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Chang CH, Drobotenko N, Ruocco AC, Lee ACH, Nestor A. Perception and memory-based representations of facial emotions: Associations with personality functioning, affective states and recognition abilities. Cognition 2024; 245:105724. [PMID: 38266352 DOI: 10.1016/j.cognition.2024.105724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
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.
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Affiliation(s)
- Chi-Hsun Chang
- Department of Psychology at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
| | - Natalia Drobotenko
- Department of Psychology at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
| | - Anthony C Ruocco
- Department of Psychology at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada; Department of Psychological Clinical Science at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada
| | - Andy C H Lee
- Department of Psychology at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada; Rotman Research Institute, Baycrest Centre, 3560 Bathurst St, North York, Ontario M6A 2E1, Canada
| | - Adrian Nestor
- Department of Psychology at Scarborough, University of Toronto, 1265 Military Trail, Scarborough, Ontario M1C 1A4, Canada.
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Uzar M, Dmitrzak-Węglarz M, Słopień A. Mentalizing in Adolescents with Borderline Personality Disorder. Brain Sci 2023; 13:1473. [PMID: 37891840 PMCID: PMC10605837 DOI: 10.3390/brainsci13101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Mentalizing, recognized as the capacity to understand behaviors in the context of our own mental states and those of other people, is being researched more and more commonly in regard to various mental disorders. The research on mentalization focuses on, among other things, borderline personality disorder, which is at present perceived as an emerging problem in the population of adolescents. In order to summarize the currently accessible knowledge of mentalizing in adolescents with borderline personality disorder, we thoroughly analyzed relevant publications. Based on the available literature, it can be concluded that the mentalizing ability of adolescents with borderline personality disorder can be impaired. The evidence demonstrates that they are prone to hypermentalizing, defined as an overattribution of mental states to other people. However, this tendency has not been proven to be specific to teenagers with this disorder. Moreover, the existing data suggest that young people with borderline personality exhibit a reduced capacity to mentalize their own inner states.
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Affiliation(s)
- Magdalena Uzar
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland;
| | - Monika Dmitrzak-Węglarz
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland;
| | - Agnieszka Słopień
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland;
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Kelly Grealy M, Godfrey E, Brady F, Whyte O’Sullivan E, Carroll GA, Burke T. Borderline personality disorder traits and mentalising ability: The self-other social cognition paradox. Front Psychiatry 2022; 13:1023348. [PMID: 36339858 PMCID: PMC9631768 DOI: 10.3389/fpsyt.2022.1023348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/06/2022] [Indexed: 11/21/2022] Open
Abstract
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.
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Affiliation(s)
- Molly Kelly Grealy
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Emmet Godfrey
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Finn Brady
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | | | - Grace A. Carroll
- School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Tom Burke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
- Galway Neuroscience Centre, National University of Ireland Galway, Galway, Ireland
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4
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Gender differences in sensitivity to provocation and hostile attribution bias toward ambiguous facial cues in violent offenders and community-based adults. MOTIVATION AND EMOTION 2022. [DOI: 10.1007/s11031-022-09972-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Gray LM, Nelson-Gray RO, Delaney PF, Gilbert LT. Item method directed forgetting occurs independently of borderline personality traits, even for borderline-salient items. Cogn Emot 2022; 36:690-704. [PMID: 35418278 DOI: 10.1080/02699931.2022.2064831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Clinical populations sometimes demonstrate difficulties forgetting stimuli related to their trauma-related disorder, perhaps because their intense personal connection to these stimuli produce deficits in the inhibitory control abilities necessary for forgetting. The present work examined this possibility for people who have high levels of traits implicated in borderline personality disorder (BPD). In two well-powered studies, we found no evidence for deficits in forgetting specific to BPD traits, even for people with clinically significant levels of the traits, contrary to previous studies. The present experiments updated the designs from earlier experiments to employ the most contemporary methods to examine directed forgetting recommended by recent reviews. With these improved methods, Study 1 found that participants showed significant directed forgetting for BPD-related words independent of their level of BPD traits, perhaps because the BPD-related words were so strongly associated with one another. Study 2 found that when we removed the strong relatedness between the stimuli, forgetting of BPD-relevant words was significant and did not interact with BPD symptomology. We concluded that in contrast to people with PTSD who show specific inhibitory deficits for trauma-related works, people with BPD show normal, intact inhibitory control even for words that they should find threatening.
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Affiliation(s)
- Laci M Gray
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Rosemery O Nelson-Gray
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Peter F Delaney
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Liz T Gilbert
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
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6
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Behavioral inhibition and emotional invalidation in the context of personality impairment. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02705-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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7
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Girasek H, Nagy VA, Fekete S, Ungvari GS, Gazdag G. Prevalence and correlates of aggressive behavior in psychiatric inpatient populations. World J Psychiatry 2022; 12:1-23. [PMID: 35111577 PMCID: PMC8783168 DOI: 10.5498/wjp.v12.i1.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/18/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest. One reason for this is that psychiatric patients are generally considered more likely to be aggressive, which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior. Predicting aggression in psychiatric wards is crucial, because aggressive behavior not only endangers the safety of both patients and staff, but it also extends the hospitalization times. Predictions of aggressive behavior also need careful attention to ensure effective treatment planning. This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes (dementia, psychoactive substance use, acute psychotic disorder, schizophrenia, bipolar affective disorder, major depressive disorder, obsessive-compulsive disorder, personality disorders and intellectual disability). The prevalence of aggressive behavior and its underlying risk factors, such as sex, age, comorbid psychiatric disorders, socioeconomic status, and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior. Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed. Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.
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Affiliation(s)
- Hunor Girasek
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
| | - Vanda Adél Nagy
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
| | - Szabolcs Fekete
- Department of Psychiatry, National Institute of Forensic Psychiatry, Budapest 1108, Hungary
- School of PhD Studies, Semmelweis University, Budapest 1085, Hungary
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Crawley 6009, Australia
- Section of Psychiatry, University of Notre Dame, Fremantle 6160, Australia
| | - Gábor Gazdag
- Department of Psychiatry and Psychiatric Rehabilitation, Jahn Ferenc South Pest Hospital, Budapest 1204, Hungary
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest 1083, Hungary
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Andermann M, Izurieta Hidalgo NA, Rupp A, Schmahl C, Herpertz SC, Bertsch K. Behavioral and neurophysiological correlates of emotional face processing in borderline personality disorder: are there differences between men and women? Eur Arch Psychiatry Clin Neurosci 2022; 272:1583-1594. [PMID: 35661904 PMCID: PMC9653371 DOI: 10.1007/s00406-022-01434-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/15/2022] [Indexed: 11/28/2022]
Abstract
Emotional dysregulation is a core feature of borderline personality disorder (BPD); it is, for example, known to influence one's ability to read other people's facial expressions. We investigated behavioral and neurophysiological foundations of emotional face processing in individuals with BPD and in healthy controls, taking participants' sex into account. 62 individuals with BPD (25 men, 37 women) and 49 healthy controls (20 men, 29 women) completed an emotion classification task with faces depicting blends of angry and happy expressions while the electroencephalogram was recorded. The cortical activity (late positive potential, P3/LPP) was evaluated using source modeling. Compared to healthy controls, individuals with BPD responded slower to happy but not to angry faces; further, they showed more anger ratings in happy but not in angry faces, especially in those with high ambiguity. Men had lower anger ratings than women and responded slower to angry but not happy faces. The P3/LPP was larger in healthy controls than in individuals with BPD, and larger in women than in men; moreover, women but not men produced enlarged P3/LPP responses to angry vs. happy faces. Sex did not interact with behavioral or P3/LPP-related differences between healthy controls and individuals with BPD. Together, BPD-related alterations in behavioral and P3/LPP correlates of emotional face processing exist in both men and women, supposedly without sex-related interactions. Results point to a general 'negativity bias' in women. Source modeling is well suited to investigate effects of participant and stimulus characteristics on the P3/LPP generators.
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Affiliation(s)
- Martin Andermann
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Natalie A. Izurieta Hidalgo
- Department for General Psychiatry, Center of Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany ,School of Medicine, Universidad San Francisco de Quito, Quito, Pichincha Ecuador
| | - André Rupp
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C. Herpertz
- Department for General Psychiatry, Center of Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Katja Bertsch
- Department for General Psychiatry, Center of Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany. .,Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, 80802, Munich, Germany. .,NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany.
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Hyniewska S, Dąbrowska J, Makowska I, Jankowiak-Siuda K, Rymarczyk K. The Borderline Bias in Explicit Emotion Interpretation. Front Psychol 2021; 12:733742. [PMID: 34975623 PMCID: PMC8715824 DOI: 10.3389/fpsyg.2021.733742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/26/2021] [Indexed: 11/28/2022] Open
Abstract
Atypical emotion interpretation has been widely reported in individuals with borderline personality disorder (iBPD); however, empirical studies reported mixed results so far. We suggest that discrepancies in observations of emotion interpretation by iBPD can be explained by biases related to their fear of rejection and abandonment, i.e., the three moral emotions of anger, disgust, and contempt. In this study, we hypothesized that iBPD would show a higher tendency to correctly interpret these three displays of social rejection and attribute more negative valence. A total of 28 inpatient iBPDs and 28 healthy controls were asked to judge static and dynamic facial expressions in terms of emotions, valence, and self-reported arousal evoked by the observed faces. Our results partially confirmed our expectations. The iBPD correctly interpreted the three unambiguous moral emotions. Contempt, a complex emotion with a difficulty in recognizing facial expressions, was recognized better by iBPD than by healthy controls. All negative emotions were judged more negatively by iBPD than by controls, but no difference was observed in the neutral or positive emotion. Alexithymia and anxiety trait and state levels were controlled in all analyses.
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Affiliation(s)
- Sylwia Hyniewska
- Department of Experimental Psychology, University College London, London, United Kingdom
- *Correspondence: Sylwia Hyniewska,
| | - Joanna Dąbrowska
- Psychiatric Clinic I, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Iwona Makowska
- Child and Adolescent Psychiatric Department, Medical University of Łódź, Łódź, Poland
| | - Kamila Jankowiak-Siuda
- Department of Biological Psychology, Behavioral Neuroscience Lab, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Krystyna Rymarczyk
- Department of Biological Psychology, Behavioral Neuroscience Lab, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Krystyna Rymarczyk,
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Lipsitz-Odess I, Fisher H, Kartaginer O, Leibovich L, Zilcha-Mano S. When less is more: The perception of psychotherapy techniques as a function of patient personality disorder. Psychol Psychother 2021; 94:929-951. [PMID: 33989455 DOI: 10.1111/papt.12347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 04/20/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Psychopathology research suggests that individuals with higher levels of personality disorder (PD) traits, especially those with a comorbid major depressive disorder (MDD), tend to be highly aroused in interpersonal contexts, manifested by an intensified perception of interpersonal interactions. Little is known about the way this tendency manifests in the process of psychotherapy. The current study explored the patient's perception of techniques in psychotherapy among patients with higher vs. lower levels of PD, as well as the patient-therapist agreement on techniques used. DESIGN The study used an integration of qualitative and quantitative methodology on data from a randomized controlled trial (RCT) for the treatment of depression. METHOD Sixty-nine patients with MDD participated in the study and were evaluated for PD symptoms prior to treatment. A set of multilevel analyses were conducted to assess the association between PD and perception of techniques, as well as a zoom-in exploration within a case study. RESULTS Patients with higher levels of PD reported more techniques implemented by the therapist than patients with lower levels. In addition, the agreement between patient and therapist on techniques was lower, such that patients with PDs reported more techniques than their therapist. The case study supported these findings and illustrates the potential for patients with PDs to perceive a greater use of techniques as a sign of therapist investment. CONCLUSION Consistent with psychopathology research, the findings suggest that patients with PDs tend to experience techniques as more intense than the therapist, in comparison with patients without PD. PRACTITIONER POINTS There are indications that patients with higher levels of personality disorder traits will tend to experience the techniques in psychotherapy in a more intense manner than patients with lower level personality disorder traits. It is likely that patients with higher levels of personality disorder traits will experience their therapists as more active than therapists think they are. Therapists of patients with higher levels of personality disorders should be sensitive of each of their patients' experiences. As the case study demonstrated at least in some cases patients with higher levels of personality disorder may experience the techniques in an intense manner as a sign of therapist investment, however, other patients may experience this differently. Therefore, it is crucial for the therapist to be aware of how the patient experienced the encounter - investment or intrusiveness.
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Affiliation(s)
| | - Hadar Fisher
- The Department of Psychology, University of Haifa, Israel
| | - Ori Kartaginer
- The Department of Psychology, University of Haifa, Israel
| | - Liat Leibovich
- The Department of Psychology, University of Haifa, Israel
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Abdo MMM, Mohamed AS, Hammed MAE, Hashem RE, El Nagar ZM. Affective theory of the mind and suicide in women with borderline personality disorder and schizophrenia: a comparative study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00142-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Theory of mind (ToM) is one of the essential components of social cognition. Affective ToM enables us to interpret other’s feelings and behaviors. Borderline personality disorder (BPD) and schizophrenia are two distinct mental disorders, yet they have a mutual deficit in interpreting emotions, thoughts, and intentions which may lead to a higher incidence of suicidality. Studies that involved social cognition, particularly ToM in schizophrenia, or BPD have controversial results. Therefore, this study aimed at comparing affective ToM functioning in female patients with BPD, schizophrenia, and healthy controls. In addition, identifying the possible impact and any correlation exists between the affective ToM and liability for suicide in those patients. Sixty individuals were recruited from the Institute of Psychiatry, Ain Shams University, Cairo, Egypt, and assigned into 3 groups where group A involved 20 BPD patients, group B involved 20 schizophrenic patients, and group C were healthy persons as a control. Assessment of affective ToM was done using Reading the Mind in the Eyes Test (RMET), and probability of suicide was measured using Suicide Probability Scale (SPS).
Results
Regarding ToM, the three groups were assessed using RMET and the results revealed a significantly higher mean score (hypermentalization) in BPD patients than both schizophrenic patients and controls. While schizophrenic patients had significantly lower mean scores than the control group (hypomentalization). As well, BPD patients had a significantly higher suicide probability total score than Schizophrenic patients and in all subdomains except for the hostility subdomain that was significantly higher in schizophrenic patients. Interestingly, in BPD, the suicide probability total score was positively correlated with RMET.
Conclusions
BPD patients have enhanced affective ToM and hypermentalization that is significantly associated with increased suicide probability in those patients, while in schizophrenia, hypomentalization could not be linked to increased suicide probability. Rehabilitation and proper management of ToM abnormalities might be a crucial tool in suicide prevention in mental illnesses, particularly, BPD.
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12
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Mitchell S, Steele K. Mentalising in complex trauma and dissociative disorders. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [DOI: 10.1016/j.ejtd.2020.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Theory of Mind in Borderline Personality Disorder: A Possible Endophenotypic Factor? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063193. [PMID: 33808735 PMCID: PMC8003401 DOI: 10.3390/ijerph18063193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to examine whether theory of mind (ToM) is an endophenotypic marker of borderline personality disorder (BPD), thus constituting an etiopathogenic factor of the disease. This would suggest familial vulnerability to BPD. This was a case-control study involving 146 individuals with 57 BPD patients, 32 first-degree relatives, and 57 controls (median age of BPD and control = 33.4 years; relatives = 52.9 years; BPD females and controls = 91.2%; female relatives = 62.5%). All the participants completed the Spanish version of the Movie for the Assessment of Social Cognition test to evaluate the ToM subclassification: interpretation of emotions, thoughts and intentions. BPD patients and their healthy first-degree relatives exhibited significant deficits in the correct interpretation of emotions and intentions compared to healthy controls. Both patients with BPD and their healthy first-degree relatives exhibited significant deficits in ToM, which suggests that it may be an etiopathogenic factor of BPD, and ToM (interpretation of emotions, thoughts and intentions) is a possible endophenotypic marker of BPD, suggesting a genetic predisposition to the disorder. Therefore, ToM could be considered as an indicator for the early detection of the disorder of and intervention for BPD.
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Fitzpatrick S, Liebman RE, Monson CM. The borderline interpersonal-affective systems (BIAS) model: Extending understanding of the interpersonal context of borderline personality disorder. Clin Psychol Rev 2021; 84:101983. [PMID: 33517245 DOI: 10.1016/j.cpr.2021.101983] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 01/10/2023]
Abstract
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.
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Affiliation(s)
- Skye Fitzpatrick
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Rachel E Liebman
- Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada; Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada
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Gulamani T, Rodrigo AH, Uliaszek AA, Ruocco AC. Facial Emotion Perception in Families Affected With Borderline Personality Disorder. J Pers Disord 2021; 35:132-148. [PMID: 33650891 DOI: 10.1521/pedi_2021_35_514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
| | | | | | - Anthony C Ruocco
- Department of Psychology, University of Toronto Scarborough, and the Department of Psychological Clinical Science, University of Toronto, Toronto, Canada
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Mneimne M, Furr RM, Mendygal D, Law MK, Arnold EM, Fleeson W. Degree of Correspondence Between Retrospective and Proximal Reports of Borderline Personality Disorder Symptoms, Symptom Triggers, and Emotions. J Pers Disord 2021; 35:1-20. [PMID: 30920939 PMCID: PMC10901452 DOI: 10.1521/pedi_2019_33_418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study investigated the degree of correspondence of retrospective reports of personality disorder symptoms, triggers, and emotions with reports closer in time to the actual experiences. Retrospective reports of symptoms, triggers, and emotions are heavily used in both clinical and research settings, yet no study has investigated the correspondence for symptoms or triggers of personality disorders. A total of 257 participants, including 75 with BPD, completed overlapping daily, weekly, monthly, and semi-annual questionnaires. Retrospective reports showed: (1) systematic biases, reporting fewer symptom and situational trigger occurrences, and greater emotion intensities; but (2) little unsystematic error, largely reproducing bias-adjusted individual levels of symptoms, situational triggers, and emotions (rs generally .70-.80). People with BPD did not retrospectively misremember their symptoms, triggers, or emotions much more than others. Thus, retrospective reports of symptoms, triggers, and emotions should be adjusted for systematic bias, but after such adjustment can be taken as relatively faithful accounts of individuals' experiences.
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Saarinen A, Keltikangas-Järvinen L, Jääskeläinen E, Huhtaniska S, Pudas J, Tovar-Perdomo S, Penttilä M, Miettunen J, Lieslehto J. Early Adversity and Emotion Processing From Faces: A Meta-analysis on Behavioral and Neurophysiological Responses. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:692-705. [PMID: 33486133 DOI: 10.1016/j.bpsc.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although the link between early adversity (EA) and later-life psychiatric disorders is well established, it has yet to be elucidated whether EA is related to distortions in the processing of different facial expressions. We conducted a meta-analysis to investigate whether exposure to EA relates to distortions in responses to different facial emotions at three levels: 1) event-related potentials of the P100 and N170, 2) amygdala functional magnetic resonance imaging responses, and 3) accuracy rate or reaction time in behavioral data. METHODS The systematic literature search (PubMed and Web of Science) up to April 2020 resulted in 29 behavioral studies (n = 8555), 32 functional magnetic resonance imaging studies (n = 2771), and 3 electroencephalography studies (n = 197) for random-effect meta-analyses. RESULTS EA was related to heightened bilateral amygdala reactivity to sad faces (but not other facial emotions). Exposure to EA was related to faster reaction time but a normal accuracy rate in response to angry and sad faces. In response to fearful and happy faces, EA was related to a lower accuracy rate only in individuals with recent EA exposure. This effect was more pronounced in individuals with exposure to EA before (vs. after) the age of 3 years. These findings were independent of psychiatric diagnoses. Because of the low number of eligible electroencephalography studies, no conclusions could be reached regarding the effect of EA on the event-related potentials. CONCLUSIONS EA relates to alterations in behavioral and neurophysiological processing of facial emotions. Our study stresses the importance of assessing age at exposure and time since EA because these factors mediate some EA-related perturbations.
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Affiliation(s)
- Aino Saarinen
- Research Unit of Psychology, Department of Psychiatry, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Erika Jääskeläinen
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Sanna Huhtaniska
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Department of Radiology, Vaasa Central Hospital, Vaasa, Finland
| | - Juho Pudas
- Research Unit of Clinical Neuroscience, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Santiago Tovar-Perdomo
- International Max Planck Research School for Translational Psychiatry, Munich, Germany; PRONIA Research Group, Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University Hospital, Munich, Germany
| | - Matti Penttilä
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, Department of Psychiatry, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johannes Lieslehto
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
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18
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Seitz KI, Leitenstorfer J, Krauch M, Hillmann K, Boll S, Ueltzhoeffer K, Neukel C, Kleindienst N, Herpertz SC, Bertsch K. An eye-tracking study of interpersonal threat sensitivity and adverse childhood experiences in borderline personality disorder. Borderline Personal Disord Emot Dysregul 2021; 8:2. [PMID: 33397512 PMCID: PMC7784013 DOI: 10.1186/s40479-020-00141-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/25/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Previous eye-tracking studies provide preliminary evidence for a hypersensitivity to negative, potentially threatening interpersonal cues in borderline personality disorder (BPD). From an etiological point of view, such interpersonal threat hypersensitivity might be explained by a biological vulnerability along with a history of early life adversities. The objective of the current study was to investigate interpersonal threat hypersensitivity and its association with adverse childhood experiences (ACE) in patients with BPD employing eye-tracking technology. METHODS We examined a sample of 46 unmedicated, adult female patients with BPD and 25 healthy female volunteers, matched on age and intelligence, with a well-established emotion classification paradigm with angry, fearful, happy, and neutral facial expressions. ACE were assessed retrospectively with the Childhood Trauma Questionnaire. RESULTS Patients as compared to healthy volunteers reflexively directed their gaze more quickly towards the eyes of emotional and neutral faces and did not adapt their fixation patterns according to the facial expression presented. Misclassifying emotional and neutral faces as angry correlated positively with the patients' self-reported ACE. CONCLUSIONS Building on and extending earlier findings, our results are likely to suggest a visual hypervigilance towards the eyes of emotional and neutral facial expressions and a childhood trauma-related anger bias in patients with BPD. Given the lack of a clinical control group, the question whether these findings are specific for BPD has to remain open. Thus, further research is needed to elucidate the specificity of altered visual attention allocation and the role of ACE in anger recognition in patients with BPD.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany.
| | - Johanna Leitenstorfer
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Marlene Krauch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Karen Hillmann
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Sabrina Boll
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Kai Ueltzhoeffer
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Nikolaus Kleindienst
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Heidelberg, Germany
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
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19
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Bortolla R, Galli M, Ramella P, Sirtori F, Visintini R, Maffei C. Negative bias and reduced visual information processing of socio-emotional context in borderline Personality Disorder: A support for the hypersensitivity hypothesis. J Behav Ther Exp Psychiatry 2020; 69:101589. [PMID: 32502878 DOI: 10.1016/j.jbtep.2020.101589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Roberta Bortolla
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy.
| | - Marco Galli
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy
| | - Pietro Ramella
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy
| | - Federica Sirtori
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy
| | - Raffaele Visintini
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy
| | - Cesare Maffei
- Vita-Salute San Raffaele University, Milan, Italy; IRCCS San Raffaele Hospital, Milan, Italy
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20
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Goueli T, Nasreldin M, Madbouly N, Dziobek I, Farouk M. Social cognition in adolescent females with borderline personality traits. Psychol Psychother 2020; 93:739-753. [PMID: 31692159 DOI: 10.1111/papt.12257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 10/10/2019] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- Tamer Goueli
- Department of Psychiatry, Faculty of Medicine, Cairo University, Egypt
| | - Mohamed Nasreldin
- Department of Psychiatry, Faculty of Medicine, Cairo University, Egypt
| | - Nagwan Madbouly
- Department of Psychiatry, Faculty of Medicine, Cairo University, Egypt
| | - Isabel Dziobek
- Faculty of Life Sciences, Institute of Psychology, Humboldt University of Berlin, Germany
| | - Mohamed Farouk
- Department of Psychiatry, Faculty of Medicine, Cairo University, Egypt
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21
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Maraz A, Nagy T, Ziegler M. When bad gets worse: Negative wording amplifies negative recall in persons with the borderline personality trait. APPLIED COGNITIVE PSYCHOLOGY 2020. [DOI: 10.1002/acp.3764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Aniko Maraz
- Institute für Psychologie Humboldt‐Universität zu Berlin Berlin Germany
| | - Tamás Nagy
- Institute of Psychology ELTE Eötvös Loránd University Budapest Hungary
| | - Matthias Ziegler
- Institute für Psychologie Humboldt‐Universität zu Berlin Berlin Germany
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22
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Haggerty G, Esang M, Salaheldin K, Lima A. The relationship between prototype ratings of personality and self and interpersonal functioning with an adolescent inpatient sample. Clin Psychol Psychother 2020; 28:364-372. [PMID: 32881158 DOI: 10.1002/cpp.2512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 06/15/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022]
Abstract
Personality pathology is conceptualized, in part, as impairments in self and interpersonal functioning. Although most of the research has focused on adult samples, fewer have looked at this relationship in adolescent samples. This paper investigates the relationship between clinician-rated personality prototypes, the Shedler-Westen Assessment Procedure-Prototype Matching Adolescent Version (SWAP-A-P) derived from the SWAP-II-A, and a measure of self and interpersonal functioning, the Social Cognition and Object Relation Scale-Global Rating (SCORS-G). Clinicians rated 66 adolescents hospitalized at a safety net teaching hospital in the northeast. The patient's individual and group therapist rated the patients at discharge using the SWAP-A-P and the SCORS-G at discharge blind to each other's ratings. Results showed that more severe personality pathology was linked with more impairments in self and interpersonal functioning.
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Affiliation(s)
- Greg Haggerty
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA
| | - Michael Esang
- Department of Behavioral Sciences, Nassau University Medical Center, East Meadow, New York, USA
| | - Khalid Salaheldin
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA.,Department of Psychiatry, Mather Hospital Northwell Health
| | - Ateaya Lima
- Graduate Medical Education, Mather Hospital/Northwell Health, Port Jefferson, New York, USA.,Department of Psychiatry, Mather Hospital Northwell Health
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23
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Abstract
The purpose of this research was to determine the differences in empathy, alexithymia features, and theory of mind between healthy controls and patients with borderline personality disorder (BPD). Thirty-five patients with BPD and 35 healthy controls were included in the study. To measure the clinical variables, the Empathy Quotient (EQ), Reading the Mind in the Eyes Test (RMET), Toronto Alexithymia Scale (TAS-20), Barratt Impulsivity Scale-11 (BIS-11), and Beck Depression Inventory (BDI) were applied. We found that the BPD group had significantly worse total RMET and neutral RMET scores than the control group. There were no differences in the EQ scores between the BPD and control groups. The patients with BPD were more alexithymic than the controls, and alexithymia and depression scores predicted BPD status. Patients with BPD who have difficulty identifying their own emotions tend to display deficits in perceptions of facial emotions, which, in turn, may lead to misperceptions of social signals and thus contribute to excessive emotional intensity and tension in social situations. The study results reveal that alexithymia and depression are important variables in predicting BPD traits.
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24
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Hillmann K, Mancke F, Herpertz SC, Jungkunz M, Olsson A, Haaker J, Bertsch K. Intact Classical Fear Conditioning to Interpersonally Threatening Stimuli in Borderline Personality Disorder. Psychopathology 2020; 53:84-94. [PMID: 32535608 DOI: 10.1159/000507794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022]
Abstract
Threat hypersensitivity is regarded as a central mechanism of deficient emotion regulation, a core feature of patients with borderline personality disorder (BPD). Here, we employed a classical fear-conditioning protocol in which interpersonally threatening, interpersonally non-threatening, and non-social (neutral) visual stimuli were predictive of an aversive auditory stimulus in a sample of 23 medication-free adult female patients with BPD and 21 age- and IQ-matched healthy women. The results did not confirm the hypothesized enhanced and prolonged conditioned skin conductance responses (SCR) and subjective stress and expectancy ratings to interpersonally threatening stimuli in patients with BPD compared to healthy women. Patients with BPD generally expected the aversive stimulus more often irrespective of stimulus category and conditioning. Furthermore, patients with BPD showed larger conditioned SCR to interpersonally non-threatening and neutral than interpersonally threatening stimuli, while interpersonally threatening stimuli elicited higher SCR compared to non-threatening or neutral stimuli in healthy controls. Together with previous studies, the results suggest no alterations in fear conditioning to generally aversive stimuli in BPD. Further studies using stimuli with BPD-specific topics, such as abandonment or rejection, and/or to investigate more interpersonal forms of learning, such as observational or instructed conditioning, are urgently needed to further elucidate the mechanisms involved in the etiology and maintenance of threat hypersensitivity in BPD.
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Affiliation(s)
- Karen Hillmann
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany,
| | - Falk Mancke
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Martin Jungkunz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Andreas Olsson
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jan Haaker
- Institute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Psychology, Ludwig-Maximilians University, Munich, Germany
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25
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Childhood stress impairs social function through AVP-dependent mechanisms. Transl Psychiatry 2019; 9:330. [PMID: 31819033 PMCID: PMC6901493 DOI: 10.1038/s41398-019-0678-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022] Open
Abstract
Impaired social function is a core feature of many psychiatric illnesses. Adverse experiences during childhood increase risk for mental illness, however it is currently unclear whether stress early in life plays a direct role in the development of social difficulties. Using a rat model of pre-pubertal stress (PPS), we investigated effects on social behaviour, oxytocin and arginine vasopressin (AVP) in the periphery (plasma) and centrally in the paraventricular and supraoptic hypothalamic nuclei. We also explored social performance and AVP expression (plasma) in participants with borderline personality disorder (BPD) who experienced a high incidence of childhood stress. Social behaviour was impaired and AVP expression increased in animals experiencing PPS and participants with BPD. Behavioural deficits in animals were rescued through administration of the AVPR1a antagonist Relcovaptan (SR49059). AVP levels and recognition of negative emotions were significantly correlated in BPD participants only. In conclusion, early life stress plays a role in the precipitation of social dysfunction, and AVP mediates at least part of this effect.
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26
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Van Heel M, Luyten P, De Meulemeester C, Vanwalleghem D, Vermote R, Lowyck B. Mentalizing Based on External Features in Borderline Personality Disorder Compared With Healthy Controls: The Role of Attachment Dimensions and Childhood Trauma. J Pers Disord 2019; 33:736-750. [PMID: 30689514 DOI: 10.1521/pedi_2019_33_373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Extant research suggests that borderline personality disorder (BPD) is associated with impairments in mentalizing, that is, comprehending behavior in terms of underlying mental states. However, the precise nature of these impairments remains unclear. The literature is mixed concerning mental-izing based on external features of others, and specifically facial emotion recognition (FER) in BPD patients. This study investigated FER differences in 79 BPD patients and 79 matched healthy controls using the Reading the Mind in the Eyes Test (RMET). The authors also investigated attachment dimensions and childhood trauma in relation to mentalizing based on external features. Results showed that BPD patients performed worse on positive and negative emotions. Furthermore, avoidant attachment was negatively related to FER for neutral emotions, particularly in the control group. Trauma was negatively related to FER at trend level, particularly in BPD patients. The implications for this understanding of mentalizing based on external features in BPD are discussed.
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Affiliation(s)
- Martijn Van Heel
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | | | | | - Rudi Vermote
- University Psychiatric Hospital UPC KU Leuven, Campus Kortenberg and Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Benedicte Lowyck
- University Psychiatric Hospital UPC KU Leuven, Campus Kortenberg and Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Research Department of Clinical, Educational and Health Psychology, University College London, UK
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27
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Pfaltz MC, Passardi S, Auschra B, Fares-Otero NE, Schnyder U, Peyk P. Are you angry at me? Negative interpretations of neutral facial expressions are linked to child maltreatment but not to posttraumatic stress disorder. Eur J Psychotraumatol 2019; 10:1682929. [PMID: 31762947 PMCID: PMC6853207 DOI: 10.1080/20008198.2019.1682929] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/30/2019] [Accepted: 09/25/2019] [Indexed: 12/23/2022] Open
Abstract
Background: Individuals with a high prevalence of child maltreatment, e.g. those with borderline personality disorder, tend to see neutral facial expressions as negative. Objective: Our aim was to assess whether this bias is present in individuals with posttraumatic stress disorder (PTSD) and whether it is linked to child maltreatment. Methods: Thirty-nine PTSD participants, 44 traumatized and 35 non-traumatized healthy controls watched 300 one-second movies showing 30 neutral and 270 emotional facial expressions, and indicated whether they interpreted each as a neutral or as one of nine emotional expressions. Results: PTSD individuals did not perform differently than the two control groups in the recognition and interpretation of neutral facial expressions (p's < .300). Higher levels of childhood sexual and emotional abuse, and physical neglect were linked to more interpretations of neutral facial expressions as contempt (p's < .043), and (for sexual abuse and physical neglect) to more interpretations of neutral facial expressions as anger (p's < .014). Comparisons of statistical model fits suggested that childhood sexual abuse was the most relevant predictor of recognition accuracy in our sample. Alexithymia, state dissociation, interpersonal trauma, and number of experienced trauma types were not associated with deficits in the interpretation of neutral expressions. Conclusions: Child maltreatment, especially sexual abuse, may shape the interpretation of neutral facial expressions. Future research should explore whether the observed biases extend to real-life situations. If so, therapists might improve the therapeutic relationship with patients with a history of child maltreatment by paying more attention to their own non-verbal communication and their patients' responses to it. Furthermore, similarly to individuals with high depressive and high social anxiety symptoms, facial expression recognition training might counteract negativity bias in individuals with a history of childhood (sexual and emotional) abuse, and (physical) neglect.
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Affiliation(s)
- Monique C Pfaltz
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sandra Passardi
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Natalia E Fares-Otero
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ulrich Schnyder
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Peter Peyk
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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28
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Kaiser D, Jacob GA, van Zutphen L, Siep N, Sprenger A, Tuschen-Caffier B, Senft A, Arntz A, Domes G. Biased Attention to Facial Expressions of Ambiguous Emotions in Borderline Personality Disorder: An Eye-Tracking Study. J Pers Disord 2019; 33:671-S8. [PMID: 30689505 DOI: 10.1521/pedi_2019_33_363] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- Deborah Kaiser
- Department of Psychology, University of Freiburg, Germany
| | | | - Linda van Zutphen
- Department of Clinical Psychological Science, University of Maastricht, The Netherlands
| | - Nicolette Siep
- Department of Clinical Psychological Science, University of Maastricht, The Netherlands
| | - Andreas Sprenger
- Department of Neurology and Institute of Psychology II, University of Luebeck, Germany
| | | | - Alena Senft
- Department of Psychiatry and Psychotherapy, University of Luebeck
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, The Netherlands
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Germany
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29
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Safar K, Sato J, Ruocco AC, Korenblum MS, O’Halpin H, Dunkley BT. Disrupted emotional neural circuitry in adolescents with borderline personality traits. Neurosci Lett 2019; 701:112-118. [DOI: 10.1016/j.neulet.2019.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/04/2019] [Accepted: 02/11/2019] [Indexed: 12/22/2022]
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30
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Emotional Responsiveness in Borderline Personality Disorder: The Role of Basal Hyperarousal and Self-Reported Emotional Regulation. J Nerv Ment Dis 2019; 207:175-183. [PMID: 30720601 DOI: 10.1097/nmd.0000000000000939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The present study aims to test the hypothesis of biological hyperarousal and hyperreactivity underpinning the dysfunctional emotional processes of borderline personality disorder (BPD). Self-reported (quality and intensity of emotions) and physiological (respiratory sinus arrhythmia [RSA] and heart rate) data were collected in 14 clinical subjects with BPD and in 14 control subjects (healthy controls [HCs]), during the administration of six video clips with different emotional contents. Our findings showed a constant hyperarousal state (lower RSA) in the clinical group, supporting the hypothesis of a biological vulnerability to emotional dysregulation. BPD patients showed lower self-reported happiness in positive stimuli compared with HCs and a significant association between emotional dysregulation and physiological hyperreactivity to neutral stimuli. Our data support the hypothesis of a constant condition of physiological preparedness to threat and danger in BPD subjects. Moreover, our results highlight the influence of self-reported ability in regulating emotions in explaining BPD responses to specific emotional situations.
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31
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Colle L, Gabbatore I, Riberi E, Borroz E, Bosco FM, Keller R. Mindreading abilities and borderline personality disorder: A comprehensive assessment using the Theory of Mind Assessment Scale. Psychiatry Res 2019; 272:609-617. [PMID: 30616131 DOI: 10.1016/j.psychres.2018.12.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 01/25/2023]
Abstract
Numerous studies have examined mindreading in borderline personality disorder (BPD). However, the empirical data obtained to date have not facilitated the development of a clear clinical profile of mindreading impairment in BPD due to a lack of consistency or incongruence across studies. One possible explanation for these inconsistencies and divergences in the current literature may lie in the multidimensional character of the mindreading construct; moreover, the heterogeneity of the experimental measures used to assess individuals with BPD mindreading skills may also need to be taken into account. The aim of the present study is to investigate mindreading skills and impairments in patients with BPD through direct comparison of a wide range of mindreading dimensions using a comprehensive semistructured interview, the Theory of Mind Assessment Scale (Th.o.m.a.s.) (Bosco et al., 2009). Our results show that the performance of patients with BPD differs from that of healthy controls only in certain specific dimensions of mindreading. The difficulties encountered by the patients with BPD typically emerge when mindreading tasks require them to disentangle their own subjective mindreading from that of another person, in other words, when they were required to assume an allocentric perspective.
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Affiliation(s)
- L Colle
- Department of Psychology, University of Turin, Italy; Neuroscience Institute of Turin, Italy
| | - I Gabbatore
- Department of Psychology, University of Turin, Italy; Child Language Research Center, University of Oulu, Finland.
| | - E Riberi
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
| | - E Borroz
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
| | - F M Bosco
- Department of Psychology, University of Turin, Italy; Neuroscience Institute of Turin, Italy
| | - R Keller
- Local Health Unit ASL City of Turin, Department of Mental Health, Turin, Italy
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32
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Flasbeck V, Enzi B, Brüne M. Enhanced Processing of Painful Emotions in Patients With Borderline Personality Disorder: A Functional Magnetic Resonance Imaging Study. Front Psychiatry 2019; 10:357. [PMID: 31191371 PMCID: PMC6545793 DOI: 10.3389/fpsyt.2019.00357] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/07/2019] [Indexed: 12/14/2022] Open
Abstract
Previous research has demonstrated that patients with borderline personality disorder (BPD) are more sensitive to negative emotions and often show poor cognitive empathy, yet preserved or even superior emotional empathy. However, little is known about the neural correlates of empathy. Here, we examined empathy for pain in 20 patients with BPD and 19 healthy controls (HC) in a functional magnetic resonance imaging (fMRI) study, which comprised an empathy for pain paradigm showing facial emotions prior to hands exposed to painful stimuli. We found a selectively enhanced activation of the right supramarginal gyrus for painful hand pictures following painful facial expressions in BPD patients, and lower activation to nonpainful pictures following angry expressions. Patients with BPD showed less activation in the left supramarginal gyrus when viewing angry facial expressions compared to HC, independent of the pain condition. Moreover, we found differential activation of the left anterior insula, depending on the preceding facial expression exclusively in patients. The findings suggest that empathy for pain becomes selectively enhanced, depending on the emotional context information in patients with BPD. Another preliminary finding was an attenuated response to emotions in patients receiving psychotropic medication compared to unmedicated patients. These effects need to be replicated in larger samples. Together, increased activation during the observation of painful facial expressions seems to reflect emotional hypersensitivity in BPD.
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Affiliation(s)
- Vera Flasbeck
- Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Björn Enzi
- Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Martin Brüne
- Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital Bochum, Ruhr-University, Bochum, Germany
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Abstract
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.
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Ritzl A, Csukly G, Balázs K, Égerházi A. Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders. Psychiatry Res 2018; 270:154-159. [PMID: 30248486 DOI: 10.1016/j.psychres.2018.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 09/03/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022]
Abstract
Previous studies that aimed to support emotion recognition deficits and alexithymia in B cluster personality disorders have mainly focused on borderline personality disorder (BPD), and resulted in mixed findings. In our study we examine emotion recognition and alexithymia in patients with histrionic (HPD), narcissistic (NPD) and borderline (BPD) personality disorders compared to each other and healthy controls. Furthermore, the possibility is investigated that it is not the type of PD but the severity of psychopathology which predicts the severity of emotion recognition deficits and alexithymia. Patients with HPD, NPD, BPD and healthy controls (N = 20 for each group) were examined by using the Ekman 60 Faces Test (FEEST) and the Toronto Alexithymia Scale (TAS-20). To measure the extent and severity of psychopathology, the Symptom-Checklist-90 Revised (SCL-90-R) was used. Patient groups performed significantly worse compared to healthy controls on the Ekman test and TAS-20, while we found no significant differences among patient groups in emotion recognition and alexithymia. Furthermore, higher scores on the SCL-90-R predicted poorer emotion recognition performance and higher alexithymic features. The empirical data supports the conclusion that the severity of psychopathology plays an important role in predicting emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders.
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Affiliation(s)
- Andrea Ritzl
- Department of Psychiatry, Medical Center, University of Debrecen, Hungary.
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Katalin Balázs
- Institute of Psychology, University of Debrecen, Hungary
| | - Anikó Égerházi
- Department of Psychiatry, Medical Center, University of Debrecen, Hungary
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35
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Stanley B, Perez-Rodriguez MM, Labouliere C, Roose S. A Neuroscience-Oriented Research Approach to Borderline Personality Disorder. J Pers Disord 2018; 32:784-822. [PMID: 29469663 DOI: 10.1521/pedi_2017_31_326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Traditionally, the study of personality disorders had been based on psychoanalytic or behavioral models. Over the past two decades, there has been an emerging neuroscience model of borderline personality disorder (BPD) grounded in the concept of BPD as a condition in which dysfunctional neural circuits underlie its pathological dimensions, some of which include emotion dysregulation (broadly encompassing affective instability, negative affectivity, and hyperarousal), abnormal interpersonal functioning, and impulsive aggression. This article, initiated at a joint Columbia University- Cornell University Think Tank on BPD with representation from the Icahn School of Medicine at Mount Sinai, suggests how to advance research in BPD by studying the dimensions that underlie BPD in addition to studying the disorder as a unitary diagnostic entity. We suggest that linking the underlying neurobiological abnormalities to behavioral symptoms of the disorder can inform a research agenda to better understand BPD with its multiple presentations.
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Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, Columbia University, New York City
| | | | | | - Steven Roose
- Department of Psychiatry, Columbia University, New York City.,New York State Psychiatric Institute, New York City
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Sato M, Fonagy P, Luyten P. Rejection sensitivity and borderline personality disorder features: A mediation model of effortful control and intolerance of ambiguity. Psychiatry Res 2018; 269:50-55. [PMID: 30145301 DOI: 10.1016/j.psychres.2018.08.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/22/2018] [Accepted: 08/11/2018] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Momoko Sato
- Department of Clinical, Educational, and Health Psychology, University College London, 1-19 Torrington Place, London WC1E7HB, The United Kingdom.
| | - Peter Fonagy
- Department of Clinical, Educational, and Health Psychology, University College London, 1-19 Torrington Place, London WC1E7HB, The United Kingdom
| | - Patrick Luyten
- Department of Clinical, Educational, and Health Psychology, University College London, 1-19 Torrington Place, London WC1E7HB, The United Kingdom; Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
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Vai B, Sforzini L, Visintini R, Riberto M, Bulgarelli C, Ghiglino D, Melloni E, Bollettini I, Poletti S, Maffei C, Benedetti F. Corticolimbic Connectivity Mediates the Relationship between Adverse Childhood Experiences and Symptom Severity in Borderline Personality Disorder. Neuropsychobiology 2018; 76:105-115. [PMID: 29860262 DOI: 10.1159/000487961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/15/2018] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Benedetta Vai
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Department of Human Studies, Libera Università Maria Ss. Assunta, Rome, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
| | - Laura Sforzini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Raffaele Visintini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Martina Riberto
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Chiara Bulgarelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centre for Brain and Cognitive Development, Birkbeck College, London, United Kingdom
| | - Davide Ghiglino
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Elisa Melloni
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
| | - Cesare Maffei
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, University Vita-Salute, Milan, Italy.,Centro di Eccellenza Risonanza Magnetica ad Alto Campo (CERMAC), Università Vita-Salute San Raffaele, Milan, Italy
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38
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Suicidal behavior and aggression-related disorders. Curr Opin Psychol 2018; 22:54-58. [DOI: 10.1016/j.copsyc.2017.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/03/2017] [Accepted: 08/03/2017] [Indexed: 11/18/2022]
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39
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Thonse U, Behere RV, Praharaj SK, Sharma PSVN. Facial emotion recognition, socio-occupational functioning and expressed emotions in schizophrenia versus bipolar disorder. Psychiatry Res 2018; 264:354-360. [PMID: 29674226 DOI: 10.1016/j.psychres.2018.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 01/05/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022]
Abstract
Facial emotion recognition deficits have been consistently demonstrated in patients with severe mental disorders. Expressed emotion is found to be an important predictor of relapse. However, the relationship between facial emotion recognition abilities and expressed emotions and its influence on socio-occupational functioning in schizophrenia versus bipolar disorder has not been studied. In this study we examined 91 patients with schizophrenia and 71 with bipolar disorder for psychopathology, socio occupational functioning and emotion recognition abilities. Primary caregivers of 62 patients with schizophrenia and 49 with bipolar disorder were assessed on Family Attitude Questionnaire to assess their expressed emotions. Patients of schizophrenia and bipolar disorder performed similarly on the emotion recognition task. Patients with schizophrenia group experienced higher critical comments and had a poorer socio-occupational functioning as compared to patients with bipolar disorder. Poorer socio-occupational functioning in patients with schizophrenia was significantly associated with greater dissatisfaction in their caregivers. In patients with bipolar disorder, poorer emotion recognition scores significantly correlated with poorer adaptive living skills and greater hostility and dissatisfaction in their caregivers. The findings of our study suggest that emotion recognition abilities in patients with bipolar disorder are associated with negative expressed emotions leading to problems in adaptive living skills.
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Affiliation(s)
- Umesh Thonse
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.
| | - Rishikesh V Behere
- KEM Hospital and Research Center, 489, Rastapeth, Sardar Moodaliar Road, Pune 411011, India.
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
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40
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Lischke A, Herpertz SC, Berger C, Domes G, Gamer M. Divergent effects of oxytocin on (para-)limbic reactivity to emotional and neutral scenes in females with and without borderline personality disorder. Soc Cogn Affect Neurosci 2018; 12:1783-1792. [PMID: 29036358 PMCID: PMC5714167 DOI: 10.1093/scan/nsx107] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 09/11/2017] [Indexed: 12/31/2022] Open
Abstract
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.
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Affiliation(s)
- Alexander Lischke
- Department of Psychology, University of Greifswald, Greifswald, Germany.,Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.,Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Christoph Berger
- Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany.,Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University of Rostock, Rostock, Germany
| | - Gregor Domes
- Department of Psychology, University of Trier, Trier, Germany
| | - Matthias Gamer
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychology, University of Würzburg, Würzburg, Germany
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41
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Haggerty G, Stein M, Siefert C, Zodan J, Mehra A, Ogbuji K, Sangha J, Habib M, Sinclair SJ, Blais MA. Dimensional measure of self and interpersonal functioning: Comparisons with treatment alliance and readiness for inpatient psychotherapy. Clin Psychol Psychother 2018; 25:575-582. [PMID: 29667270 DOI: 10.1002/cpp.2193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 11/08/2022]
Abstract
The social cognition and object relations scale-global rating method is a clinical rating system assessing 8 domains of self and interpersonal functioning. It can be applied to score numerous forms of narrative data. In this study, we investigate the SCORS-G relationship to measures of alliance and readiness for psychotherapy with an adolescent inpatient sample. Seventy-two psychiatrically hospitalized adolescents were consented and subsequently rated by their individual and group therapist using the SCORS-G. The unit psychiatrist also completed an assessment of patients' readiness for inpatient psychotherapy. The patients completed a self-report of their alliance with the inpatient treatment team as a whole. SCORS-G ratings were positively correlated with assessments of readiness for inpatient psychotherapy and patient-reported alliance. This study further demonstrates the clinical utility of the SCORS-G with adolescents.
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Affiliation(s)
- Greg Haggerty
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Michelle Stein
- Psychiatry Department, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Caleb Siefert
- Psychology, University of Michigan-Dearborn, Dearborn, MI, USA
| | - Jennifer Zodan
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Ashwin Mehra
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Kelechi Ogbuji
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Jaspreet Sangha
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | - Michael Habib
- Psychiatry Department, Nassau University Medical Center, East Meadow, NY, USA
| | | | - Mark A Blais
- Psychiatry Department, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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42
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Ferreira GCS, Sanches RF, Crippa JADS, Mello MFD, Osório FL. Borderline personality disorder and bias in the recognition of facial expressions of emotion: a pathway to understand the psychopathology. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/0101-60830000000146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | | | | | - Flávia L. Osório
- University of São Paulo, Brazil; National Institute of Science and Technology – Translational Medicine, Brazil
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43
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Berchio C, Piguet C, Gentsch K, Küng AL, Rihs TA, Hasler R, Aubry JM, Dayer A, Michel CM, Perroud N. Face and gaze perception in borderline personality disorder: An electrical neuroimaging study. Psychiatry Res Neuroimaging 2017; 269:62-72. [PMID: 28941875 DOI: 10.1016/j.pscychresns.2017.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/18/2017] [Accepted: 08/25/2017] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Cristina Berchio
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland.
| | - Camille Piguet
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland; Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland
| | - Kornelia Gentsch
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Anne-Lise Küng
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Tonia A Rihs
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Roland Hasler
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Alexandre Dayer
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland; Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Christoph M Michel
- Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland; Biomedical Imaging Center (CIBM) Lausanne, Geneva, Switzerland
| | - Nader Perroud
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, Mood Disorders Unit, University Hospitals of Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
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44
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Bertsch K, Krauch M, Stopfer K, Haeussler K, Herpertz SC, Gamer M. Interpersonal Threat Sensitivity in Borderline Personality Disorder: An Eye-Tracking Study. J Pers Disord 2017; 31:647-670. [PMID: 28072041 DOI: 10.1521/pedi_2017_31_273] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Marlene Krauch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katharina Stopfer
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katrin Haeussler
- Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Matthias Gamer
- Department of Psychology, University of Würzburg, Würzburg, Germany
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Sinke C, Wollmer MA, Kneer J, Kahl KG, Kruger THC. Interaction between behavioral inhibition and emotional processing in borderline personality disorder using a pictorial emotional go/no-go paradigm. Psychiatry Res 2017; 256:286-289. [PMID: 28654876 DOI: 10.1016/j.psychres.2017.06.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/13/2017] [Accepted: 06/08/2017] [Indexed: 11/17/2022]
Abstract
Borderline personality disorder (BPD) is characterized by difficulties in emotional regulation and impulse control. In this study, we presented a novel picture-based emotional go/no-go task with distracting emotional faces in the background, which was administered to 16 patients with BPD and 16 age-matched healthy controls. The faces displayed different emotional content (angry, neutral, or happy). Results showed differences in sensitivity between patients and the control group, with patients exhibiting less sensitivity in the task, and also showed influences of emotional content represented in the distracting faces in both groups. Specifically, happy faces decreased sensitivity compared to angry faces. It seemed as though processing of a positive emotional stimulus led to a more relaxed state and thereby to decreased sensitivity, while a negative emotional stimulus induced more alertness and tension, leading to higher sensitivity. Thus, this paradigm is suitable to investigate the interplay between emotion processing and impulse control in patients with BPD.
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Affiliation(s)
- Christopher Sinke
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany
| | - M Axel Wollmer
- Asklepios Clinic North - Ochsenzoll, Asklepios Campus Hamburg, Medical Faculty, Semmelweis University, Hamburg, Germany
| | - Jonas Kneer
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany
| | - Kai G Kahl
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany
| | - Tillmann H C Kruger
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Germany.
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Meehan KB, De Panfilis C, Cain NM, Antonucci C, Soliani A, Clarkin JF, Sambataro F. Facial emotion recognition and borderline personality pathology. Psychiatry Res 2017; 255:347-354. [PMID: 28605709 DOI: 10.1016/j.psychres.2017.05.042] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/23/2017] [Accepted: 05/28/2017] [Indexed: 11/24/2022]
Abstract
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.
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Affiliation(s)
- Kevin B Meehan
- Department of Psychology, Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA; Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10605, USA.
| | - Chiara De Panfilis
- Unit of Psychiatry, Department of Neuroscience, University of Parma, c/o Ospedale Maggiore, pad. 21 Braga, viale Gramsci 14, 43126 Parma, Italy
| | - Nicole M Cain
- Department of Psychology, Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA
| | - Camilla Antonucci
- Service of Hospital-based Psychiatry, Department of Mental Health, Parma Local Health Agency, c/o Ospedale Maggiore, pad. 21 Braga, viale Gramsci 14, 43126 Parma, Italy
| | - Antonio Soliani
- Unit of Psychiatry, Department of Neuroscience, University of Parma, c/o Ospedale Maggiore, pad. 21 Braga, viale Gramsci 14, 43126 Parma, Italy
| | - John F Clarkin
- Department of Psychiatry, Weill Cornell Medical College, 21 Bloomingdale Road, White Plains, NY 10605, USA
| | - Fabio Sambataro
- Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
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Niedtfeld I. Experimental investigation of cognitive and affective empathy in borderline personality disorder: Effects of ambiguity in multimodal social information processing. Psychiatry Res 2017; 253:58-63. [PMID: 28351003 DOI: 10.1016/j.psychres.2017.03.037] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/13/2017] [Accepted: 03/20/2017] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- Inga Niedtfeld
- Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim / Heidelberg University, Germany.
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Kiel EJ, Viana AG, Tull MT, Gratz KL. Emotion Socialization Strategies of Mothers With Borderline Personality Disorder Symptoms: The Role of Maternal Emotion Regulation and Interactions With Infant Temperament. J Pers Disord 2017; 31:399-416. [PMID: 27322579 DOI: 10.1521/pedi_2016_30_256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although the interpersonal difficulties associated with borderline personality disorder (BPD) are well established, their manifestations within the context of parent-child relationships remain understudied. The current study investigated the relation of maternal BPD symptoms to nonsupportive emotion socialization (i.e., the extent to which mothers punish or minimize their young children's displays of negative emotions), as well as the mediating role of maternal emotion regulation difficulties in this relation. The authors also investigated the moderating role of maternal BPD symptoms in the relation between infant temperamental anger and fear and punitive/minimizing emotion socialization. Using a sample of 99 mother-infant dyads, the authors found that maternal BPD symptoms were significantly related to punitive/minimizing emotion socialization and that maternal emotion regulation difficulties mediated this relation. Moreover, maternal BPD symptoms strengthened the association between mother-reported infant anger and punitive/minimizing emotion socialization. These results extend the growing literature on the impact of maternal BPD on child development.
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Affiliation(s)
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, Texas
| | - Matthew T Tull
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
| | - Kim L Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi
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Bujalski AS, Chesin MS, Jeglic EL. Cognitive Empathy Partially Mediates the Relationship between Childhood Physical Abuse and Borderline Personality Disorder Features in College Students. CURRENT PSYCHOLOGY 2017. [DOI: 10.1007/s12144-017-9597-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Trujillo S, Trujillo N, Lopez JD, Gomez D, Valencia S, Rendon J, Pineda DA, Parra MA. Social Cognitive Training Improves Emotional Processing and Reduces Aggressive Attitudes in Ex-combatants. Front Psychol 2017; 8:510. [PMID: 28428767 PMCID: PMC5382221 DOI: 10.3389/fpsyg.2017.00510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/20/2017] [Indexed: 01/15/2023] Open
Abstract
Emotional processing (EP) is a complex cognitive function necessary to successfully adjust to social environments where we need to interpret and respond to cues that convey threat or reward signals. Ex-combatants have consistently shown atypical EP as well as poor social interactions. Available reintegration programs aim to facilitate the re-adaptation of ex-combatants to their communities. However, they do not incorporate actions to improve EP and to enhance cognitive-emotional regulation. The present study was aimed at evaluating the usefulness of an intervention focused on Social Cognitive Training (SCT), which was designed to equip ex-combatants enrolled in the Social Reintegration Route with EP and social cognition skills. A group of 31 ex-combatants (mean age of 37.2, 29 men) from Colombian illegal armed groups were recruited into this study. Of these, 16 were invited to take part in a SCT and the other continued with the conventional reintegration intervention. Both groups underwent 12 training sessions in a period 12–14 weeks. They were assessed with a comprehensive protocol which included Psychosocial, Behavioral, and Emotion Processing instruments. The scores on these instruments prior to and after the intervention were compared within and between groups. Both groups were matched at baseline. Ex-combatants receiving the SCT experienced significant improvements in EP and a reduction in aggressive attitudes, effects not observed in those continuing the conventional reintegration intervention. This is the first study that achieves such outcomes in such a population using SCT intervention. We discuss the implications of such results toward better social reintegration strategies.
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Affiliation(s)
- Sandra Trujillo
- Grupo de Investigación en Salud Mental, Facultad Nacional de Salud Pública, Universidad de AntioquiaMedellín, Colombia.,Doctoral Program in Psychology, Department of Psychology, Universidad de GranadaGranada, España.,Department of Experimental Psychology, University of GranadaGranada, Spain
| | - Natalia Trujillo
- Grupo de Investigación en Salud Mental, Facultad Nacional de Salud Pública, Universidad de AntioquiaMedellín, Colombia.,Grupo de Neurociencias, Universidad de AntioquiaMedellin, Colombia
| | - Jose D Lopez
- SISTEMIC, Facultad de Ingeniería, Universidad de AntioquiaMedellín, Colombia
| | - Diana Gomez
- Grupo de Investigación en Salud Mental, Facultad Nacional de Salud Pública, Universidad de AntioquiaMedellín, Colombia
| | - Stella Valencia
- Grupo de Investigación en Salud Mental, Facultad Nacional de Salud Pública, Universidad de AntioquiaMedellín, Colombia
| | - Jorge Rendon
- Department of Cognitive Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - David A Pineda
- Grupo de Neuropsicología y Conducta, Universidad de AntioquiaMedellin, Colombia
| | - Mario A Parra
- School of Social Sciences, Psychology, Heriot-Watt UniversityEdinburgh, UK.,Cerebro, Cognición y Procesos Sociales, Psicologia, Universidad Autónoma del CaribeBarranquilla, Colombia
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