Understanding Interpersonal Dysfunction in Borderline Personality Disorder

2017 ◽  
Vol 5 (2) ◽  
pp. 355-366 ◽  
Author(s):  
Annemarie Miano ◽  
Isabel Dziobek ◽  
Stefan Roepke
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Empathic Accuracy ◽  
Healthy Controls ◽  
Heterosexual Couples ◽  
The Core ◽  
Interpersonal Difficulties ◽  
Interpersonal Dysfunction

The core interpersonal dysfunction in borderline personality disorder (BPD) has not yet been conclusively explained. We used a naturalistic dyadic paradigm to test for the presence of functional empathic inaccuracy in BPD, which is a reduced understanding of the partner’s feelings in relationship-threatening situations. A total of 64 heterosexual couples ( N = 128) were videotaped while engaging in (a) neutral (favorite films), (b) personally threatening (personal fears), and (c) relationship-threatening (separation from partner) conversations. Females were either diagnosed with BPD or healthy controls. Empathic accuracy (EA) was measured from the recorded interactions. Healthy couples’ EA was lower during relationship-threatening compared with personally threatening situations. In contrast, women with BPD showed increased EA, relative to the controls, for relationship- versus personally threatening situations. Reduced EA in response to relationship-threatening situations is likely to be relationship protective. This mechanism appears to be defective in women with BPD, which might explain the interpersonal difficulties experienced by BPD individuals.

Progression from interpersonal problems to suicidal ideation and suicidal behavior in borderline personality disorder

2020 ◽  
Author(s):  
Timothy Allen ◽  
Michael Hallquist ◽  
Aidan G.C. Wright ◽  
Alexandre Dombrovski
Keyword(s):  
Borderline Personality Disorder ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Negative Affect ◽  
Structural Equation ◽  
Suicide Attempts ◽  
Borderline Personality ◽  
Equation Modeling ◽  
Interpersonal Dysfunction ◽  
Suicidal Crisis

Importance: Clinicians treating borderline personality disorder (BPD) are often faced with the difficult challenge of assessing when, and for whom, risk for suicide is greatest. Addressing this dilemma requires longitudinal, prospective data from high-risk samples with an elevated base rate of suicide attempts.Objective: To test whether dispositional characteristics modulate the pathway from interpersonal dysfunction to suicide in BPD. Design: This longitudinal, observational study was conducted between 1990 and 2020. Data were analyzed between April and July 2020. Participants were assessed annually for up to 30 years (mean number of follow-ups = 7.82). Setting: Participants were recruited from inpatient, outpatient, and community referral sources.Participants: 458 individuals (Mean age = 28.59, 77% female) diagnosed with BPD.Main Outcomes and Measures: Presence or absence of a suicide attempt within one year of each follow-up assessment. Multilevel structural equation modeling was used to 1) examine longitudinal, within-person transitions from interpersonal dysfunction to suicidal ideation to suicide attempts (i.e., the [I]nterpersonal-[I]deation-[A]ttempt pathway); and 2) evaluate whether two maladaptive personality dimensions, negative affect and disinhibition, moderated these transitions.Results: At the within-person level, there was support for the I-I-A pathway: suicidal ideation accounted for the association between interpersonal dysfunction and suicide attempts. Personality further moderated each component of the I-I-A pathway: negative affect was associated with a stronger coupling between interpersonal dysfunction and ideation; and disinhibition was associated with a stronger coupling between ideation and attempts. Conclusions and Relevance: The escalation from interpersonal difficulties to a suicidal crisis in BPD involves two psychologically distinct process. An internalizing process links interpersonal dysfunction to suicidal ideation and is facilitated by trait negative. An additional externalizing process links suicidal ideation to suicide attempts, and is facilitated by trait disinhibition. Assessment of these intra- and interindividual risk factors may inform clinical decisions about when, and for whom, crisis intervention is necessary.

Acetaminophen Reduces Distrust in Individuals With Borderline Personality Disorder Features

2017 ◽  
Vol 6 (1) ◽  
pp. 145-154 ◽  
Author(s):  
Ian D. Roberts ◽  
Ian Krajbich ◽  
Jennifer S. Cheavens ◽  
John V. Campo ◽  
Baldwin M. Way
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Assessment ◽  
Personality Assessment Inventory ◽  
Borderline Personality ◽  
Trust Game ◽  
Placebo Condition ◽  
Double Blind ◽  
Adult Participants ◽  
Interpersonal Difficulties

People with borderline personality disorder (BPD) tend to distrust others. We hypothesized that acetaminophen might reduce distrust in people with high BPD features because disordered affective responses are partially responsible for the interpersonal difficulties of people with BPD features, and acetaminophen has been shown in multiple studies to reduce negative affect. Using a double-blind, parallel-arm design, 284 young adult participants were administered either acetaminophen (1,000 mg; acute) or placebo and subsequently completed an economic trust game. BPD features were assessed with the Personality Assessment Inventory–Borderline Features scale. Participants with elevated BPD features showed less trust in their partners in the placebo condition but increased trust in the acetaminophen condition. Acetaminophen did not change expectations of trustee’s trustworthiness and did not impact trusting behavior in participants low in BPD features. Our results indicate that acetaminophen may reduce the behavioral distrust exhibited at high levels of BPD features.

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.

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.

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.

scholarly journals Effects of intranasal oxytocin administration on empathy and approach motivation in women with borderline personality disorder: a randomized controlled trial

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Gregor Domes ◽  
Nicole Ower ◽  
Bernadette von Dawans ◽  
Franny B. Spengler ◽  
Isabel Dziobek ◽  
...  
Keyword(s):  
Single Dose ◽  
Social Cognition ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Beneficial Effect ◽  
Borderline Personality ◽  
Affective Empathy ◽  
Approach Motivation ◽  
Healthy Controls ◽  
Social Approach

AbstractBorderline personality disorder (BPD) is characterized by severe interpersonal dysfunction with problems in social cognition, empathy and social approach. Although the neuropeptide oxytocin is known to regulate complex social cognition and behavior in healthy individuals and clinical populations, there is still a lack of evidence for a potential beneficial effect of oxytocin administration on social cognition and social approach in BPD. Fifty-one women with BPD and 51 matched healthy controls were randomized to a double-blind, placebo-controlled, between-subject experimental trial. We administered a single dose of 24 IU oxytocin or placebo intranasally prior to a standardized task measuring affective and cognitive empathy and approach motivation. All participants were free of hormonal contraception and tested in the mid-luteal phase of their menstrual cycle. In the placebo condition, patients with BPD showed reduced cognitive and affective empathy, and less approach behavior motivation than healthy controls. Intranasal oxytocin significantly increased affective empathy and approach motivation in both BPD patients and healthy controls compared to placebo. More importantly, oxytocin administration led to similar scores between BPD and healthy controls. These findings provide the first evidence for a beneficial effect of oxytocin on deficits in affective empathy and approach motivation of BPD. Our results indicate a beneficial effect of a single dose of oxytocin on affective empathy and approach motivation in women with BPD adapting their level of social functioning to healthy controls. Future clinical trials will need to investigate the long-term effects and effectiveness of oxytocin as an add-on treatment for social impairments in BPD.

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