Social cognition in borderline personality disorder

Abstract

Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in mental state attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.

Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature

“…There is increasing evidence from both clinical and nonclinical samples that adverse childhood experiences are associated with deficits in social cognitive processes such as emotion perception and theory of mind (Barahal et al 1981;Cicchetti et al 2003;Pears & Fisher, 2005;Koizumi & Takagishi, 2014). Social cognitive deficits are a core impairment of borderline personality disorder and are thought to be worsened by childhood maltreatment (Roepke et al 2013). Among 143 patients with a schizophrenia-spectrum diagnosis or bipolar disorder, social functioning was best amongst those patients who performed well on a social inference and theory of mind task and exhibited a lower external locus of control, regardless of history of childhood physical abuse (Choi et al 2011).…”

Aberrant link between empathy and social attribution style in borderline personality disorder

“…Empathy can be defined as the ability to understand and share the feelings of others (Haas and Miller, 2015), and as such lies at the heart of social cognition (Roepke et al, 2013). Sharing the feelings of others may be seen as the spontaneous dimension of empathy, and partly for this reason, it is also what has lead some authors to question the supposedly positive view on empathy (Rifkin, 2010) altogether (Bloom, 2013(Bloom, , 2017Lamm and Majdanduic, 2015).…”

“…Key findings include reduced activity in the left superior temporal cortex when inferring others' mental states together with increased responsiveness of the right midinsula and left posterior insula when sharing others' emotions (Dziobek et al, 2011;Mier et al, 2013;Roepke et al, 2013). In addition, activity in the temporoparietal junction and superior temporal sulcus scaled negatively with borderline symptoms in an emotional perspective-taking task (Haas and Miller, 2015).…”

De-stigmatising manipulation: An exercise in second-order empathic understanding

“…Impaired social cognition or deficits in 'mentalisation' are hypothesised to underlie disturbed relatedness, a core feature of borderline personality disorder. [10] We may argue that disturbed relatedness, through impaired social cognition, is the outcome of dysphoric mood. [11,12] In other terms, dysphoria sets a person in a kind of life-world dominated by cognitive indecision and lack of grasp on the meaning of things and on the intentions of the others -as it is indeed the case with our patient.…”