Understanding Interpersonal Dysfunction in Borderline Personality Disorder

Abstract

The core interpersonal dysfunction in borderline personality disorder (BPD) has not yet been conclusively explained. We used a naturalistic dyadic paradigm to test for the presence of functional empathic inaccuracy in BPD, which is a reduced understanding of the partner’s feelings in relationship-threatening situations. A total of 64 heterosexual couples ( N = 128) were videotaped while engaging in (a) neutral (favorite films), (b) personally threatening (personal fears), and (c) relationship-threatening (separation from partner) conversations. Females were either diagnosed with BPD or healthy controls. Empathic accuracy (EA) was measured from the recorded interactions. Healthy couples’ EA was lower during relationship-threatening compared with personally threatening situations. In contrast, women with BPD showed increased EA, relative to the controls, for relationship- versus personally threatening situations. Reduced EA in response to relationship-threatening situations is likely to be relationship protective. This mechanism appears to be defective in women with BPD, which might explain the interpersonal difficulties experienced by BPD individuals.