Abstract
BackgroundPatients with Borderline Personality Disorder (BPD) expect and perceive social rejection stronger than healthy individuals. Shifting ones attention from oneself to others has been suggested as a mechanism to deal with the experience of social rejection. Here, we investigated whether BPD participants avoid increased self-awareness and whether this is done intentionally.MethodsThirty BPD patients and 30 healthy control participants, all naïve of the study’s purpose, were asked to choose either a seat facing a mirror (self-awareness) or not facing the mirror (avoidance of self-awareness). Afterwards they were asked to indicate if they have chosen the seat intentionally.ResultsBPD patients avoided as a trend the chair facing the mirror more often than healthy control participants. 90 % of the patients reported that they made their seating decision intentionally in contrast to 26.7 % of the healthy participants (odd ratio = 24.75).ConclusionsResults revealed altered reactions to self-awareness cues in BPD. While BPD patients avoided such a cue slightly more often, they were more often aware of their behavior than healthy participants. As possible explanations, a negative body related, shame-prone self-concept as well as a simultaneously increased degree of self-focused attention are suggested.
Highlights
Patients with Borderline Personality Disorder (BPD) expect and perceive social rejection stronger than healthy individuals
As one factor contributing to these difficulties, studies demonstrated that BPD patients expect to be rejected more frequently in social interactions than healthy controls and are more concerned by this perception in social interactions [4,5,6,7]
BPD patients perceived to be more excluded from an interaction even when, objectively, they were included as much as every other team member [6, 8, 9]
Summary
Thirty BPD patients and 30 healthy control participants, all naïve of the study’s purpose, were asked to choose either a seat facing a mirror (self-awareness) or not facing the mirror (avoidance of self-awareness). Afterwards they were asked to indicate if they have chosen the seat intentionally. We informed all participants regarding study procedures and obtained written informed consent. Exclusion criteria for all participants were any traumatic brain injuries and lifetime schizophrenia or bipolar I disorder, mental or developmental disorders as well as substance dependency during the last year and current substance abuse. Trained clinical psychologist obtained the diagnosis of BPD using the International Personality Disorder Examination (IPDE; [22]). Borderline symptom severity was measured using the short version of the Borderline Symptom List (BSL-23; [24])
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