Negative feelings toward borderline patients: Are layperson emotional reactions disorder-specific?

Abstract

Patients with borderline personality disorder (BPD) are typically confronted with others having negative emotional reactions toward them. This is especially the case with therapeutic laypersons in the health care system as well as in their social surroundings. It is unclear, however, whether these reactions are specific to BPD or associated more broadly with poor ego functioning. In this experimental analogue study, therapeutic laypersons (N = 147) were asked to watch 20-min video segments showing different types of patients talking about an interpersonal conflict. There were three conditions: (a) patients with BPD and low levels of structural integration (LSI), (b) patients without any cluster B personality disorder and with low LSI, and (c) patients without any cluster B personality disorder and moderate LSI. Axis-I-diagnoses of all patients were mood and/or anxiety disorders. The videos and their sequence were counterbalanced across participants. After each video, participants responded to the Emotional Experience and Emotion Regulation Questionnaire (EER) and the Operationalized Psychodynamic Diagnosis-Interpersonal Relations Axis (OPD-IRA). Compared to patients with moderate LSI, patients with BPD as well as other patients with low LSI evoked more active negative emotions among participants, and patients with BPD evoked more self-perceived tendencies to engage in negative interpersonal behavior. There were no significant differences in reactions toward patients with low LSI with or without BPD. Results indicate that negative emotional reactions might be associated more broadly with low ego functioning rather than being specific to BPD.