Wenk Taavi, Günther Anna-Christina, Webelhorst Carolin, Kersting Anette, Bodenschatz Charlott Maria, Suslow Thomas
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Semmelweisstr. 10, 04103, Leipzig, Germany.
Borderline Personal Disord Emot Dysregul. 2024 Sep 16;11(1):24. doi: 10.1186/s40479-024-00267-y.
Attentional processes are important for regulating emotional states and coping with stressful events. Orientation of attention acts as filter for subsequent information processing. So far, only few eye-tracking studies have examined attentional processes during emotion perception in borderline personality disorder (BPD). In these studies, gaze behaviour was analysed during simultaneous or delayed evaluation of single stimuli. The objective of the present eye-tracking study was to investigate early and late attention allocation towards emotional facial expressions in patients with BPD and non-patients (NPs) based on a free-viewing paradigm, which allows to examine processes of self-generated attention deployment.
In a multiple-stimulus free-viewing task with facial expressions, i.e. happy, angry, sad, and neutral faces, presented simultaneously early and late attentional allocation was analysed in 43 patients with BPD and 43 age- and sex-matched NPs. We assessed study participants' trait anxiety, depressive symptoms, level of alexithymia, traumatic childhood experiences, and borderline symptoms. Entry time was used to measure initial gaze orientation, whereas dwell time was calculated as an index of late attention allocation.
As could be expected, patients with BPD reported more anxiety, depressive symptoms, experiences of childhood maltreatment, and showed higher levels of alexithymia than NPs. Patients differed from NPs in dwell time on happy facial expressions but not in dwell time on angry, sad, and neutral expressions. Contrary to our hypothesis, patients did not differ from NPs concerning entry times on angry facial expressions.
According to our results, patients with BPD show a reduced attentional preference for happy facial expression during free viewing compared to NPs. A decreased positive attentional bias at a late processing stage could be part of emotion regulation impairments and add to the vulnerability for negative affects in BPD, which represent core symptoms of the disorder. In contrast to previous eye-tracking research in BPD examining attention during evaluative processing, our dwell time data could be more indicative of self-generated, endogenously controlled attentional processes in emotion perception. The present data do not support an early vigilance for threatening social information in BPD.
注意力过程对于调节情绪状态和应对压力事件很重要。注意力定向作为后续信息处理的过滤器。到目前为止，只有少数眼动追踪研究考察了边缘型人格障碍（BPD）患者在情绪感知过程中的注意力过程。在这些研究中，在对单个刺激进行同时或延迟评估期间分析了注视行为。本眼动追踪研究的目的是基于自由观看范式，调查BPD患者和非患者（NP）对情绪化面部表情的早期和晚期注意力分配情况，该范式允许检查自我产生的注意力部署过程。
在一个具有面部表情（即开心、愤怒、悲伤和中性面孔）的多刺激自由观看任务中，同时在早期和晚期分析了43名BPD患者和43名年龄及性别匹配的NP的注意力分配情况。我们评估了研究参与者的特质焦虑、抑郁症状、述情障碍水平、童年创伤经历和边缘型症状。进入时间用于测量初始注视定向，而注视时间被计算为晚期注意力分配的指标。
正如预期的那样，BPD患者报告的焦虑、抑郁症状、童年虐待经历更多，并且述情障碍水平高于NP。患者与NP在开心面部表情上的注视时间存在差异，但在愤怒、悲伤和中性表情上的注视时间没有差异。与我们的假设相反，患者在愤怒面部表情的进入时间上与NP没有差异。
根据我们的结果，与NP相比，BPD患者在自由观看期间对开心面部表情的注意力偏好降低。在后期处理阶段积极注意力偏差的减少可能是情绪调节障碍的一部分，并增加了BPD中负面影响的易感性，这是该障碍的核心症状。与之前在BPD中检查评估过程中注意力的眼动追踪研究不同，我们的注视时间数据可能更能表明情绪感知中自我产生的、内源性控制的注意力过程。目前的数据不支持BPD患者对威胁性社会信息的早期警觉。
