Cognitive and affective processing of social exclusion in borderline personality disorder and social anxiety disorder

Individuals with Borderline Personality Disorder (BPD) or Social Anxiety Disorder (SAD) suffer from substantial interpersonal dysfunction and have difficulties establishing social bonds. A tendency to form negative first impressions of others could contribute to this by way of reducing approach behavior. We tested whether women with BPD or SAD would show negative impression formation compared to healthy women (HCs). We employed the Thin Slices paradigm and showed videos of 52 authentic target participants to 32 women with BPD, 29 women with SAD, and 37 HCs. We asked participants to evaluate whether different positive or negative adjectives described targets and expected BPD raters to provide the most negative ratings, followed by SAD and HC. BPD and SAD raters both agreed with negative adjectives more often than HCs (e.g., ‘Yes, the person is greedy’), and BPD raters rejected positive adjectives more often (e.g., ‘No, the person is not humble.’). However, BPD and SAD raters did not differ significantly from each other. Additionally, we used the novel process tracing method mouse-tracking to assess the cognitive conflict (via trajectory deviations) raters experienced during decision-making. We hypothesized that HCs would experience more conflict when making unfavorable (versus favorable) evaluations and that this pattern would flip in BPD and SAD. We quantified cognitive conflict via maximum absolute deviations (MADs) of the mouse-trajectories. As hypothesized, HCs showed more conflict when rejecting versus agreeing with positive adjectives. The pattern did not flip in BPD and SAD but was substantially reduced, such that BPD and SAD showed similar levels of conflict when rejecting and agreeing with positive adjectives. Contrary to the hypothesis for BPD and SAD, all three groups experienced substantial conflict when agreeing with negative adjectives. We discuss therapeutic implications of the combined choice and mouse-tracking results.

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The human extended socio-attentional field and its impairment in borderline personality disorder and in social anxiety disorder

Phenomenology and the Cognitive Sciences ◽

10.1007/s11097-019-09621-w ◽

2019 ◽

Vol 19 (1) ◽

pp. 169-189 ◽

Cited By ~ 1

Author(s):

Oren Bader

Keyword(s):

Borderline Personality Disorder ◽

Anxiety Disorder ◽

Personality Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Borderline Personality

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Processing of increased frequency of social interaction in social anxiety disorder and borderline personality disorder

Scientific Reports ◽

10.1038/s41598-021-85027-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anna Weinbrecht ◽

Michael Niedeggen ◽

Stefan Roepke ◽

Babette Renneberg

Keyword(s):

Borderline Personality Disorder ◽

Social Interaction ◽

Anxiety Disorder ◽

Personality Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Positive Emotions ◽

Borderline Personality ◽

Event Related Potential ◽

Outcome Variable

AbstractWe investigated how patients with social anxiety disorder (SAD) and patients with borderline personality disorder (BPD) process an increase in the frequency of social interaction. We used an EEG-compatible version of the online ball-tossing game Cyberball to induce an increase in the frequency of social interaction. In the first condition, each player received the ball equally often (inclusion: 33% ball reception). In the following condition, the frequency of the ball reception was increased (overinclusion: 45% ball reception). The main outcome variable was the event-related potential P2, an indicator for social reward processing. Moreover, positive emotions were assessed. Twenty-eight patients with SAD, 29 patients with BPD and 28 healthy controls (HCs) participated. As expected, HCs and patients with BPD, but not patients with SAD, showed an increase in the P2 amplitude from the inclusion to the overinclusion condition. Contrary to our expectations, positive emotions did not change from the inclusion to the overinclusion condition. EEG results provide preliminary evidence that patients with BPD and HCs, but not patients with SAD, process an increase in the frequency of social interaction as rewarding.

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Altered neural correlates of affective processing after internet-delivered cognitive behavior therapy for social anxiety disorder

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2013.08.012 ◽

2013 ◽

Vol 214 (3) ◽

pp. 229-237 ◽

Cited By ~ 56

Author(s):

Kristoffer N.T. Månsson ◽

Per Carlbring ◽

Andreas Frick ◽

Jonas Engman ◽

Carl-Johan Olsson ◽

...

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Social Anxiety Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Neural Correlates ◽

Affective Processing ◽

Cognitive Behavior

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Facial emotional expression in reaction to social exclusion in borderline personality disorder

Psychological Medicine ◽

10.1017/s0033291711000080 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1929-1938 ◽

Cited By ~ 50

Author(s):

K. Staebler ◽

B. Renneberg ◽

M. Stopsack ◽

P. Fiedler ◽

M. Weiler ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Social Exclusion ◽

Social Contexts ◽

Emotional Reactions ◽

Borderline Personality ◽

Emotional Expressions ◽

Control Group ◽

Coding System ◽

Emotional Facial Expressions

BackgroundDisturbances in social interaction are a defining feature of patients with borderline personality disorder (BPD). In this study, facial emotional expressions, which are crucial for adaptive interactions in social contexts, were assessed in patients with BPD in response to social exclusion.MethodWe examined facial emotional reactions of 35 patients with BPD and 33 healthy controls when playing Cyberball, a virtual ball-tossing game that reliably induces social exclusion. Besides self-reported emotional responses, facial emotional expressions were analyzed by applying the Emotional Facial Action Coding System (EMFACS).ResultsPatients with BPD showed a biased perception of participation. They more readily reported feeling excluded compared to controls even when they were included. In BPD, social exclusion led to an increase in self-reported other-focused negative emotions. Overall, EMFACS analyses revealed that BPD patients reacted with fewer positive expressions and with significantly more mixed emotional expressions (two emotional facial expressions at the same time) compared to the healthy control group when excluded.ConclusionsBesides a negative bias for perceived social participation, ambiguous facial emotional expressions may play an important role in the disturbed relatedness in patients with BPD.

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Affective Processing in Young Adults with Borderline Personality Disorder

European Psychiatry ◽

10.1016/s0924-9338(09)70335-9 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

S. Herpertz

Keyword(s):

Young Adults ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Young Adulthood ◽

Affect Regulation ◽

Young Patients ◽

Borderline Personality ◽

Brain Maturation ◽

Affective Processing ◽

Future Research

Individuals diagnosed with borderline personality disorder usually seek for treatment as adolescents or young adults. As age progresses, longitudinal studies suggest that borderline patients improve psychosocially, suggesting that they may somewhat belatedly achieve the milestones of young adulthood. Affect regulation may be particularly subject to major changes in young adulthood, as the prefrontal brain areas involved in affective processing underlie maturation processes up into the late third decade. From studies in healthy volunteers we know that that the capacity to process positive affects improves with age. Young adults with borderline personality disorder, however, display a negativity bias in emotion recognition and they have difficulties in inhibiting the recall of negative information. Neuroimaging data suggest that they suffer from deficient implicit affect regulation but they are able to profit from explicit strategies to suppress negative emotions, an observation which could have interesting implications for treatment. Regarding future research more efforts on developmental psychopathology on the one hand, brain maturation on the other will help to further understand the nature of borderline personality disorder. Regarding clinical issues early treatment designed to foster affect regulating competencies and self-esteem and to develop interpersonal skills might benefit young patients diagnosed with borderline personality disorder.

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