Self vs. Other-Referential Mentalization in Individuals with Borderline Features and the Possible Role of Shameful Early Maladaptive Schemas

Abstract

Borderline personality disorder (BPD) is a condition marked by emotion dysregulation and interpersonal strife. The ability to understand and predict the mental states of self and others (mentalization) affects relationship functioning, and research has been inconclusive on whether people with BPD show deficits in this ability. Further, shame has been demonstrated to be particularly relevant to this population, and as a social emotion, it may have implications for mentalization ability. Existing research has used other-referential tasks to study mentalization in BPD; these tasks ask the participant to mentalize about other people unrelated to them and with whom they are not interacting. Due to the primacy of shame in this population, the present study proposed that mentalization deficits may be higher if tasks were adjusted to be self-referential- that is, the participant imagines that they are involved in the interaction. It was hypothesized that (1) participants with high features of BPD would show greater hypermentalization during a self-referential task as opposed to an other-referential task; (2) participants with high borderline features would show patterns of hypermentalization and mentalization deficits overall as compared to both a healthy control group and a clinical control group on both self- and other-referential tasks; and (3) shame would correlate positively with both greater hypermentalization and more frequent mentalization errors overall. Results indicated no significant differences between performances on other- vs self-referential tasks across groups. Hypermentalization and mentalization deficits overall were higher in the BPD features group compared to both control groups, and shame was significantly positively correlated with mentalization errors. These findings highlight the role of hypermentalization and shame in BPD, even in the absence of self-referential task effects.