What's in a (Neutral) Face? Personality Disorders, Attachment Styles, and the Appraisal of Ambiguous Social Cues

The University of Surrey Roehampton, Whitelands College, West Hill, London, UK.
Journal of Personality Disorders (Impact Factor: 2.31). 08/2004; 18(4):320-336. DOI: 10.1521/pedi.18.4.320.40344


Attachment theory suggests that borderline, avoidant, and schizoid personality disorders are differentially associated with anxious and avoidant attachment styles. The variations of insecure attachment in these disorders, in turn, might influence how others are perceived or appraised. To test these ideas, 176 college students completed questionnaires measuring attachment styles and personality disorder features, and each rated 10 emotionally neutral faces on 18 bipolar appraisal dimensions. As expected, borderline personality was associated with anxious attachment, avoidant personality was associated with anxious and avoidant attachment, and schizoid personality was weakly associated only with avoidant attachment. Furthermore, path analyses showed that borderline and avoidant personality features were associated with anxious attachment, which in turn related to negative face appraisals (e.g., tendencies to rate faces as less friendly and more rejecting). Discussion highlights the potential of simultaneously studying biases in social information processing and attachment disturbances among individuals with personality disorders.

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Available from: Paul A Pilkonis, Jul 07, 2014
    • "Thus, attachment anxiety regarding abandonment seems to be an important aspect of the AvPD pathology, and this disorder has been associated with pessimistic cognitive-affective responses to rejection-related situations (Meyer, Ajchenbrenner , & Bowles, 2005). In addition, anxious attachment has been associated with tendencies to rate neutral faces as less friendly and more rejecting (Meyer et al., 2004). "
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    ABSTRACT: Avoidant personality disorder (AvPD) and social phobia (SP) are common, closely related conditions. Little is known about the underlying processes related to the social discomfort of subjects with AvPD and SP. Both disorders are associated with interpersonal problems. An attachment perspective may shed light on similarities and differences in close relationships between the disorders. The aim of the study was to compare self-reported attachment styles in patients with AvPD and SP. We expected that patients with AvPD would have more attachment anxiety and avoidance and more often a Fearful attachment style, compared with SP. This is a cross-sectional multisite study of 90 adult patients with AvPD and SP. Patients with AvPD with and without SP (AvPD group) were compared with patients with SP without AvPD (SP group). Patients were assessed using structured diagnostic interviews and self-reporting questionnaires, including Experiences in Close Relationships (ECR). The ECR dimensions, Anxiety and Avoidance, and the new described five factors of the ECR were used. The AvPD group had higher levels of attachment anxiety than the SP group, especially for the sub-factors Anxiety for abandonment and Separation frustration. The diagnostic groups did not differ in levels of avoidance. Anxiety for abandonment was still associated with AvPD after controlling for symptom disorders and the criteria of other personality disorders. A Fearful attachment style was more frequent among patients with AvPD. The results indicate AvPD is associated with more attachment anxiety than SP. Fear of abandonment may play a significant role in the AvPD pathology. This is the first study to compare attachment styles in patients with avoidant personality disorder (AvPD) and social phobia (SP).The AvPD group had higher attachment-related anxiety than the SP group, and anxiety was most pronounced for the fear of abandonment.Fear of abandonment may play an important role in the AvPD pathology.
    08/2015; DOI:10.1111/papt.12075
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    • "It was expected that, compared with the healthy control group, mothers with BPD would be significantly poorer at accurately recognizing the emotional displays of infants, and more specifically, would show a misattribution pattern with a tendency to more negatively interpret neutral facial expressions of infants. It was further expected that control mothers would show preferential attention for images of their own infant, measured by greater emotion-recognition accuracy, as compared with images of unknown infants, whereas mothers with BPD, who have been observed previously to have attachment-related disturbances (e.g., Choi-Kain et al., 2009; Fonagy et al., 2000; Levy et al., 2005; Meyer et al., 2004), would not show this differential pattern. "
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    ABSTRACT: Mothers with borderline personality disorder (BPD) have disturbed relationships with their infants, possibly associated with poor nonverbal cue perception. Individuals with BPD are poor at recognizing emotion in adults and tend to misattribute neutral (i.e., no emotion) as sad. This study extends previous research by examining how mothers with BPD perceive known (own) and unknown (control) infant stimuli depicting happy, sad, and neutral emotions. The sample consisted of 13 women diagnosed with BPD and 13 healthy control mothers. All participants completed clinical and parenting questionnaires and an infant emotion recognition task. Compared to control mothers, mothers with BPD were significantly poorer at infant emotion recognition overall, but especially neutral expressions which were misattributed most often as sad. Performance was not related to disturbed parenting but rather mothers’ age and illness duration. Neither the BPD nor control mothers showed enhanced accuracy for emotional displays of their own verses unknown infant-face images. Although the sample size was small, this study provides evidence that mothers with BPD negatively misinterpret neutral images, which may impact sensitive responding to infant emotional cues. These findings have implications for clinical practice and the development of remediation programs targeting emotion-perception disturbances in mothers with BPD.
    Infant Mental Health Journal 11/2014; 35(1). DOI:10.1002/imhj.21426 · 0.61 Impact Factor
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    • "Studies of facial expression recognition in BDP to date have recorded inconsistent findings - two studies reported impairments in recognising facial emotions [17,18], while another study found no significant deficit of facial emotion identification, but noted a tendency of individuals with BPD to rate ambiguous faces as negative or aversive [19]. Three studies further identified a more intense response of those with BPD to images of negative facial emotion compared to positive, a finding which was not evident in control participants [17,18,20]. Using interview-based methods Hill and colleagues demonstrated impairments in social function in BPD [21]. "
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    ABSTRACT: Borderline personality disorder (BPD) is a common and serious mental illness, associated with a high risk of suicide and self harm. Those with a diagnosis of BPD often display difficulties with social interaction and struggle to form and maintain interpersonal relationships. Here we investigated the ability of participants with BPD to make social inferences from faces. 20 participants with BPD and 21 healthy controls were shown a series of faces and asked to judge these according to one of six characteristics (age, distinctiveness, attractiveness, intelligence, approachability, trustworthiness). The number and direction of errors made (compared to population norms) were recorded for analysis. Participants with a diagnosis of BPD displayed significant impairments in making judgements from faces. In particular, the BPD Group judged faces as less approachable and less trustworthy than controls. Furthermore, within the BPD Group there was a correlation between scores on the Childhood Trauma Questionnaire (CTQ) and bias towards judging faces as unapproachable. Individuals with a diagnosis of BPD have difficulty making appropriate social judgements about others from their faces. Judging more faces as unapproachable and untrustworthy indicates that this group may have a heightened sensitivity to perceiving potential threat, and this should be considered in clinical management and treatment.
    PLoS ONE 11/2013; 8(11):e73440. DOI:10.1371/journal.pone.0073440 · 3.23 Impact Factor
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