderline personality features related to decreased accuracy in detecting neutral faces, but increased accuracy in detecting negative emotion faces, particularly at low-intensity thresholds. This pattern was moderated by effortful control; for individuals with low but not high effortful control, greater borderline personality features related to misattributions of emotion to neutral expressions, and enhanced detection of low-intensity emotional expressions. Individuals with high borderline personality features may therefore exhibit a bias toward detecting negative emotions that are not or barely present; however, good self-regulatory skills may protect against this potential social-cognitive vulnerability.

Experimental investigation of cognitive and affective empathy in borderline personality disorder: Effects of ambiguity in multimodal social information processing

Borderline personality disorder (BPD) is characterized by affective instability and interpersonal problems. In the context of social interaction, impairments in empathy are proposed to result in inadequate social behavior. In contrast to findings of reduced cognitive empathy, some authors suggested enhanced emotional empathy in BPD. It was investigated whether ambiguity leads to decreased cognitive or emotional empathy in BPD. Thirty-four patients with BPD and thirty-two healthy controls were presented with video clips, which were presented through prosody, facial expression, and speech content. Experimental conditions were designed to induce ambiguity by presenting neutral valence in one of these communication channels. Subjects were asked to indicate the actors' emotional valence, their decision confidence, and their own emotional state. BPD patients showed increased emotional empathy when neutral stories comprised nonverbally expressed emotions. In contrast, when all channels were emotional, patients showed lower emotional empathy than healthy controls. Regarding cognitive empathy, there were no significant differences between BPD patients and healthy control subjects in recognition accuracy, but reduced decision confidence in BPD. These results suggest that patients with BPD show altered emotional empathy, experiencing higher rates of emotional contagion when emotions are expressed nonverbally. The latter may contribute to misunderstandings and inadequate social behavior.

The Positivity Bias Phenomenon in Face Perception Given Different Information on Ability

The negativity bias has been shown in many fields, including in face processing. We assume that this bias stems from the potential threat inlayed in the stimuli (e.g., negative moral behaviors) in previous studies. In the present study, we conducted one behavioral and one event-related potentials (ERPs) experiments to test whether the positivity bias rather than negativity bias will arise when participants process information whose negative aspect involves no threat, i.e., the ability information. In both experiments, participants first completed a valence rating (negative-to-positive) of neutral facial expressions. Further, in the learning period, participants associated the neutral faces with high-ability, low-ability, or control sentences. Finally, participants rated these facial expressions again. Results of the behavioral experiment showed that compared with pre-learning, the expressions of the faces associated with high ability sentences were classified as more positive in the post-learning expression rating task, and the faces associated with low ability sentences were evaluated as more negative. Meanwhile, the change in the high-ability group was greater than that of the low-ability group. The ERP data showed that the faces associated with high-ability sentences elicited a larger early posterior negativity, an ERP component considered to reflect early sensory processing of the emotional stimuli, than the faces associated with control sentences. However, no such effect was found in faces associated with low-ability sentences. To conclude, high ability sentences exerted stronger influence on expression perception than did low ability ones. Thus, we found a positivity bias in this ability-related facial perceptual task. Our findings demonstrate an effect of valenced ability information on face perception, thereby adding to the evidence on the opinion that person-related knowledge can influence face processing. What’s more, the positivity bias in non-threatening surroundings increases scope for studies on processing bias.

Facing the Problem: Impaired Emotion Recognition During Multimodal Social Information Processing in Borderline Personality Disorder

Previous research has revealed alterations and deficits in facial emotion recognition in patients with borderline personality disorder (BPD). During interpersonal communication in daily life, social signals such as speech content, variation in prosody, and facial expression need to be considered simultaneously. We hypothesized that deficits in higher level integration of social stimuli contribute to difficulties in emotion recognition in BPD, and heightened arousal might explain this effect. Thirty-one patients with BPD and thirty-one healthy controls were asked to identify emotions in short video clips, which were designed to represent different combinations of the three communication channels: facial expression, speech content, and prosody. Skin conductance was recorded as a measure of sympathetic arousal, while controlling for state dissociation. Patients with BPD showed lower mean accuracy scores than healthy control subjects in all conditions comprising emotional facial expressions. This was true for the condition with facial expression only, and for the combination of all three communication channels. Electrodermal responses were enhanced in BPD only in response to auditory stimuli. In line with the major body of facial emotion recognition studies, we conclude that deficits in the interpretation of facial expressions lead to the difficulties observed in multimodal emotion processing in BPD.

Perception of Verbal and Nonverbal Emotional Signals in Women With Borderline Personality Disorder: Evidence of a Negative Bias and an Increased Reliance on Nonverbal Cues

Studies conducted in patients diagnosed with borderline personality disorder (BPD) have documented a variety of anomalies concerning patients' abilities to interpret emotional signals. Attempting to clarify the bases of these anomalies, the current literature draws attention to a possible role of dysfunctional expectations, such as the expectation of social rejection. Dysfunctional expectations, however, may not only bias social interpretations, but may also focus attention on social cues most important in conveying emotional messages, such as nonverbal signals. To explore these assumptions, 30 female BPD patients were tasked to judge the valence of emotional states conveyed by combinations of verbal and nonverbal emotional cues. Compared to controls, BPD patients exhibited a negative bias in their interpretations and relied more on available nonverbal cues. Shifts in the relative importance of nonverbal cues appeared to be rooted mainly in a reduced reliance on positive verbal cues presumably deemed less credible by BPD patients.

Identification of mental states and interpersonal functioning in borderline personality disorder

Atypical identification of mental states in the self and others has been proposed to underlie interpersonal difficulties in borderline personality disorder (BPD), yet no previous empirical research has directly examined associations between these constructs. We examine 3 mental state identification measures and their associations with experience-sampling measures of interpersonal functioning in participants with BPD relative to a healthy comparison (HC) group. We also included a clinical comparison group diagnosed with avoidant personality disorder (APD) to test the specificity of this constellation of difficulties to BPD. When categorizing blended emotional expressions, the BPD group identified anger at a lower threshold than did the HC and APD groups, but no group differences emerged in the threshold for identifying happiness. These results are consistent with enhanced social threat identification and not general negativity biases in BPD. The Reading the Mind in the Eyes Test (RMET) showed no group differences in general mental state identification abilities. Alexithymia scores were higher in both BPD and APD relative to the HC group, and difficulty identifying one's own emotions was higher in BPD compared to APD and HC. Within the BPD group, lower RMET scores were associated with lower anger identification thresholds and higher alexithymia scores. Moreover, lower anger identification thresholds, lower RMET scores, and higher alexithymia scores were all associated with greater levels of interpersonal difficulties in daily life. Research linking measures of mental state identification with experience-sampling measures of interpersonal functioning can help clarify the role of mental state identification in BPD symptoms. (PsycINFO Database Record

The Influence of Social Comparison and Peer Group Size on Risky Decision-Making

This study explores the influence of different social reference points and different comparison group sizes on risky decision-making. Participants were presented with a scenario describing an exam, and presented with the opportunity of making a risky decision in the context of different information provided about the performance of their peers. We found that behavior was influenced, not only by comparison with peers, but also by the size of the comparison group. Specifically, the larger the reference group, the more polarized the behavior it prompted. In situations describing social loss, participants were led to make riskier decisions after comparing themselves against larger groups, while in situations describing social gain, they become more risk averse. These results indicate that decision making is influenced both by social comparison and the number of people making up the social reference group.

The wandering mind in borderline personality disorder: Instability in self- and other-related thoughts

Diagnostic criteria for borderline personality disorder (BPD) include instability in identity and interpersonal relationships. Here, we probed whether instability is already present in BPD patients' thoughts about themselves and others. We tested BPD patients (N=27) and healthy controls (N=25) with a mind-wandering task that assesses content and variability of stimulus-independent self-generated thoughts. Multi-level modeling revealed that while BPD patients and healthy controls mind-wander to a similar extent, BPD patients' thoughts are colored predominantly negatively. Most importantly, although their thoughts concerned the self and others as much as in controls, they fluctuated more strongly in the degree to which their thoughts concerned themselves and others and also gave more extreme ratings. Self- and other related thoughts that were more extreme were also more negative in valence. The increased variability supports current conceptualizations of BPD and may account for the instability in identity and interpersonal relationships.

Neuroimagerie fonctionnelle chez l’adolescent avec un trouble de personnalité limite

De nombreuses études en neuroimagerie fonctionnelle (IRMf) menées chez les adultes présentant un trouble de personnalité limite (TPL) convergent pour identifier un patron d’activation neuronale, notamment fronto-limbique, différent de celui activé chez les adultes sans TPL lors des tâches de visualisation d’images émotionnelles. À ce jour, aucune étude en IRMf n’a été réalisée chez les adolescents avec TPL. Ce projet pilote vise à évaluer la faisabilité d’un protocole d’IRMf chez des adolescentes avec TPL et à identifier les régions neuronales d’intérêt pour les études de neuroimagerie chez cette population. Le projet porte sur six adolescentes euthymiques présentant un diagnostic de TPL (âge moyen : 15,8 ± 0,9 ans) et six adolescentes témoins sans diagnostic psychiatrique (âge moyen : 15,5 ± 1,2 ans). Après l’évaluation diagnostique incluant le Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime et le Diagnostic Interview for Borderline – Revised version, les participantes ont complété une tâche d’IRMf au cours de laquelle elles devaient regarder 20 images à valence affective positive, 20 images à valence affective négative et 20 images neutres. L’étude de faisabilité montre que les participantes ont été recrutées en 22 mois et que le protocole était bien toléré par celles-ci. Les résultats montrent que le visionnement des scènes positives et négatives a entraîné une plus grande activation de plusieurs aires limbiques ainsi que frontales, temporales et du cervelet chez le groupe TPL. Les aires limbiques et préfrontales semblent être des régions d’intérêt dans l’étude du fonctionnement neuronal chez les adolescentes avec TPL.