Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran.
J Psychiatr Res. 2021 Nov;143:445-450. doi: 10.1016/j.jpsychires.2021.10.009. Epub 2021 Oct 11.
Studies on the theory of mind (TOM) and alexithymia in borderline personality disorder (BPD) have yielded inconsistent results. Also, the relationship between TOM abilities and alexithymia facets as two domains of social cognition has not been studied in BPD. This study aimed to fill this gap. Participants were 50 outpatients with BPD and 50 age and gender-matched healthy controls. Assessments performed using Reading the Mind in Eyes Task (RMET), Toronto Alexithymia Scale (TAS-20), Faux Pas Task (FPT), and Digit Span subtest of Wechsler Adult Intelligence Scale. Results showed that BPD patients scored lower on overall FPT (p < .001) and its cognitive (p < .001) and affective TOM (p < .001) subtests but were comparable with healthy controls in emotion recognition ability assessed by RMET (p = .241). The BPD group also scored significantly lower in overall alexithymia (p < .001) and subscales of difficulty identifying feelings (DIF; p < .001) and difficulty describing emotions (DDF; p = .001). However, they performed similarly to the healthy control group in externally oriented thinking (EOT; p = .164). Correlation analysis revealed a significant negative correlation between EOT and RMET in the BPD group (r = -0.33, p < .05). No association, however, was found between FPT and RMET. This study suggests that BPD patients are impaired in the complex TOM abilities and have lower self-awareness of emotions, but their recognition of others' emotions is intact. Also, the results demonstrate that a heightened level of EOT is associated with difficulties in facial emotion recognition in BPD patients.
心智理论（TOM）和述情障碍在边缘型人格障碍（BPD）中的研究结果不一致。此外，TOM 能力和述情障碍两个领域的社会认知之间的关系在 BPD 中尚未得到研究。本研究旨在填补这一空白。参与者为 50 名 BPD 门诊患者和 50 名年龄和性别匹配的健康对照者。使用阅读眼心理任务（RMET）、多伦多述情障碍量表（TAS-20）、失误任务（FPT）和韦氏成人智力量表的数字广度亚测验进行评估。结果显示，BPD 患者在总体 FPT（p<0.001）及其认知（p<0.001）和情感 TOM（p<0.001）子测验中的得分较低，但在 RMET 评估的情绪识别能力方面与健康对照组相当（p=0.241）。BPD 组在总体述情障碍（p<0.001）和难以识别情绪（DIF；p<0.001）和难以描述情绪（DDF；p=0.001）分量表上的得分也显著较低。然而，他们在外部定向思维（EOT；p=0.164）方面的表现与健康对照组相似。相关性分析显示，BPD 组的 EOT 与 RMET 之间存在显著负相关（r=-0.33，p<0.05）。然而，FPT 与 RMET 之间没有关联。本研究表明，BPD 患者在复杂的 TOM 能力方面存在障碍，对情绪的自我意识较低，但对他人情绪的识别能力完好。此外，结果表明，在 BPD 患者中，EOT 水平的升高与面部情绪识别困难有关。
