Low positive affect display mediates the association between borderline personality disorder and negative evaluations at zero acquaintance

Abstract

Background Several recent studies have demonstrated that naïve raters tend to evaluate individuals with Borderline Personality Disorder (BPD) negatively at zero-acquaintance (i.e., in a ‘first impression’ type situation, where the rater has no knowledge of the individual and no prior interactions with them). Specifically, individuals with BPD were evaluated as less trustworthy, likeable, and cooperative than healthy participants (HCs). Based on previous impression formation studies, we hypothesized that the non-verbal cues positive affect display, negative affect display, and eye contact contribute to negative first impressions of those with BPD. Methods To address this question, we recruited 101 participants that rated the degree of positive affect display, negative affect display, and eye contact in 52 videos of age-and gender-matched BPD and HC participants. We hypothesized that low positive affect display, high negative affect display, and eye contact would mediate the association between group (BPD vs. HC) and ratings of trustworthiness, likeability, and cooperativeness. Results Ratings for positive affect display were significantly lower and those for negative affect display significantly higher for BPD versus HC targets, whereas eye contact did not differ significantly between groups. In multiple mediation models, positive affect display significantly mediated the association between group and trustworthiness/likeability, whereas negative affect display only mediated the association between group and likeability. None of the individual cues was a significant mediator of the association between group and cooperation. Conclusions We emphasize therapeutic possibilities to improve positive affect display –and thus overall first impressions– to increase the chances of forming social bonds for BPD individuals.

Facial Affective Behavior in Borderline Personality Disorder Indicating Two Different Clusters and Their Influence on Inpatient Treatment Outcome: A Preliminary Study

“…In a first step, we examined general facial affective behavior. Corresponding to the results of Benecke and Dammann (2004) , Renneberg et al (2005) , Buchheim et al (2007) , and Hepp et al (2019) , we found a high amount of negative facial affects such as disgust and contempt in our patients. The highest score was found for disgust, which seems to be the predominant emotion for these patients ( Krause, 1998 ; Benecke and Dammann, 2004 ; Buchheim et al, 2007 ).…”

“…Presumably, patients with BPD are chronically in a mental state of being too close to something negative or threatening. The predominance of facial disgust expressions might contribute to the described interpersonal problems of these groups of patients by eliciting negative evaluation (Hepp et al, 2019). In a similar vein, Benecke et al (2011) described a maladaptive cycle of easily triggered internal affective states (e.g., passive-negative affect, such as fear or despair) in patients with severe mental disorders based on problematic former relationship experiences.…”

“…In sum, the result indicated that patients with BPD or patients with a low level of structural integration show more negative facial affective behavior (in particular, disgust) or less positive affect as well as less affiliative behavior than healthy controls (e.g., Buchheim et al, 2007 ; Brüne et al, 2015 ; Bock et al, 2016 ; Hepp et al, 2019 ). Moreover, the patients with BPD were rated more negatively than healthy controls based on visual cues during first acquaintances ( Hepp et al, 2018 ).…”

“…The authors conclude that low expectations of likeability, trustworthiness, and cooperation in persons with BPD could lead to problems in social interactions in the future and therefore maintain the disorder by strengthening their dysfunctional beliefs that they will be rejected and have to protect themselves to prevent negative events. In a subsequent study, Hepp et al (2019) examined which cues (i.e., positive affect display, negative affect display, and eye contact) raters could have used to form their negative judgments about individuals with BPD. Individuals with BPD were rated as showing less positive affect and more negative affect than the healthy controls.…”

Mouse-tracking reveals cognitive conflict during negative impression formation in women with Borderline Personality Disorder or Social Anxiety Disorder

“…We were interested whether targets with BPD would be perceived differently than HC targets and found that individuals with BPD were perceived more negatively than HCs [ 54 ]. Next, we asked a third sample of students to rate observable behavioral cues for all targets, e.g., amount of eye-contact with the camera, and used this as a mediator for the previously observed negative ratings [ 53 ]. Thus, all studies in phase II investigated BPD individuals as targets .…”