Impaired complex theory of mind and low emotional self-awareness in outpatients with borderline personality disorder compared to healthy controls: A cross-sectional study

Abstract Background It is widely accepted that borderline personality disorder (BPD) is associated with significant impairments in mentalization and theory of mind (ToM) which are considered as closely related concepts by many authors particularly in psychoanalytical circles. However, for understanding interpersonal difficulties in personality disorders, it is important to distinguish neuro-social cognitive impairment from the abnormal meta-social-cognitive style of patients. Methods The current systematic review aimed to conduct separate meta-analyses of ‘mentalization’ [reflective functioning (RF] and different aspects of ToM in BPD. A literature search was conducted to locate relevant articles published between January 1990 to July 2021. Random-effect meta-analyses were conducted in 34 studies involving 1448 individuals with BPD and 2006 healthy controls. Results A very large impairment in RF was evident in BPD [d = 1.68, confidence interval (CI) = 1.17–2.19]. In contrast, ToM impairment was modest (d = 0.36, CI = 0.24–0.48). BPD patients underperformed healthy controls in ToM-reasoning (d = 0.44, CI = 0.32–0.56) but not ToM-decoding. Increased HyperToM (d = 0.60, CI = 0.41–0.79) and faux pas recognition (d = 0.62, CI = 0.35–0.90) errors in BPD compared to healthy controls were most robust ToM findings in this meta-analysis. Conclusions BPD is characterized by very severe deficits in RF and modest and selective abnormalities in ToM. Interpersonal problems and difficulties in processing social information in BPD can be best explained by patients' maldaptive meta-social cognitive style and top-down effects of these abnormalities rather than having a primary neuro-social cognitive deficit.

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Are Impairments in Theory of Mind Specific to Borderline Personality Disorder?

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_417 ◽

2020 ◽

Vol 34 (6) ◽

pp. 827-841 ◽

Cited By ~ 3

Author(s):

Eivind Normann-Eide ◽

Bj⊘rnar Torske Antonsen ◽

Elfrida Hartveit Kvarstein ◽

Geir Pedersen ◽

Anja Vaskinn ◽

...

Keyword(s):

Social Cognition ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Theory Of Mind ◽

Personality Disorders ◽

Interpersonal Problems ◽

Borderline Personality ◽

Healthy Controls ◽

Per Se ◽

The Relationship

Impaired theory of mind (ToM) is an assumed feature of borderline personality disorder (BPD). Yet, no studies have compared ToM abilities in patients with BPD, other personality disorders, and healthy controls, or investigated the relationship between ToM and severity of psychopathology and interpersonal problems. In this study, ToM was investigated by the Movie for the Assessment of Social Cognition. No differences were found between the three groups in overall ToM abilities. The BPD group was, however, characterized by more excessive ToM (interpreted as hypermentalization). Yet, when differentiating between BPD and further severity indicators, excessive ToM was not specifically associated with a BPD diagnosis per se. Finally, there was a moderate association between hypermentalization and interpersonal problems in the BPD group. This study suggests that BPD patients tend to hypermentalize when they misinterpret social information, and that this tendency is related to the severity of their psychopathology.

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Sub-clinical borderline personality disorder symptoms as predictor of suicidality and non-suicidal self-injury in young Pakistani females

Journal of the Pakistan Medical Association ◽

10.47391/jpma.1088 ◽

2020 ◽

pp. 1-10

Author(s):

Gull Zareen ◽

Farzana Ashraf ◽

Admin

Keyword(s):

Borderline Personality Disorder ◽

Suicidal Ideation ◽

Personality Disorder ◽

Cross Sectional Study ◽

Borderline Personality ◽

Clinical Population ◽

Future Research ◽

Cross Sectional ◽

Self Injury ◽

Personality Features

Abstract The aim of this study was to determine if suicidal and non-suicidal self-injury can be predicted by the symptoms of Borderline Personality Disorder (BPD) and if non-suicidal self-injury predicts suicidality in young adult females. In this cross-sectional study, 150 undergraduate females (mean age 20.47±3.17) were conveniently sampled and assessed on McLean Screening Instrument for Borderline Personality Disorder, Suicidal Behaviour Questionnaire-Revised, and the Inventory of Statements about Self-injury. Borderline Personality features significantly predicted suicidal ideation and behaviour (?=.383, p<.001) and non-suicidal self-injury (?.282, p<.01). Likewise, non-suicidal self-injury was positively associated with suicidality (r =.330, p<.01). Even sub-threshold BPD features in a non-clinical population may be predictive of suicidal and non-suicidal self-injury. Future research should be based on the management and interventional strategies for tested constructs. Further, screening measures need to be introduced to better detect population at risk of subclinical BPD, suicidal ideation and self-injury. Keywords: Suicidal, Self-injury, Continuous...

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