Decreased facial reactivity and mirroring in women with Borderline Personality Disorder - A facial electromyography study

Abstract

Maladaptive interpersonal relationships are a core feature of Borderline Personality Disorder (BPD). Poor social communication including the capacity to convey one's emotional state non-verbally and to mirror others' facial expressions may be affected in BPD. 81 women with BPD and 38 female healthy controls (HCs) participated in an emotion recognition task. Facial activity of four muscles (zygomaticus major, levator labii superioris, orbicularis oculi, corrugator supercilii) was measured by electromyography (EMG) and participants rated their subjective emotional responses to dynamic facial expressions (happiness, fear, anger, sadness, disgust, surprise). Compared to HCs, patients with BPD overall showed lower EMG activity of facial muscles in response to dynamic facial expressions. Particularly, the BPD group showed less EMG activity to happy faces in the zygomaticus major, to disgusted faces in the levator labii superioris and to surprised faces in the corrugator supercilii compared to HCs. In contrast to HCs, patients with BPD reported stronger subjective emotional responses to all presented emotions but happiness. Decreased facial reactivity and mirroring along with increased stronger subjective responses to negative emotions of others' facial emotions is not in accordance with the facial feedback hypothesis and could trigger difficulties in social communication. Therapeutic approaches targeting non-verbal behavior in social communication may be a worthwhile element of psychotherapy in BPD. DRKS00009551. • Patients with BPD show decreased facial reactivity as measured by electromyography. • Patients with BPD show increased emotional response to negative emotions. • Patients with BPD show intact emotion recognition capacities. • Enhanced risk of misunderstandings, conflicts and negative evaluation by others.