Normal mind-reading capacity but higher response confidence in borderline personality disorder patients

Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Psychiatry and Clinical Neurosciences (Impact Factor: 1.63). 06/2012; 66(4):322-7. DOI: 10.1111/j.1440-1819.2012.02334.x
Source: PubMed


Borderline personality disorder (BPD) is characterized by a pattern of instability in interpersonal relationships. Therefore, the investigation of social cognition is of compelling interest for the understanding of BPD. One important aspect of social cognition is theory of mind (ToM), which describes the ability to understand others' mental states, such as beliefs, desires and intentions. The aim of the present study was to further investigate ToM in BPD patients.
The Reading the Mind in the Eyes Test was assessed in 31 BPD patients and 27 healthy controls. In addition, the test was complemented by a response confidence rating.
BPD patients and healthy controls did not differ in their mind-reading ability with respect to accuracy, but patients were significantly more often highly confident in their decisions than controls.
Overconfidence might contribute to the severe difficulties in interpersonal relationships often observed in BPD patients.

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    • "Thus, it would be useful to include measures of knowledge and intention attribution, as well as emotional intelligence, which encompasses the ability to both understand and manage one's own emotions in contexts that relate to the emotions and intentions of others. Individuals with high levels of narcissism (Ames & Kammrath, 2004), Machiavellianism (Giammarco, Atkinson, Baughman, Veselka, & Vernon, 2013; Klaver, Lee, Spidel, & Hart, 2009), and borderline traits (Schilling et al., 2012) have reported a higher degree of confidence in their responses to ToM tasks than other individuals despite the fact that their actual performance was not superior. Such findings point to the need to assess ToM using actual tests of the ability to interpret emotions and intentions of others rather than focusing on self-perceptions. "
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    • "Indeed, this framework does not seem to consider how the participant who takes part in the ToM task manages this information, depending on the fact that he or she is involved in the interaction or not and how the information concerning the agent may impact the participant attribution of mental states. For example, people with borderline personality disorder are known to be impaired in the ability to differentiate mental states of self and other, particularly emotional states during daily social interaction (Fonagy, Luyten, & Strathearn, 2011), whereas they rarely underperform in classical ToM tasks (Schilling et al., 2012). The 8-SIF did not enable us to make a difference between these two kinds of situations (i.e., involved in the interaction vs. not involved in the interaction) in which ToM can be measured (cf. "
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