Facial and Vocal Expressions During Clinical Interviews Suggest an Emotional Modulation Paradox in Borderline Personality Disorder: An Explorative Study

Abstract

Videotape recordings obtained during an initial and conventional psychiatric interview were used to assess possible emotional differences in facial expressions and acoustic parameters of the voice between Borderline Personality Disorder (BPD) female patients and matched controls. The incidence of seven basic emotion expressions, emotional valence, heart rate, and vocal frequency (f0), and intensity (dB) of the discourse adjectives and interjections were determined through the application of computational software to the visual (FaceReader) and sound (PRAAT) tracks of the videotape recordings. The extensive data obtained were analyzed by three statistical strategies: linear multilevel modeling, correlation matrices, and exploratory network analysis. In comparison with healthy controls, BPD patients express a third less sadness and show a higher number of positive correlations (14 vs. 8) and a cluster of related nodes among the prosodic parameters and the facial expressions of anger, disgust, and contempt. In contrast, control subjects showed negative or null correlations between such facial expressions and prosodic parameters. It seems feasible that BPD patients restrain the facial expression of specific emotions in an attempt to achieve social acceptance. Moreover, the confluence of prosodic and facial expressions of negative emotions reflects a sympathetic activation which is opposed to the social engagement system. Such BPD imbalance reflects an emotional alteration and a dysfunctional behavioral strategy that may constitute a useful biobehavioral indicator of the severity and clinical course of the disorder. This face/voice/heart rate emotional expression assessment (EMEX) may be used in the search for reliable biobehavioral correlates of other psychopathological conditions.

Automatic detection of facial expressions during the Cyberball paradigm in Borderline Personality Disorder: a pilot study

“…These findings were interpreted in light of the challenges individuals with BPD encounter when engaging in social interactions, stemming from an initial heightened activation response. Consistent with the hypothesis of the emotional modulation paradox in patients with BPD, reports of autonomic nervous system activations associated with fight-or-flight responses (i.e., increased heart rate) have been observed during both the Cyberball paradigm and interviews, rather than a predominant involvement of the ventral vagal parasympathetic branch, which is linked to the social engagement system ( 28 ).…”

Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review

“…Moreover, emotional regulation deficits have been described in children and adolescents with this condition ( Romani et al, 2018 ). This may manifest as altered facial emotion recognition (FER), which has also been described in individuals with borderline personality disorder, autism spectrum disorders (ASD), Parkinson’s disease, and schizophrenia ( Romani et al, 2018 ; Villanueva-Valle et al, 2021 ).…”

“…Emotions can be divided into positive emotions such as surprise and happiness, negative emotions such as madness, sadness, fear, and disgust, and neutral facial expressions ( Greco et al, 2021 ). Emotional deficits have been examined according to changes in emotional vocalizations as well as changes in biological parameters such as heart rate, which are related to autonomic responses ( Villanueva-Valle et al, 2021 ).…”