Automatic processing of facial affects in patients with borderline personality disorder: associations with symptomatology and comorbid disorders.

Uta-Susan Donges,Thomas Suslow,Bibiana Dukalski,Anette Kersting

doi:10.1186/s12991-015-0058-y

Uta-Susan Donges, Thomas Suslow + Show 2 more

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https://doi.org/10.1186/s12991-015-0058-y

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Abstract

BackgroundInstability of affects and interpersonal relations are important features of borderline personality disorder (BPD). Interpersonal problems of individuals suffering from BPD might develop based on abnormalities in the processing of facial affects and high sensitivity to negative affective expressions. The aims of the present study were to examine automatic evaluative shifts and latencies as a function of masked facial affects in patients with BPD compared to healthy individuals. As BPD comorbidity rates for mental and personality disorders are high, we investigated also the relationships of affective processing characteristics with specific borderline symptoms and comorbidity.MethodsTwenty-nine women with BPD and 38 healthy women participated in the study. The majority of patients suffered from additional Axis I disorders and/or additional personality disorders. In the priming experiment, angry, happy, neutral, or no facial expression was briefly presented (for 33 ms) and masked by neutral faces that had to be evaluated. Evaluative decisions and response latencies were registered. Borderline-typical symptomatology was assessed with the Borderline Symptom List.ResultsIn the total sample, valence-congruent evaluative shifts and delays of evaluative decision due to facial affect were observed. No between-group differences were obtained for evaluative decisions and latencies. The presence of comorbid anxiety disorders was found to be positively correlated with evaluative shifting owing to masked happy primes, regardless of baseline—neutral or no facial expression condition. The presence of comorbid depressive disorder, paranoid personality disorder, and symptoms of social isolation and self-aggression were significantly correlated with response delay due to masked angry faces, regardless of baseline.ConclusionsIn the present affective priming study, no abnormalities in the automatic recognition and processing of facial affects were observed in BPD patients compared to healthy individuals. The presence of comorbid anxiety disorders could make patients more susceptible to the influence of a happy expression on judgment processes at an automatic processing level. Comorbid depressive disorder, paranoid personality disorder, and symptoms of social isolation and self-aggression may enhance automatic attention allocation to threatening facial expressions in BPD. Increased automatic vigilance for social threat stimuli might contribute to affective instability and interpersonal problems in specific patients with BPD.

Highlights

Instability of affects and interpersonal relations are important features of borderline personality dis‐ order (BPD)
BPD patients and healthy individuals did not differ in reporting perceptions of happy, surprised, and disgusted faces (p > 0.05), but BPD patients more frequently perceived anger [χ2(1) = 4.03, p < 0.05], fear [χ2(1) = 10.20, p < 0.001], and sadness [χ2(1) = 4.53, p < 0.05]
The latter response behavior suggests a bias toward the perception of threat-related or negative facial expressions in BPD patients

Summary

Introduction

Instability of affects and interpersonal relations are important features of borderline personality dis‐ order (BPD). Interpersonal problems of individuals suffering from BPD might develop based on abnormalities in the processing of facial affects and high sensitivity to negative affective expressions. As BPD comorbidity rates for mental and personality disorders are high, we investigated the relationships of affective processing characteristics with specific borderline symptoms and comorbidity. Facial expressions of affects convey important information about feeling states, intentions, wishes, and beliefs to persons in the environment [7, 8]. Against this background, it is not surprising that much research has been conducted in the last few years examining the perception of facial affect in individuals with BPD. This field of research should increase our understanding of basic perceptual factors possibly underlying dysfunctional interaction styles [9] and define more precisely the sensitivities and biases in the perception of others’ facial affects with respect to BPD [10]

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