scholarly journals Enhanced ‘Reading the Mind in the Eyes’ in borderline personality disorder compared to healthy controls

2009 ◽  
Vol 39 (12) ◽  
pp. 1979-1988 ◽  
Author(s):  
E. A. Fertuck ◽  
A. Jekal ◽  
I. Song ◽  
B. Wyman ◽  
M. C. Morris ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental State ◽  
Emotional State ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Depression Severity ◽  
The Face ◽  
Axis I ◽  
The Mind

BackgroundBorderline personality disorder (BPD) is partly characterized by chronic instability in interpersonal relationships, which exacerbates other symptom dimensions of the disorder and can interfere with treatment engagement. Facial emotion recognition paradigms have been used to investigate the bases of interpersonal impairments in BPD, yielding mixed results. We sought to clarify and extend past findings by using the Reading the Mind in the Eyes Test (RMET), a measure of the capacity to discriminate the mental state of others from expressions in the eye region of the face.MethodThirty individuals diagnosed with BPD were compared to 25 healthy controls (HCs) on RMET performance. Participants were also assessed for depression severity, emotional state at the time of assessment, history of childhood abuse, and other Axis I and personality disorders (PDs).ResultsThe BPD group performed significantly better than the HC group on the RMET, particularly for the Total Score and Neutral emotional valences. Effect sizes were in the large range for the Total Score and for Neutral RMET performance. The results could not be accounted for by demographics, co-occurring Axis I or II conditions, medication status, abuse history, or emotional state. However, depression severity partially mediated the relationship between RMET and BPD status.ConclusionsMental state discrimination based on the eye region of the face is enhanced in BPD. An enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.

scholarly journals Mentalizing Based on External Features in Borderline Personality Disorder Compared With Healthy Controls: The Role of Attachment Dimensions and Childhood Trauma

2019 ◽  
Vol 33 (6) ◽  
pp. 736-750 ◽  
Author(s):  
Martijn Van Heel ◽  
Patrick Luyten ◽  
Celine De Meulemeester ◽  
Dominique Vanwalleghem ◽  
Rudi Vermote ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Childhood Trauma ◽  
Mental States ◽  
Borderline Personality ◽  
Control Group ◽  
Healthy Controls ◽  
Avoidant Attachment ◽  
The Mind ◽  
Attachment Dimensions

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.

scholarly journals Mental state decoding impairment in major depression and borderline personality disorder: Meta-analysis

2015 ◽  
Vol 207 (6) ◽  
pp. 483-489 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka
Keyword(s):  
Borderline Personality Disorder ◽  
Major Depression ◽  
Personality Disorder ◽  
Mental State ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Clinical Feature ◽  
Cross Sectional ◽  
Positive Valence ◽  
The Mind

BackgroundPatients with major depression and borderline personality disorder are characterised by a distorted perception of other people's intentions. Deficits in mental state decoding are thought to be the underlying cause of this clinical feature.AimsTo examine, using meta-analysis, whether mental state decoding abilities in patients with major depression and borderline personality disorder differ from those of healthy controls.MethodA systematic review of 13 cross-sectional studies comparing Reading in the Mind of the Eyes Test (RMET) accuracy performance of patients with major depression or borderline personality disorder and healthy age-matched controls (n = 976). Valence scores, where reported, were also assessed.ResultsLarge significant deficits were seen for global RMET performance in patients with major depression (d =–0.751). The positive RMET valence scores of patients with depression were significantly worse; patients with borderline personality disorder had worse neutral scores. Both groups were worse than controls. Moderator analysis revealed that individuals with comorbid borderline personality disorder and major depression did better than those with borderline personality disorder alone on accuracy. Those with comorbid borderline personality disorder and any cluster B or C personality disorder did worse than borderline personality disorder alone. Individuals with both borderline personality disorder and major depression performed better then those with borderline personality disorder without major depression for positive valence.ConclusionsThese findings highlight the relevance of RMET performance in patients with borderline personality disorder and major depression, and the importance of considering comorbidity in future analysis.

Shame in Borderline Personality Disorder: Meta-Analysis

2021 ◽  
Vol 35 (Supplement A) ◽  
pp. 149-161
Author(s):  
Tzipi Buchman-Wildbaum ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Gabriella Vizin ◽  
Zsolt Demetrovics ◽  
...  
Keyword(s):  
Systematic Review ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Meta Analysis ◽  
Education Level ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Moderator Variables ◽  
Core Feature ◽  
Ptsd Symptomatology

Shame has been found to be a core feature of borderline personality disorder (BPD). To date, there is no existing systematic review or meta-analysis examining shame in individuals with BPD as compared to healthy controls (HCs). A meta-analysis of 10 studies comparing reported shame in BPD patients to HCs was carried out. Demographic and clinical moderator variables were included to see if they have a relationship with the effect size. Results showed that those with BPD had more reported shame than healthy controls. In addition, in BPD patients and HCs, higher education level was related to lower reported shame. In HCs, it was found that those who were younger reported a higher level of shame. Finally, among BPD patients, there was a relationship between levels of reported shame and elevated PTSD symptomatology. These findings emphasize the clinical relevance of shame in individuals with BPD and the need to formulate psychotherapeutic strategies that target and decrease shame.

A meta-analysis of theory of mind and ‘mentalization’ in borderline personality disorder: a true neuro-social-cognitive or meta-social-cognitive impairment?

2021 ◽  
pp. 1-11
Author(s):  
Emre Bora
Keyword(s):  
Cognitive Impairment ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Theory Of Mind ◽  
Cognitive Style ◽  
Social Cognitive ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Meta Analyses

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.

The Relationship Between Cognitive Abilities and Trait Clinical Features in Patients With Borderline Personality Disorder

2021 ◽  
Vol 35 (5) ◽  
pp. 730-749
Author(s):  
Martino Belvederi Murri ◽  
Federica Folesani ◽  
Silvia Costa ◽  
Bruno Biancosino ◽  
Luigi Zerbinati ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Clinical Features ◽  
Cognitive Functions ◽  
Borderline Personality ◽  
Brief Symptom Inventory ◽  
Structure Questionnaire ◽  
Healthy Controls ◽  
Personality Dysfunction ◽  
The Relationship

Very few studies have focused on the relationship between cognitive functions and clinical features in borderline personality disorder (BPD). Subjects with BPD and healthy controls were administered the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test A and B, and the Wisconsin Card Sorting Test. The Brief Symptom Inventory (BSI-53) was used to assess the severity of current symptoms. Attachment style was assessed with the Experiences in Close Relationship Questionnaire, identity integration with the Personality Structure Questionnaire, and other domains of personality dysfunction with the RUDE Scale for Personality Dysfunction. Patients with BPD performed significantly worse than healthy controls in all cognitive domains. Cognitive functions, particularly delayed memory and visuospatial abilities, displayed meaningful associations with trait-like clinical features, above the effect of global cognition and state psychopathology. These findings highlight the need to evaluate effects of cognitive rehabilitation on trait features among individuals with BPD.

Economic Evaluation of a Mobile Diary App versus Paper-based Diary Cards for Patients with Borderline Personality Disorder (Preprint)

2021 ◽  
Author(s):  
Sidsel Lund Laursen ◽  
Astrid Langergaard ◽  
Jesper Søndergaard ◽  
Sabrina Storgaard Sørensen ◽  
Stig Helweg-Jørgensen ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Data Collection ◽  
Suicidal Behaviour ◽  
Borderline Personality ◽  
Healthcare Sector ◽  
Qaly Gain ◽  
Depression Severity ◽  
Advantages And Disadvantages ◽  
Psychiatric Outpatient

BACKGROUND The use of mobile diary applications (apps) in dialectical behaviour therapy (DBT) could entail several positive consequences, such as allowing therapists to follow their patients during treatment. OBJECTIVE The objective of this study was to examine the costs and consequences of using a mobile diary app compared to paper-based diary cards in DBT treatment for patients with borderline personality disorder (BPD) in a psychiatric outpatient facility to develop the current knowledge. METHODS The study was conducted alongside a pragmatic, multicentre randomized controlled trial. Participants were recruited at five Danish psychiatric outpatient facilities and were randomized to register emotions, urges, and skills use in a mobile diary app or on paper-based diary cards. Participants in both groups received DBT delivered by therapists. A cost-consequence analysis with a time horizon of 12 months was undertaken. Consequences included quality-adjusted life years (QALY), depression severity, borderline severity, suicidal behaviour, healthcare use, and treatment compliance. Moreover, advantages and disadvantages of using a mobile diary app were studied. All relevant costs were included. RESULTS In total, 78 participants were included in the analysis. Participants in both groups had a QALY gain, and a decrease in depression severity, borderline severity, and suicidal behaviour. Significant differences were found between the app group and the paper group for both QALY gain (adjusted difference -0.054, SE 0.03) and depression severity (adjusted difference -1.11, SE 1.57). The use of services in the healthcare sector was similar across both time points and groups (difference: psychiatric hospitalization <5 and <5, general practice -1.32, SE 3.68 and 2.02, SE 3.19). An insignificantly higher number of participants in the paper group dropped out before treatment start (P value .07). Of those starting treatment, participants in the app group had an average of 37.1 (SE 27.55) more days of treatment and registered an average of 3.16 (SE 5.10) more skills per week than participants in the paper group. The mobile diary app was considered timesaving as it was expected to be 1 minute faster to complete. Advantages of the app were the opportunity to choose between different methods of registering; comparative ease of use; increased self-insight; and a new type of data collection. Disadvantages were a negative influence on the therapist-patient interaction; worries about performance goals; reduced flexibility in data collection; and implementation issues. The between-group difference in total costs ranged from £78.15-234.44 per participant during the 12-months. CONCLUSIONS A mobile diary app can potentially entail several positive consequences for patients suffering from BPD although at a higher cost than paper-based diary cards. A mobile diary app might contribute with new information on the patients, which is not available from the paper diary. Further research is encouraged, as this is still a new field. CLINICALTRIAL ClinicalTrials.gov NCT03191565 INTERNATIONAL REGISTERED REPORT RR2-

Self-Compassion Mediates the Relationship Between Mindfulness and Borderline Personality Disorder Symptoms

2018 ◽  
Vol 32 (6) ◽  
pp. 838-856 ◽  
Author(s):  
Hannah J. Scheibner ◽  
Anna Daniels ◽  
Simon Guendelman ◽  
Franca Utz ◽  
Felix Bermpohl
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Symptom Severity ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Psychological Process ◽  
Healthy Controls ◽  
Self Compassion ◽  
Nonclinical Sample ◽  
The Relationship

Individuals suffering from borderline personality disorder (BPD) experience difficulties with mindfulness. How mindfulness influences BPD symptoms, however, is still unknown. We hypothesized that the relationship between mindfulness and BPD symptoms would be mediated by self-compassion. In study 1, we recruited 29 individuals with BPD and 30 group-matched healthy controls. In study 2, we complemented our results with findings from a larger, nonclinical sample of 89 participants that were recruited during an open-house event at the local university. All participants completed questionnaires assessing self-compassion, mindfulness, BPD symptom severity, and emotion dysregulation. In both studies, self-compassion mediated the relationship between mindfulness and BPD symptom severity as well as between mindfulness and emotion dysregulation. Self-compassion seems to be one psychological process that could explain the relationship between mindfulness and BPD symptoms. One promising approach in therapy could be to target self-compassion more directly during mindfulness trainings and interventions.

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