Social cognition
How do women with BPD and schizophrenia read other people?
Open access · cc by · source: Europe PMC
While women with schizophrenia struggle with overall social reasoning, women with borderline personality disorder generally understand others well but tend to over-interpret people's intentions.
How this study connects
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Social cognitive and mentalizing difficulties manifest differently across psychiatric profiles, with schizophrenia and high schizotypy generally leading to undermentalizing or severe overall deficits, whereas borderline personality disorder and social anxiety lead to 'hypermentalizing' patterns.
Evidence for the claim as stated.
Study at a glance
- Design
- Case-control — Overall ToM comparison of women with BPD, schizophrenia, and healthy controls
- N
- N=75 · 25 per group, Oslo University Hospital / TOP study
- Population
- Women with borderline personality disorder, patients with schizophrenia, and healthy controls
- Outcome
- Overall theory-of-mind ability across BPD, schizophrenia, and healthy controls
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How do women with BPD and schizophrenia read other people?
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25 participants with borderline personality disorder
Participants with BPD (n = 25) were recruited from the Department of Personality Psychiatry (DPP), whereas participants with SZ ( n = 25) and healthy control participants (HC, n = 25) were recruited from the Thematically Organized Psychosis (TOP) Study at NORMENT KG Jebsen Centre for Psychosis Research.
15-minute video
The test consists of a 15-min video showing four people that come together for dinner and can be considered an ecologically valid measure ().
Key findings
Women with schizophrenia showed severe overall impairments in social reasoning, performing nearly two standard deviations below the healthy controls and making more errors of all types. In contrast, women with borderline personality disorder had normal overall scores but showed a specific tendency to over-interpret social cues, attributing excessive meaning or hostile intentions to others. This tendency to over-interpret was just as strong in women with borderline personality disorder as it was in women with schizophrenia.
Methodology
The researchers compared social reasoning abilities in groups of female participants: 25 with borderline personality disorder, 25 with schizophrenia, and 25 healthy controls. All participants watched a 15-minute video of a social dinner party, which paused 45 times to ask multiple-choice questions about the characters' thoughts, feelings, and intentions. Based on their wrong answers, participants were scored on different error patterns: over-interpreting social cues, under-interpreting cues, or failing to identify any social meaning at all.
Limitations
Additionally, because the sample only included female participants, the results cannot be automatically generalized to men with borderline personality disorder or schizophrenia. Furthermore, the study's correlational nature means we cannot prove whether trauma, symptoms, or emotional dysregulation directly cause these differing social reasoning styles. Lastly, the study evaluated participants in a calm, non-interactive lab setting, meaning it does not capture how their social reasoning might break down during highly stressful, real-life interpersonal conflicts.
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