Features of social perception in female patients with borderline personality disorder

Context and relevance. Borderline personality disorder (BPD) is associated with significant disturbances in interpersonal relationships. It is assumed that the development of these disturbances is influenced by the patients’ social perception. Objective. To determine the spesofocity of social perception in patients with BPD. Hypothesis. In patients with BPD, the process of social perception is impaired at the level of mentalization (inferences) and does not suffer at the level of identification of social signals, while there is a qualitative specificity of social perception of interpersonal interaction depending on the nature of the relationship (family, romantic, partnership). Methods and materials. The study involved 30 female patients with BPD (age range 18-30 years) undergoing inpatient treatment and 30 age-matched women not observed by a psychiatrist. The Guilford Social Intelligence Test was used, content analysis and frequency analysis of word usage in stories using cards 4, 6gf, 7gf of the Thematic Apperception Test were conducted. Results. The results showed that patients with BPD have lower scores on the subtests of the social intelligence test, reflecting the ability to comprehensively understand social situations and predict their development. Qualitative features of the interpretation of TAT pictures were revealed, correlating with the clinical features of the disorder (intolerance of loneliness, over-involvement in relationships, emotional instability). The greatest specificity of the interpretation was of the card actualizing the mother-daughter relationship. In general, there was a higher relevance of family themes in the stories. Conclusions. Female patients with BPD have features of social perception that can become targets of psychological correction to improve the quality of interpersonal relationships.

1. Бениашвили, К.Е., Холмогорова, А.Б. (2017). Нарушения социального познания при пограничном расстройстве личности как важная мишень психотерапии. Современная терапия психических расстройств, (3), 16–26. https://doi.org/10.21265/PSYPH.2017.42.6850
   Beniashvili, K.E., Kholmogorova, A.B. (2017) Impairments of Social Cognition in Borderline Personality Disorder as an Important Target of Psychotherapy. Journal of Current Therapy of Mental Disorders, (3), 16–26. (In Russ.)
2. Иосифян, М.А., Мершина, Е.А., Баженова, Д.А. и др. (2020). Мозговые механизмы нарушения модели психического при расстройствах аутистического спектра и шизофрении: обзор данных фМРТ. Клиническая и специальная психология, 9(1), 17–46. https://doi.org/10.17759/cpse.2020090102
   Iosifyan M.A., Mershina E.A., Bazhenova D.A., Sinitsyn V.E., Larina O.M., Pechenkova E.V. Neural Mechanisms of Theory of Mind in Autism and Schizophrenia: A Review of fMRI Studies [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2020. Vol. 9, no. 1, pp. 17–46. DOI: 10.17759/cpse.2020090102. (In Russ., аbstr. in Engl.)
3. Леонтьев, Д.А. (2000). Тематический апперцептивный тест (2-е изд., стереотипное). М.: Смысл. 254 c.
   Leontiev, D.A. Thematic apperception test. (2000) Moscow: Smysl, 2nd ed. 254 p.
4. Михайлова (Алешина), Е.С. (1996). Методика исследования социального интеллекта: Адаптация теста Дж. Гилфорда и М. Салливена: Руководство по использованию. СПб.: ГП «ИМАТОН».
   Mikhailova (Aleshina) E.S. Metodika issledovaniia sotsial'nogo intellekta. Rukovodstvo po ispol'zovaniiu [Methodology study of social intelligence]. Saint Petersburg: Imaton, 1996. 56 p.
5. Хасанова, А.К., Мосолов, С.Н. (2023). Пограничное расстройство личности: клиника, классификация и дифференциальная диагностика. Психиатрия и психофармакотерапия, 5, 4–17.
   Khasanova, A.K., Mosolov, S.N. (2023). Borderline personality disorder, clinic, classification and differential diagnosis. Psychiatry and Psychopharmacotherapy, 5, 4–17. (In Russ.). doi
6. Asztalos, L., Senra, H., O'Driscoll, C., Feigenbaum, J., Griem, J., King-Casas, B., London Personality and Mood Disorder Consortium, Nolte, T., Pratt, R., Vaziri, F., Montague, R., Fonagy, P. (2025). An exploration of the relationship between ineffective modes of mentalization and difficulties related to borderline personality disorder: A network approach. J Affect Disord, 374, 225-234. https://doi.org/10.1016/j.jad.2025.01.031.
7. Benoit, K, Watanabe, K, Wang, H, Nulty, P, Obeng, A, Müller, S, Matsuo, A (2018). Quanteda: An R package for the quantitative analysis of textual data. Journal of Open Source Software, 3(30), 774. doi:10.21105/joss.00774, https://quanteda.io.
8. Bora, E. (2021). A meta-analysis of theory of mind and 'mentalization' in borderline personality disorder: A true neuro-social-cognitive or meta-social-cognitive impairment? Psychol Med, 51(15), 2541-2551. https://doi.org/10.1017/S0033291721003718
9. Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M., Bellino, S. (2021). The role of trauma in early onset borderline personality disorder: A biopsychosocial perspective. Front Psychiatry, 12, 721361. https://doi.org/10.3389/fpsyt.2021.721361
10. Carpenter, R.W., Trull, T.J. (2013). Components of emotion dysregulation in borderline personality disorder: A review. Curr Psychiatry Rep, 15(1), 335. https://doi.org/10.1007/s11920-012-0335-2
11. Crowell, S.E., Beauchaine, T.P., Linehan, M.M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychol Bull, 135(3), 495-510. https://doi.org/10.1037/a0015616
12. Daros, A.R., Zakzanis, K.K., Ruocco, A.C. (2013). Facial emotion recognition in borderline personality disorder. Psychol Med, 43(9), 1953-1963. https://doi.org/10.1017/S0033291712002607
13. Dinsdale, N., Crespi, B.J. (2013). The borderline empathy paradox: Evidence and conceptual models for empathic enhancements in borderline personality disorder. J Pers Disord, 27(2), 172-195. https://doi.org/10.1521/pedi.2013.27.2.172
14. D'Iorio, A., Benedetto, G.L.D., Santangelo, G. (2024). A meta-analysis on the neuropsychological correlates of borderline personality disorder: An update. Neurosci Biobehav Rev, 165, 105860. https://doi.org/10.1016/j.neubiorev.2024.105860
15. Fatimah, H, Wiernik, BM, Gorey, C, McGue, M, Iacono, WG, Bornovalova, MA. (2020) Familial factors and the risk of borderline personality pathology: genetic and environmental transmission. Psychol Med, 50(8):1327-1337. doi: 10.1017/S0033291719001260.
16. Fonagy, P., Luyten, P., Allison, E., Campbell, C. (2017). What we have changed our minds about: Part 2. Borderline personality disorder, epistemic trust and the developmental significance of social communication. Borderline Personal Disord Emot Dysregul, 4, 9. https://doi.org/10.1186/s40479-017-0062-8
17. Kaur, M, Sanches, M. (2023) Parenting Role in the Development of Borderline Personality Disorder. Psychopathology, 56(1-2):109-116. doi: 10.1159/000524802.
18. Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O.F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4-25. https://doi.org/10.1002/wps.21156
19. Liu, Y., Chen, C., Zhou, Y., Zhang, N., Liu, S. (2024). Twenty years of research on borderline personality disorder: A scientometric analysis of hotspots, bursts, and research trends. Front Psychiatry, 15, 1361535. https://doi.org/10.3389/fpsyt.2024.1361535
20. 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, 6:647–55.
21. McLaren, V., Gallagher, M., Hopwood, C.J., Sharp, C. (2022). Hypermentalizing and borderline personality disorder: A meta-analytic review. Am J Psychother, 75(1), 21-31. https://doi.org/10.1176/appi.psychotherapy.20210018
22. Messina, I., Spataro, P., Gagliardini, G., Rossi, T., Grecucci, A. (2026) Attachment orientations and borderline personality features: the mediating role of difficulties in interpersonal emotion regulation. Borderline Personal Disord Emot Dysregul. 13(1), 4. doi: 10.1186/s40479-025-00323-1. PMID: 41645338; PMCID: PMC12874987.
23. R Core Team (2024). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria. URL: https://www.R-project.org.
24. Roepke, S., Vater, A., Preißler, S, Heekeren, HR, Dziobek, I. (2013) Social cognition in borderline personality disorder. Front Neurosci, 6:195. doi: 10.3389/fnins.2012.00195. PMID: 23335877; PMCID: PMC3543980.
25. Salgado, RM, Pedrosa, R, Bastos-Leite, AJ. (2020) Dysfunction of Empathy and Related Processes in Borderline Personality Disorder: A Systematic Review. Harv Rev Psychiatry, 28(4):238-254. doi: 10.1097/HRP.0000000000000260.
26. Segalovich, I. (2003). A Fast Morphological Algorithm with Unknown Word Guessing Induced by a Dictionary for a Web Search Engine. International Conference on Machine Learning; Models, Technologies and Applications.
27. Tate, A.E., Sahlin, H., Liu, S., Lu, Y., Lundström, S., Larsson, H., Lichtenstein, P., Kuja-Halkola, R. (2022). Borderline personality disorder: Associations with psychiatric disorders, somatic illnesses, trauma, and adverse behaviors. Mol Psychiatry, 27(5), 2514-2521. https://doi.org/10.1038/s41380-022-01503-z
28. Wagner, A.W., Linehan, M.M. (1999). Facial expression recognition ability among women with borderline personality disorder: Implications for emotion regulation? J Pers Disord, 13, 329–344.
29. Winsper, C., Lereya, S.T., Marwaha, S., Thompson, A., Eyden, J., Singh, S.P. (2016) The aetiological and psychopathological validity of borderline personality disorder in youth: A systematic review and meta-analysis. Clin Psychol Rev, 44:13-24. doi: 10.1016/j.cpr.2015.12.001.
30. Wrege, JS, Ruocco, AC, Carcone, D, Lang, UE, Lee, ACH, Walter, M. (2021) Facial Emotion Perception in Borderline Personality Disorder: Differential Neural Activation to Ambiguous and Threatening Expressions and Links to Impairments in Self and Interpersonal Functioning. J Affect Disord, 284:126-135. doi: 10.1016/j.jad.2021.01.042.