Borderline personality disorder features are associated with inflexible social interpretations

J Affect Disord. 2024 Mar 1:348:78-87. doi: 10.1016/j.jad.2023.12.036. Epub 2023 Dec 17.

Abstract

Background: Borderline personality disorder (BPD) is thought to involve aberrant social learning, including impaired revision of social interpretations with new evidence (social interpretation inflexibility). However, this topic has received little empirical attention outside of specific literatures, such as moral inference or behavioral economics. Further, the contribution of comorbid depression to BPD-related interpretation inflexibility has not yet been assessed.

Methods: In two independent samples (Study 1: N = 213; Study 2: N = 210, oversampled for BPD features), we assessed the associations between BPD symptoms, depressive symptoms, and task-based measures of social interpretation flexibility.

Results: We found that BPD symptoms, particularly volatility of identity and relationships, were associated with less revision of social interpretations with both positive and negative evidence. Meanwhile, depressive symptoms were associated with a pattern of less revision of social interpretations with positive versus negative information.

Limitations: The use of cross-sectional, crowdsourced samples limits causal interpretations. Translation to clinical populations should be assessed in future studies.

Conclusions: Results suggest that inflexible social interpretations across valences may be a feature of BPD-related pathology, and could be connected to symptoms involving volatility in social contexts. Future studies should investigate whether treatments geared toward increasing the flexibility of social interpretations are effective in treating BPD symptoms, especially those involving interpersonal difficulties.

Keywords: Borderline personality disorder; Cognitive flexibility; Depression; Interpretation bias; Social learning.

MeSH terms

  • Borderline Personality Disorder* / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Humans
  • Social Environment