Loneliness, social networks, and social functioning in borderline personality disorder.

Persistent loneliness is often reported by patients with borderline personality disorder (BPD). However, empirical studies investigating this aspect of BPD psychopathology are sparse. Studies from social psychology revealed that social isolation and low social functioning contribute to loneliness, that is, the subjective feeling of being alone. The aim of the present study was to contribute to the understanding of loneliness in BPD by investigating its relation to social isolation and functioning in different domains of life. Subjective experience of loneliness was measured in 80 women (40 BPD patients, 40 healthy controls) with the UCLA Loneliness Scale. Social isolation and social functioning were assessed with the Social Network Inventory and the Social Functioning Scale. In addition, we assessed global functioning with the Global Assessment of Functioning. BPD patients reported stronger feelings of loneliness compared to healthy participants. In general, the level of loneliness was linked to network size, social engagement, and prosocial behavior. Diversity of social networks and functioning in the domain of interpersonal communication were associated with the level of loneliness only in BPD. A reduced variety of roles in social life together with impairments in interpersonal communication were particularly relevant for the experience of loneliness in BPD, suggesting an indirect path to target this psychopathological feature in therapeutic interventions. However, both social isolation and social functioning were not sufficient to explain the severely increased loneliness experienced by these patients, stressing the need for further investigation of determinants of loneliness in this clinical population. (PsycINFO Database Record

Liebke L ，Bungert M ，Thome J ，Hauschild S ，Gescher DM ，Schmahl C ，Bohus M ，Lis S ... -  《-》

Behavioural mimicry and loneliness in borderline personality disorder.

Interpersonal problems together with feelings of intense loneliness constitute a core symptom domain in borderline personality disorder (BPD). Mimicry is one social behaviour that serves the forming of social affiliation and building a sense of belonging. In the present study, we investigated whether behavioural mimicry is altered in BPD and whether it is linked to the patient's feeling of loneliness. Individuals with BPD (N = 26) and healthy participants (HC, N = 25) performed a finger tapping task with a congruent or incongruent finger movement displayed preceding the presentation of the task relevant stimulus. Additional trials showing an immobile hand were used as a control condition. Mimicry strength was estimated as response facilitation after congruent and response interference after incongruent cues. Both HC and BPD patients showed facilitated responses after congruent finger movements. Only BPD patients exhibited interference by incongruent cues. The lonelier the BPD patients felt, the weaker was the interference of the incongruent cues. In contrast, interference increased with the level of loneliness in the HC group. Behavioural mimicry was increased in BPD. However, this effect was less pronounced in those BPD patients who reported the highest levels of loneliness. Our findings emphasize that mimicry is a complex construct and only some of the involved processes are altered in BPD. Future studies must further disentangle the contribution of cognitive and social cognitive processes, address a potential causality in the link between loneliness and mimicry in BPD, and relate alterations of mimicry to interpersonal dysfunction during every-day life.

Hauschild S ，Winter D ，Thome J ，Liebke L ，Schmahl C ，Bohus M ，Lis S ... -  《-》

Confidence in facial emotion recognition in borderline personality disorder.

Dysfunctions of social-cognitive processes such as the recognition of emotions have been discussed to contribute to the severe impairments of interpersonal functioning in borderline personality disorder (BPD). By investigating how patients with BPD experience the intensity of different emotions in a facial expression and how confident they are in their own judgments, the current study aimed at identifying subtle alterations of emotion processing in BPD. Female patients with BPD (N = 36) and 36 healthy controls were presented with faces that displayed low-intense anger and happiness or ambiguous expressions of anger and happiness blends. Subjects were asked to rate (a) the intensity of anger and happiness in each facial expression and (b) their confidence in their judgments. Patients with BPD rated the intensity of happiness in happy faces lower than did controls, but did not differ in regard to the assessment of angry or ambiguous facial stimuli or the rating of anger. They reported lower confidence in their judgments, which was particularly pronounced for the assessment of happy facial expressions. The reduced rating of happiness was linked to higher state anger, whereas the reduced confidence in the assessment of happy faces was related to stronger feelings of loneliness and the expectation of social rejection. Our findings suggest alterations in the processing of positive social stimuli that affect both the experience of the emotional intensity and the confidence subjects experience during their assessment. The link to loneliness and social rejection sensitivity points to the necessity to target these alterations in psychotherapeutical interventions.

Thome J ，Liebke L ，Bungert M ，Schmahl C ，Domes G ，Bohus M ，Lis S ... -  《-》

Loneliness, Social Isolation and Their Difference: A Cross-Diagnostic Study in Persistent Depressive Disorder and Borderline Personality Disorder.

Background: Interpersonal difficulties are a key feature of persistent depressive disorder (PDD) and borderline personality disorder (BPD). Caught in a vicious circle of dysfunctional interpersonal transaction, PDD and BPD patients are at great risk of experiencing prolonged loneliness. Loneliness, in turn, has been associated with the development of mental disorders and chronic illness trajectories. Besides, several factors may contribute to the experience of loneliness across the lifespan, such as social network characteristics, a history of childhood maltreatment (CM), and cognitive-affective biases such as rejection sensitivity (RS). This cross-diagnostic study approached the topic of perceived loneliness by comparing PDD and BPD patients with healthy controls (HC) in its interplay with symptom burden, social network characteristics, RS as well as CM. Method: Thirty-four PDD patients (DSM-5; 15 female, Mage = 38.2, SD = 12.3), 36 BPD patients (DSM-5; 19 female, Mage = 28.8, SD = 9.2), and 70 age- and gender-matched HC were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI; size, diversity, and embeddedness), Beck Depression Inventory (BDI-II), Borderline Symptom List (BSL-23), Childhood Trauma Questionnaire (CTQ), and Rejection Sensitivity Questionnaire (RSQ). Results: Both patient groups reported significantly higher levels of perceived loneliness, symptom severity, and smaller social network characteristics compared to HC. Loneliness was significantly correlated with severity of self-reported clinical symptoms in PDD and at trend level in BPD. Besides, loneliness tended to be related to social network characteristics for all groups except PDD patients. Both PDD and BPD patients showed higher RS as well as CTQ scores than HC. A history of emotional abuse and emotional neglect was associated with loneliness, and this association was mediated by RS as demonstrated by an exploratory mediation analysis. Discussion: Loneliness is highly prevalent in PDD and BPD patients and contributes to the overall symptom burden. Interestingly, loneliness showed an association with prior experiences of CM as well as current RS. We therefore propose a comprehensive model on how intra- und interpersonal aspects may interplay in the dynamics of loneliness in light of CM. Finally, this model may have further implications for psychotherapeutic interventions.

Nenov-Matt T ，Barton BB ，Dewald-Kaufmann J ，Goerigk S ，Rek S ，Zentz K ，Musil R ，Jobst A ，Padberg F ，Reinhard MA ... -  《Frontiers in Psychiatry》

An examination of social network quality and composition in women with and without borderline personality disorder.

Borderline personality disorder (BPD) is characterized by interpersonal difficulties including fears of abandonment, unstable relationships, and intense and inappropriate anger (American Psychiatric Association, 2013). However, there is limited research aimed at understanding the social networks of individuals with BPD, particularly in comparison to others. In this study, we compared the social networks of women with BPD to a group of women who did not meet criteria for any psychological disorders (i.e., healthy control (HC) group). Participants recruited from the community and local clinics completed a diagnostic evaluation and the social network assessment, a measure designed to assess the number and perceived quality of partners with whom participants frequently interact. Women in the BPD group had smaller social networks, characterized by less satisfaction and support, and more conflict and criticism among partners than women in the HC group. In addition, the networks of women with BPD were more variable in terms of these quality variables compared to the networks of HC women. However, the 2 groups did not differ on overall closeness or variability in closeness in relationships. Finally, women with BPD reported more relationships in which there had been a significant change or rupture in the past month. These findings suggest that interpersonal distress experienced by women with BPD occurs in the context of smaller and less satisfying social networks compared to the networks of their peers. The examination of additional control groups and longitudinal social network change will further characterize interpersonal dysfunction experienced in BPD. (PsycINFO Database Record

Lazarus SA ，Cheavens JS 《-》