Perceptual biases in facial emotion recognition in borderline personality disorder

Individuals with borderline personality disorder (BPD) have biases in facial emotion recognition, which may underlie many of the core features of this disorder. Although they are known to misperceive specific prototypic expressions of emotion (i.e., those displayed at full emotional intensity), patients with this disorder may also show biases in their perceptions of emotions that are expressed at lower levels of emotional intensity. Females with BPD (n = 31) and IQ- and demographically matched nonpsychiatric controls (n = 28) completed a task assessing the recognition of neutral as well as happy and sad facial expressions at mild, moderate, and prototypic emotional intensities. Whereas patients with BPD were more likely than controls to ascribe an emotion to a neutral facial expression, they did not consistently attribute a more negative or positive valence to these faces as compared with controls. Patients were also more likely to perceive mildly sad facial expressions as more intensely sad, and this finding could not be attributed to depressed mood. The results of this study suggest that perceptions of even subtle expressions of negative affect in faces may be subjectively magnified by individuals with BPD, although there was no consistent evidence for a negative perceptual bias for faces displaying a neutral expression. These biases in facial emotion perception for patients with BPD may contribute to difficulties understanding others' emotional states and to problems engaging effectively in social interactions.