Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-15T19:23:33.382Z Has data issue: false hasContentIssue false
  • English
  • Français

Facial emotional expression in reaction to social exclusion in borderline personality disorder

Published online by Cambridge University Press:  09 February 2011

K. Staebler ,
B. Renneberg ,
M. Stopsack ,
P. Fiedler ,
M. Weiler  and
S. Roepke
K. Staebler
Affiliation:
Department of Psychology, Freie Universität Berlin, Germany Department of Psychology, University of Heidelberg, Germany
B. Renneberg*
Affiliation:
Department of Psychology, Freie Universität Berlin, Germany
M. Stopsack
Affiliation:
Department of Psychology, University of Heidelberg, Germany
P. Fiedler
Affiliation:
Department of Psychology, University of Heidelberg, Germany
M. Weiler
Affiliation:
Department of Psychology, Freie Universität Berlin, Germany
S. Roepke
Affiliation:
Department of Psychiatry, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany Cluster of Excellence Languages of Emotion, Freie Universität Berlin, Germany
*
*Address for correspondence: Prof. Dr B. Renneberg, Department of Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, D-14195 Berlin, Germany. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Disturbances in social interaction are a defining feature of patients with borderline personality disorder (BPD). In this study, facial emotional expressions, which are crucial for adaptive interactions in social contexts, were assessed in patients with BPD in response to social exclusion.

Method

We examined facial emotional reactions of 35 patients with BPD and 33 healthy controls when playing Cyberball, a virtual ball-tossing game that reliably induces social exclusion. Besides self-reported emotional responses, facial emotional expressions were analyzed by applying the Emotional Facial Action Coding System (EMFACS).

Results

Patients with BPD showed a biased perception of participation. They more readily reported feeling excluded compared to controls even when they were included. In BPD, social exclusion led to an increase in self-reported other-focused negative emotions. Overall, EMFACS analyses revealed that BPD patients reacted with fewer positive expressions and with significantly more mixed emotional expressions (two emotional facial expressions at the same time) compared to the healthy control group when excluded.

Conclusions

Besides a negative bias for perceived social participation, ambiguous facial emotional expressions may play an important role in the disturbed relatedness in patients with BPD.

Keywords

Borderline personality disorderCyberballemotional reactionfacial expressionsocial exclusion
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1929 - 1938
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Arntz, A, Dietzel, R, Dreessen, L (1999). Assumptions in borderline personality disorder: specificity, stability and relationship with etiological factors. Behaviour Research and Therapy 37, 545–557.CrossRefGoogle ScholarPubMed
Bohus, M, Haaf, B, Stiglmayr, C, Pohl, U, Böhme, R, Linehan, M (2000). Evaluation of inpatient dialectical-behavioral therapy for borderline personality disorder – a prospective study. Behaviour Research and Therapy 38, 875–887.CrossRefGoogle ScholarPubMed
Bohus, M, Limberger, MF, Frank, U, Chapman, AL, Kühler, T, Stieglitz, RD (2007). Psychometric properties of the Borderline Symptom List (BSL). Psychopathology 40, 126–132.CrossRefGoogle ScholarPubMed
Conklin, CZ, Bradley, R, Westen, D (2006). Affect regulation in borderline personality disorder. Journal of Nervous and Mental Disease 194, 69–77.CrossRefGoogle ScholarPubMed
Dimberg, U, Thunberg, M, Elmehed, K (2000). Unconscious facial reactions to emotional facial expressions. Psychological Science 11, 86–89.CrossRefGoogle ScholarPubMed
Domes, G, Czieschnek, D, Weidler, F, Berger, C, Fast, K, Herpertz, SC (2008). Recognition of facial affect in borderline personality disorder. Journal of Personality Disorders 22, 135–147.CrossRefGoogle ScholarPubMed
Domes, G, Schulze, L, Herpertz, SC (2009). Emotion recognition in borderline personality disorder – a review of the literature. Journal of Personality Disorders 23, 6–19.CrossRefGoogle ScholarPubMed
Dyck, M, Habel, U, Slodczyk, J, Schlummer, J, Backes, V, Schneider, F, Reske, M (2009). Negative bias in fast emotion discrimination in borderline personality disorder. Psychological Medicine 39, 865–874.CrossRefGoogle ScholarPubMed
Ekman, P, Friesen, W, Hager, J (2002 a). Facial Action Coding System: Investigator's Guide. Research Nexus: Salt Lake City, UT.Google Scholar
Ekman, P, Friesen, W, Hager, J (2002 b). Facial Action Coding System: The Manual on CD-ROM. Research Nexus: Salt Lake City, UT.Google Scholar
Ekman, P, Irwin, W, Rosenberg, E (1994). Emotional Facial Action Coding System (EMFACS-8): Coders Instructions. Unpublished manuscript, University of California at San Diego.Google Scholar
First, MB, Spitzer, RL, Smith, BL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Publishing: Arlington, VA.Google Scholar
Flury, JM, Ickes, W, Schweinle, W (2008). The borderline empathy effect: do high BPD individuals have greater empathic ability? Or are they just more difficult to ‘read’? Journal of Research in Personality 42, 312–332.CrossRefGoogle Scholar
Franke, GH (1995). SCL-90-R The Symptom Checklist of Derogatis, German Version. Testzentrale: Göttingen, Germany.Google Scholar
Friesen, W (1988). INTER.BAS Turbo Basic Version of FACS Interpretation Program. Computer software available from Jörg Merten, University of Saarland, Saarbrücken, Germany.Google Scholar
Frith, C (2009). Role of facial expressions in social interactions. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 364, 3453–3458.CrossRefGoogle ScholarPubMed
Fydrich, T, Renneberg, B, Schmitz, B, Wittchen, H-U (1997). Strukturiertes Klinisches Interview für DSM-IV, Achse II: Persönlichkeitsstörungen, SKID II [Structured clinical interview for DSM-IV, Axis II: Personality disorders, SCID II]. Hogrefe: Göttingen, Germany.Google Scholar
Gunderson, JG (2007). Disturbed relationships as a phenotype for borderline personality disorder. American Journal of Psychiatry 164, 1637–1640.CrossRefGoogle ScholarPubMed
Herpertz, SC, Werth, U, Lucas, G, Qunaibi, M, Schuerkens, A, Kunert, H-J, Freese, R, Flesch, M, Mueller-Isberner, R, Osterheider, M, Sass, H (2001). Emotion in criminal offenders with psychopathy and borderline personality disorders. Archives of General Psychiatry 58, 737–745.CrossRefGoogle Scholar
Hill, J, Pilkonis, P, Morse, J, Feske, U, Reynolds, S, Hope, H, Charest, C, Broyden, N (2008). Social domain dysfunction and disorganization in borderline personality disorder. Psychological Medicine 38, 135–146.CrossRefGoogle ScholarPubMed
Jacob, GA, Guenzler, C, Zimmermann, S, Scheel, CN, Rusch, N, Leonhart, R, Nerb, J, Lieb, K (2008). Time course of anger and other emotions in women with borderline personality disorder: a preliminary study. Journal of Behavior Therapy and Experimental Psychiatry 39, 391–402.CrossRefGoogle ScholarPubMed
King-Casas, B, Sharp, C, Lomax-Bream, L, Lohrenz, T, Fonagy, P, Montague, PR (2008). The rupture and repair of cooperation in borderline personality disorder. Science 321, 806–810.CrossRefGoogle ScholarPubMed
Kleindienst, N, Limberger, MF, Schmahl, C, Steil, R, Ebner-Priemer, UW, Bohus, M (2008). Do improvements after inpatient dialectical behavioral therapy persist in the long term? A naturalistic follow-up in patients with borderline personality disorder. Journal of Nervous and Mental Disease 196, 847–851.CrossRefGoogle Scholar
Linehan, MM (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press: New York.Google Scholar
Lynch, TR, Rosenthal, MZ, Kosson, DS, Cheavens, JS, Lejuez, CW, Blair, RJ (2006). Heightened sensitivity to facial expressions of emotion in borderline personality disorder. Emotion 6, 647–655.CrossRefGoogle ScholarPubMed
Minzenberg, MJ, Poole, JH, Vinogradov, S (2006). Social-emotion recognition in borderline personality disorder. Comprehensive Psychiatry 47, 468–474.CrossRefGoogle ScholarPubMed
Preissler, S, Dziobek, I, Ritter, K, Heekeren, HR, Roepke, S (2010). Social cognition in borderline personality disorder: evidence for disturbed recognition of the emotions, thoughts, and intentions of others. Frontiers in Behavioral Neuroscience 4, 182.CrossRefGoogle ScholarPubMed
Renneberg, B, Heyn, K, Gebhard, R, Bachmann, S (2005 a). Facial expression of emotions in borderline personality disorder and depression. Journal of Behavior Therapy and Experimental Psychiatry 36, 183–196.CrossRefGoogle ScholarPubMed
Renneberg, B, Schmidt-Rathjens, C, Hippin, R, Backenstrass, M, Fydrich, T (2005 b). Cognitive characteristics of patients with borderline personality disorder: development and validation of a self-report inventory. Journal of Behavior Therapy and Experimental Psychiatry 36, 173–182.CrossRefGoogle ScholarPubMed
Renneberg, B, Seehausen, A (2010). Questionnaire of thoughts and feelings: a screening instrument for borderline-specific thinking [in German]. Zeitschrift für Klinische Psychologie und Psychotherapie 39, 170–178.CrossRefGoogle Scholar
Ruocco, AC, Medaglia, JD, Tinker, JR, Ayaz, H, Forman, EM, Newman, CF, Williams, JM, Hillary, FG, Platek, SM, Onaral, B, Chute, DL (2010). Medial prefrontal cortex hyperactivation during social exclusion in borderline personality disorder. Psychiatry Research 181, 233–236.CrossRefGoogle ScholarPubMed
Russell, JJ, Moskowitz, DS, Zuroff, DC, Sookman, D, Paris, J (2007). Stability and variability of affective experience and interpersonal behavior in borderline personality disorder. Journal of Abnormal Psychology 116, 578–588.CrossRefGoogle ScholarPubMed
Sanislow, CA, Morey, LC, Grilo, CM, Gunderson, JG, Shea, MT, Skodol, AE, Stout, RL, Zanarini, MC, McGlashan, TH (2002). Confirmatory factor analysis of DSM-IV borderline, schizotypal, avoidant and obsessive-compulsive personality disorders: findings from the Collaborative Longitudinal Personality Disorders Study. Acta Psychiatrica Scandinavica 105, 28–36.CrossRefGoogle Scholar
Seres, I, Unoka, Z, Keri, S (2009). The broken trust and cooperation in borderline personality disorder. Neuroreport 20, 388–392.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 22–33; quiz 34–57.Google ScholarPubMed
Silk, KR (2010). The quality of depression in borderline personality disorder and the diagnostic process. Journal of Personality Disorders 24, 25–37.CrossRefGoogle ScholarPubMed
Staebler, K, Gebhard, R, Barnett, W, Renneberg, B (2009). Emotional responses in borderline personality disorder and depression: assessment during an acute crisis and 8 months later. Journal of Behavior Therapy and Experimental Psychiatry 40, 85–97.CrossRefGoogle ScholarPubMed
Wagner, AW, Linehan, MM (1999). Facial expression recognition ability among women with borderline personality disorder: implications for emotion regulation? Journal of Personality Disorders 13, 329–344.CrossRefGoogle ScholarPubMed
Williams, K, Cheung, CKT, Choi, W (2000). Cyberostracism: effects of being ignored over the internet. Journal of Personality and Social Psychology 79, 748–762.CrossRefGoogle Scholar
Williams, KD (2007). Ostracism. Annual Review of Psychology 58, 425–452.CrossRefGoogle ScholarPubMed
Williams, KD, Jarvis, B (2006). Cyberball: a program for use in research on interpersonal ostracism and acceptance. Behavior Research Methods 38, 174–180.CrossRefGoogle ScholarPubMed
Wolff, S, Stiglmayr, C, Bretz, HJ, Lammers, C-H, Auckenthaler, A (2007). Emotion identification and tension in female patients with borderline personality disorder. British Journal of Clinical Psychology 46, 347–360.CrossRefGoogle ScholarPubMed
Zanarini, MC, Frankenburg, FR, Hennen, J, Reich, DB, Silk, KR (2005). Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years. Journal of Personality Disorders 19, 19–29.CrossRefGoogle ScholarPubMed