Abstract
BackgroundThe purpose of the present study was threefold: first, to investigate the facial affective behavior in patients with a borderline personality disorder (BPD); second, to examine whether these patients could be divided into clusters according to facial affective behavior; and third, to test whether these clusters would influence the inpatient treatment outcome.MethodsThirty inpatients with BPD were assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I, SCID II) and had to complete a series of questionnaires before and directly after the 12-week long inpatient treatment. Facial affective behavior was recorded during the structured interview for personality organization (STIPO) and afterward coded with the emotional facial action coding system (EMFACS). Measures on psychopathology [beck depression inventory (BDI), Spielberger state and trait anxiety inventory (STAI), Spielberger state and trait anger inventory (STAXI), and symptom cheklist-90-revised (SCL-90-R)], interpersonal problems [Inventory of Interpersonal Problems (IIP)], and personality organization [inventory of personality organization (IPO)] were administered.ResultsCluster analysis before the treatment yielded two groups that differed in general facial expressivity, and regarding the display of anger, contempt, and disgust. The effect sizes of the repeated measures ANOVAs showed that persons with higher scores on the affective facial expressions benefitted more from the treatment in terms of STAI state anxiety, STAXI state and trait anger, IIP total, and the two scales primitive defenses and identity diffusion of the IPO, whereas persons with lower scores benefitted more on the scale IPO reality testing.ConclusionOur results indicated some initial trends for the importance of facial affective behavior in patients with BPD and their treatment outcome.
Highlights
Borderline personality disorder (BPD) is one of the most common personality disorders, affecting about 0.5–5.9% of the general population, around 10% of psychiatric outpatients, and 15–20% of psychiatric inpatients (Lenzenweger et al, 2007; Trull et al, 2010)
While there is evidence that facial affective behavior can predict the severity of depressive disorders over the course of treatment (e.g., Harati et al, 2019), we are not aware of any study that examined the influence of facial affective behavior on treatment success in BPD
Patients participated in an inpatient study for BPD patients [Basel Borderline Inpatient Study (BABIS)] and were treated at a specialized psychotherapeutic unit with a set stay length of 12 weeks, based on empirically validated treatment manuals “transference-based psychotherapy (TFP)” and “dialectical behavior therapy (DBT).”
Summary
Borderline personality disorder (BPD) is one of the most common personality disorders, affecting about 0.5–5.9% of the general population, around 10% of psychiatric outpatients, and 15–20% of psychiatric inpatients (Lenzenweger et al, 2007; Trull et al, 2010). There are several studies comparing differences in facial affective behavior between clinical and non-clinical populations (Davies et al, 2016). The purpose of the present study was threefold: first, to investigate the facial affective behavior in patients with a borderline personality disorder (BPD); second, to examine whether these patients could be divided into clusters according to facial affective behavior; and third, to test whether these clusters would influence the inpatient treatment outcome
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