Individuals with Borderline Personality Disorder manifest cognitive biases implicated in psychosis

Puri, Priya; Kumar, Deepak; Muralidharan, Kesavan; Kishore, M. Thomas

doi:10.1016/j.psychres.2018.06.040

Cited by 10 publications

(12 citation statements)

References 31 publications

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“…For the first time, these impairments have been confirmed with respect to verbal irony. This is of particular importance, as other forms of nonliteral language commonly impaired in the schizophrenic spectrum (i.e., metaphors) seem to be preserved in BPD (Felsenheimer et al, 2020) although both share common symptoms (Kwapil et al, 2021;Puri et al, 2018). In addition to emphasizing that linguistic phenomena are subject to different cognitive structures, this shows that psychopathologies may be subject to them as well.…”

Section: Discussionmentioning

confidence: 95%

“…BPD is eponymously described as the 'border' between psychosis and neurosis (Kernberg, 1980). Recent research has demonstrated that individuals with BPD share cognitive (Puri et al, 2018), schizotypal traits (Kwapil et al, 2021), and/or psychotic symptoms (Cavelti et al, 2021;D'Agostino et al, 2019;Moritz et al, 2011;Slotema et al, 2012Slotema et al, , 2017. Such a transdiagnostic symptomatology challenges the differential diagnostic specificity of language phenomena that have traditionally been ascribed to schizophrenia (Bleuler, 1911).…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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

Felsenheimer¹,

Kieckhäfer²,

Rapp³

2022

Preprint

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“…Similar to the results of the maladaptive schema modes, the quantitative and qualitative data revealed that individuals with BPD tend to use various cognitive distortions frequently. The most commonly evident cognitive distortion was “should statements” (9.17%), followed by “jumping to conclusions,” “all‐or‐none thinking,” “labeling,” and “personalization.” Previous studies have indicated the presence of jumping to conclusions (Moritz et al, 2011; Puri et al, 2018) and dichotomous thinking (Arntz & ten Haaf, 2012; Moritz et al, 2011; Napolitano & McKay, 2007) in individuals with BPD. Findings of this study show that there is a need for exploring other cognitive distortions in individuals with BPD also as they seemingly manifest many cognitive distortions that can have a bearing on their thought process.…”

Section: Discussionmentioning

confidence: 95%

“…“dichotomous thinking” (Arntz & ten Haaf, 2012; Napolitano & McKay, 2007). A few studies have reported the presence of other cognitive distortions such as thought‐abandonment fusion, jumping to conclusions, belief inflexibility bias, attribution bias, and catastrophization in individuals with BPD (del Pozo et al, 2018; Moritz et al, 2011; Puri et al, 2018; Schilling et al, 2015; Winter et al, 2015); nonetheless, more research is needed to validate the findings of these studies. Furthermore, to the best of our knowledge, there is a dearth of studies examining cognitive distortions and schema modes together in people with BPD despite the indications that cognitive distortions may perpetuate maladaptive schemas (Young et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Evaluating schema modes and cognitive distortions in borderline personality disorder: A mixed‐method approach

et al. 2021

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Objectives Cognitive processes, such as schema modes and cognitive distortions, may play a role in the genesis and maintenance of affective, interpersonal, and behavioral difficulties in individuals with Borderline Personality Disorder (BPD). This study aimed at exploring the schema modes and cognitive distortions in individuals with BPD. Methods Using a mixed‐method approach, 30 individuals with BPD and 30 healthy participants were assessed on the Borderline Personality Questionnaire, the Schema Mode Inventory, the Cognitive Distortions Scale, and a semi‐structured interview schedule. Results The BPD group had higher scores than the control group on all the maladaptive schema modes and cognitive distortions subscales. The child modes were the commonest and were also the strongest correlate of BPD symptomatology. Qualitative analysis of the content of the semi‐structured interview also corroborated these findings. Conclusions There could be many schema modes and cognitive distortions operating behind the diverse psychopathology seen in BPD.

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“…Other forms of nonliteral language, such as metaphors, have recently been shown to be preserved in BPD [ 78 ]. This is of particular importance, as metaphor comprehension is commonly impaired in schizophrenia [ 79 ] with whom BPD patients share symptoms [ 32 , 33 ]. Contrary to other studies [ 28 , 29 , 40 , 63 , 80 ], schizotypal symptoms did not explain irony detection beyond borderline symptoms, although patients scored high on both.…”

Section: Discussionmentioning

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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Individuals with Borderline Personality Disorder manifest cognitive biases implicated in psychosis

Cited by 10 publications

References 31 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

Evaluating schema modes and cognitive distortions in borderline personality disorder: A mixed‐method approach

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

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