The Role of Impairments in Self–Other Distinction in Borderline Personality Disorder:  A Narrative Review of Recent Evidence

Meulemeester, Celine De; Lowyck, Benedicte; Luyten, Patrick

doi:10.31234/osf.io/v8crz

Cited by 4 publications

(5 citation statements)

References 178 publications

(297 reference statements)

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“…Indeed, shifts in the representation of the self and of others have long been deemed problematic in BPD (Kernberg, 1980). Empirically, patients experience difficulties alternating between egocentric and altercentric perspectives with face-morphing tasks (De Meulemeester et al, 2021) and show overlapping self-other boundaries on a bodily and cognitive level (De Meulemeester et al, 2021;Luyten et al, 2021). Accordingly, in our study, patient's personal distress in response to others' emotions was increased and cognitive perspective-taking reduced, replicating previous findings on self-reported empathy scales in BPD (Harari et al, 2010;New et al, 2012;Petersen et al, 2016).…”

Section: Discussionsupporting

confidence: 87%

Irony detection, implicit and explicit response biases in patients with borderline personality disorder

Felsenheimer¹,

Kieckhäfer²,

Rapp³

2022

Preprint

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Objectives: Intended meanings in verbal irony differ from those of the actual words. To look behind these words, we need to integrate perspectives of ourselves, others, and their beliefs about us. Although patients with borderline personality disorder (BPD) experience problems in social cognition and schizotypal symptoms, research on irony comprehension mainly focused on the latter. Accounting for possible negative biases in BPD, the current study examined the detection of praising and critical irony in a text message interface. Design: A cross-sectional study including 30 patients and 30 matched healthy controls (HC).Methods: Participants completed measures of cognitive and affective empathy (Interpersonal Reactivity Index, IRI), schizotypal (Schizotypal Personality Questionnaire; SPQ), and borderline symptoms (Borderline Symptom List; BSL-23). Asking for literality and intention ratings of the stimuli, the paradigm allowed to analyze literality detection, implicit and explicit response biases in a signal detection framework.Results: Borderline symptoms explained decreased sensitivity for the detection of literal and ironic statements across groups. While HC showed a negativity bias on an implicit level, BPD perceived praising remarks less praising when explicitly asked, but no difference on critical remarks. Neither empathy, nor schizotypy explained any outcomes. Conclusion: This was the first study to show impaired detection of verbal irony in patients with BPD. While patients were less biased than HC in implicit measurements, they perceived praising remarks as less positive. Results stress the potential resource of non-verbal therapies to establish an appreciating therapeutical environment and contribute to difficulties in self-other distinction in BPD.

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Section: Discussionsupporting

confidence: 87%

Irony detection, implicit and explicit response biases in patients with borderline personality disorder

Felsenheimer¹,

Kieckhäfer²,

Rapp³

2022

Preprint

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“…They constitute the main personality psychopathology captured in Criterion A of the DSM-5 [90] and are largely represented by borderline symptoms [91]. Empirically, patients with BPD experience difficulties alternating between egocentric and altercentric perspectives with face-morphing tasks [54] and show overlapping self-other boundaries on a bodily and cognitive level [53,54]. Accordingly, in our study, patient's personal distress in response to others' emotions was higher and cognitive perspective-taking lower than those of HC, replicating previous findings on self-reported empathy scales in BPD [92][93][94].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple perspectives, however, are an inevitable part of irony [41,51,52]. And understanding irony requires a flexible shift between them -shifts that seems to be harder for individuals with BPD [53][54][55].…”

Section: Introductionmentioning

confidence: 99%

Irony detection in patients with borderline personality disorder: an experimental study examining schizotypal traits, response biases and empathy

Felsenheimer

Kieckhäfer

Rapp

2022

bord personal disord emot dysregul

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Background In verbal irony we often convey meanings that oppose the literal words. To look behind these words, we need to integrate perspectives of ourselves, others, and their beliefs about us. Although patients with borderline personality disorder (BPD) experience problems in social cognition and schizotypal symptoms, research on irony comprehension mainly focused on the schizophrenic spectrum. Accounting for possible negative biases in BPD, the current study examined the detection of praising and critical irony in a text messaging interface. Methods The cross-sectional study included 30 patients and 30 matched controls, who completed measures of cognitive and affective empathy (Interpersonal Reactivity Index, IRI), schizotypal (Schizotypal Personality Questionnaire; SPQ), and borderline symptoms (Borderline Symptom List; BSL-23) and the irony detection task. The irony task contained critical and praising remarks embedded in text messages. Asking for literality (ironic vs. literal) and intention ratings (critical to praising) of the stimuli, it allowed to analyze the sensitivity of literality detection as well as implicit and explicit response biases in a signal detection framework. Results Borderline symptoms explained lower sensitivity for the detection of literal and ironic statements across groups. Whereas HC showed a negativity bias when implicitly asked about the literalness of the statement, patients with BPD perceived praising utterances as less praising when explicitly asked about their perceived intention. Neither empathy nor schizotypy explained outcomes beyond borderline symptoms. Conclusions This was the first study to show lower detection of verbal irony in patients with BPD. While patients were less biased when asked about the literality of a statement, they perceived praising remarks as less positive on explicit measurements. The results highlight the importance of congruent, transparent communication in promoting epistemic trust in individuals with BPD.

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“…Indeed, the disturbances to identity and the paranoid ideations were not pervasive or permanent but mostly moderately and temporarily present, as became clearer once he felt more at ease in the therapeutic setting. Nevertheless, as we argued that the background of safety has a constitutive function for experience and perception, and thus for self-experience and self-perception, it is not surprising that people with BPD can demonstrate symptoms related to disturbances of self-experience and selfhood [50, 51], as more often present in psychosis [52].…”

Section: Disturbances To the Background Of Safetymentioning

confidence: 99%

Borderline We-Space? The Phenomenology of the Background of Safety in Borderline Personality Disorder

Duppen¹,

Schmidt²,

Lowyck

2021

Psychopathology

Self Cite

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Borderline personality disorder (BPD) is a severe psychiatric condition characterized by instability in identity, relationships, and affect. Individuals, with BPD typically lack a coherent sense of self, are highly sensitive to interpersonal stressors, experience intense fluctuations in mood, and frequently engage in impulsive and self-destructive behaviors. Although both empirical research and development of effective psychotherapy have evidently progressed over the past years, many aspects regarding the structure of experience and the life-world typical for persons with BPD are not yet fully understood. Somewhat surprisingly, phenomenological psychopathology has only recently started to pay more attention to the disorder. A comprehensive elaboration of the phenomenology of BPD is therefore still lacking. This article aimed to contribute to such a phenomenological understanding by focusing on what we think is an essential aspect that has yet not been sufficiently addressed: the background of safety. To clarify what this means, we depart from Sandler’s [<i>Int J Psychoan</i>. 1960;41:352–6] psychoanalytic concept and elaborate on it phenomenologically. This leads us to argue that the development of a background of safety requires a particular embodied presence of others, which, in turn, contributes to the constitution of a safe we-space, a shared and familiar environment providing a matrix for the experience of a stable world. However, even when established, the background of safety remains in need of a continuous reconfirmation through corresponding experiences within a sufficiently reliable and controllable environment. The background of safety is vulnerable and open to (interpersonal) disruptions like trauma or neglect. In BPD, we suggest 3 aspects regarding the phenomenology of the background of the safety need to be considered: first, typically, patients with BPD did not develop a robust background of safety in infancy; second, weakening of the background of safety gives rise to symptoms and dynamics typical for BPD; third, these symptoms and dynamics further undermine the possible development of a background of safety in adult life and thus gravitate toward a petrification of the borderline condition, a “stable instability.” To conclude, we examine whether this concept should be understood as a <i>trouble générateur</i> and, last, consider its clinical implications.

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The Role of Impairments in Self–Other Distinction in Borderline Personality Disorder: A Narrative Review of Recent Evidence

Cited by 4 publications

References 178 publications

Irony detection, implicit and explicit response biases in patients with borderline personality disorder

Irony detection, implicit and explicit response biases in patients with borderline personality disorder

Irony detection in patients with borderline personality disorder: an experimental study examining schizotypal traits, response biases and empathy

Borderline We-Space? The Phenomenology of the Background of Safety in Borderline Personality Disorder

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