Enhanced ‘Reading the Mind in the Eyes’ in borderline personality disorder compared to healthy controls

Abstract

Background Borderline personality disorder (BPD) is partly characterized by chronic instability in interpersonal relationships, which exacerbates other symptom dimensions of the disorder and can interfere with treatment engagement. Facial emotion recognition paradigms have been used to investigate the bases of interpersonal impairments in BPD, yielding mixed results. We sought to clarify and extend past findings by using the Reading the Mind in the Eyes Test (RMET), a measure of the capacity to discriminate the mental state of others from expressions in the eye region of the face. Method Thirty individuals diagnosed with BPD were compared to 25 healthy controls (HCs) on RMET performance. Participants were also assessed for depression severity, emotional state at the time of assessment, history of childhood abuse, and other Axis I and personality disorders (PDs). Results The BPD group performed significantly better than the HC group on the RMET, particularly for the Total Score and Neutral emotional valences. Effect sizes were in the large range for the Total Score and for Neutral RMET performance. The results could not be accounted for by demographics, co-occurring Axis I or II conditions, medication status, abuse history, or emotional state. However, depression severity partially mediated the relationship between RMET and BPD status. Conclusions Mental state discrimination based on the eye region of the face is enhanced in BPD. An enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.

Recognition of Emotional Facial Expressions in Alexithymia

“…We also classified the stimuli used in the Eyes task into three emotional valence categories: positive (8 items), neutral (16 items) and negative (12 items), using the criterion of Yildirim et al (2011) and Fertuck et al (2009).…”

The Borderline Empathy Paradox: Evidence and Conceptual Models for Empathic Enhancements in Borderline Personality Disorder

“…Consistent with some of the facial expression recognition research, Preißler et al (2010) argued that the higher sensitivity of the MASC reveals a reduction in the ability of individuals with BPD to integrate complex social information, especially when time is constrained. In contrast, Fertuck et al (2009) (2009) control group may have reduced control scores to a lower end of the range than is normally reported in control subjects, and therefore increased the probability of detecting group differences.…”

“…This general lack of study may be attributable in part to the questions of whether or not the phenomenon actually exists, and furthermore, if it can be clearly and reliably documented and explained. Recent studies have reported both enhanced (i.e., Fertuck et al, 2009;Franzen et al, 2011;Frick et al 2012) and impaired (i.e., Preißler, Dziobek, Ritter, Heekeren, & Roepke, 2010) social cognition in BPD, but the evidence for borderline empathy has yet to be comprehensively reviewed and evaluated in the context of alternative hypotheses for causation. In this article, we evaluate the existing evidence for enhanced empathy in BPD by systematically searching the literature and providing an overview of the relevant studies with consideration of their varying methodological approaches.…”

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

“…Previous findings regarding empathy in BPD have been conflicting: some studies showed that patients exhibit less empathy compared to controls (Minzenberg et al, 2006;Preißler et al, 2010;Fertuck et al, 2009), while others found evidence for heightened empathy (Franzen et al, 2011;Dinsdale and Crespi, 2013) in patients. Although this conflicting pattern has been explained by referring to the different domains of empathy that show reduced cognitive empathy in BPD patients with unchanged or even heightened affective empathy (reviewed in Dinsdale and Crespi, 2013), here we found that even the affective domain of empathy may be reduced, possibly reflecting a compensatory response in order to protect from emotional contagion through the emotions of others that has been found in BPD (Dinsdale and Crespi, 2013).…”