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.

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.

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

2020 ◽  
Vol 34 (6) ◽  
pp. 827-841 ◽  
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.

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

2018 ◽  
Vol 270 ◽  
pp. 143-153 ◽  
Author(s):  
Nándor Németh ◽  
Péter Mátrai ◽  
Péter Hegyi ◽  
Boldizsár Czéh ◽  
László Czopf ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Theory Of Mind ◽  
Meta Analysis ◽  
Borderline Personality

Hippocampal volume in borderline personality disorder with and without comorbid posttraumatic stress disorder: A meta-analysis

2011 ◽  
Vol 26 (7) ◽  
pp. 452-456 ◽  
Author(s):  
E. Rodrigues ◽  
A. Wenzel ◽  
M.P. Ribeiro ◽  
L.C. Quarantini ◽  
A. Miranda-Scippa ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Hippocampal Volume ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Left And Right

AbstractBackgroundSeveral studies have found a reduction in hippocampal volume in borderline personality disorder (BPD) patients.MethodsIn order to investigate the degree to which comorbid posttraumatic stress disorder (PTSD) could account for reduction in hippocampal volume in these patients, we conducted a systematic review and meta-analysis of studies that compared hippocampal volume in BPD patients with and without PTSD relative to healthy controls.ResultsSeven articles, involving 124 patients and 147 controls, were included. We found a statistically significant reduction for the left and right hippocampus. Data from the four studies that discriminated BPD patients with and without PTSD indicate that hippocampal volumes were reduced bilaterally in BPD patients with PTSD, relative to healthy controls, but that results were mixed for BPD patients without PTSD, relative to healthy controls.ConclusionsResults from this meta-analysis suggest that hippocampal volumes are reduced in patients with BPD, relative to healthy controls, but particularly in cases in which patients are diagnosed with comorbid PTSD.

scholarly journals Common and distinct patterns of grey matter alterations in borderline personality disorder and bipolar disorder: voxel-based meta-analysis

2019 ◽  
Vol 215 (01) ◽  
pp. 395-403 ◽  
Author(s):  
Hua Yu ◽  
Ya-jing Meng ◽  
Xiao-jing Li ◽  
Chengcheng Zhang ◽  
Sugai Liang ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Frontal Cortex ◽  
Grey Matter ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Healthy Controls ◽  
Orbital Frontal Cortex ◽  
The Right

BackgroundWhether borderline personality disorder (BPD) and bipolar disorder are the same or different disorders lacks consistency.AimsTo detect whether grey matter volume (GMV) and grey matter density (GMD) alterations show any similarities or differences between BPD and bipolar disorder.MethodWeb-based publication databases were searched to conduct a meta-analysis of all voxel-based studies that compared BPD or bipolar disorder with healthy controls. We included 13 BPD studies (395 patients with BPD and 415 healthy controls) and 47 bipolar disorder studies (2111 patients with bipolar disorder and 3261 healthy controls). Peak coordinates from clusters with significant group differences were extracted. Effect-size signed differential mapping meta-analysis was performed to analyse peak coordinates of clusters and thresholds (P< 0.005, uncorrected). Conjunction analyses identified regions in which disorders showed common patterns of volumetric alteration. Correlation analyses were also performed.ResultsPatients with BPD showed decreased GMV and GMD in the bilateral medial prefrontal cortex network (mPFC), bilateral amygdala and right parahippocampal gyrus; patients with bipolar disorder showed decreased GMV and GMD in the bilateral medial orbital frontal cortex (mOFC), right insula and right thalamus, and increased GMV and GMD in the right putamen. Multi-modal analysis indicated smaller volumes in both disorders in clusters in the right medial orbital frontal cortex. Decreased bilateral mPFC in BPD was partly mediated by patient age. Increased GMV and GMD of the right putamen was positively correlated with Young Mania Rating Scale scores in bipolar disorder.ConclusionsOur results show different patterns of GMV and GMD alteration and do not support the hypothesis that bipolar disorder and BPD are on the same affective spectrum.Declaration of interestNone.

Rumination in Borderline Personality Disorder: Meta-Analysis

2018 ◽  
Author(s):  
Mara J. Richman ◽  
Zsolt Unoka ◽  
Robert Dudas ◽  
Zsolt Demetrovics
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Meta Analysis ◽  
Borderline Personality ◽  
Therapeutic Interventions ◽  
Sample Type ◽  
Moderator Variables ◽  
Analytic Review ◽  
Self Harm

Borderline personality disorder (BPD) is characterized by deficits in emotion regulation and affective liability. Of this domain, ruminative behaviors have been considered a core feature of emotion dysregulation difficulties. Despite this, inconsistencies have existed in the literature regarding which rumination type is most prominent in those with BPD symptoms. Moreover, no meta-analytic review has been performed to date on rumination in BPD. Taking this into consideration, a meta-analysis was performed to assess how BPD symptoms correlate with rumination, while also considering clinical moderator variables (i.e., BPD symptom domain, co-morbidities, GAF score) and demographic moderator variables (i.e., age, gender, sample type, and education level). Analysis of correlation across rumination domains for the entire sample revealed a medium overall correlation between BPD symptoms and rumination. When assessing types of rumination, the largest correlation was among pain rumination followed by anger, depressive, and anxious rumination. Among BPD symptom domain, affective instability had the strongest correlation with increased rumination, followed by unstable relationships, identity disturbance, and self-harm/ impulsivity, respectively. Demographic variables showed no significance. Clinical implications are considered and further therapeutic interventions are discussed in the context of rumination.

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