Self-referential processing and perspective taking in patients with a borderline personality disorder

Divergent self- and other-referential processes play a particular role in the development and maintenance of borderline personality disorder (BPD). This study investigated self-referential processes in patients with BPD and age-matched controls. Participants performed a trait-judgment task, taking their own and the perspective of a close other person. Memory was assessed during recall of the previous choices. Results revealed over all more negative self-appraisals in patients than controls, which seemed due to making less positive self-referential choices rather than an increased choice of negative traits. Interestingly, taking another perspective, patients had a healthier, predominantly positive self-assessment, albeit still attenuated compared to controls. The characteristics of the appraisals were mirrored in memory performances. Moreover, self-esteem seems to be a potential protective factor, as self-appraisals were more positive with higher self-esteem. Altogether, this study shows significantly deviant self-referential processes in patients with BPD, suggesting that patients do not integrate what they believe others think about them into their self-concept.