Mindreading and metacognition patterns in patients with borderline personality disorder: experimental study

Abstract

Current psychopathology attempts to understand personality disorders in relation to deficits in higher cognition such as mindreading and metacognition. Deficits in mindreading are usually related to limitations in or a complete lack of the capacity to understand and attribute mental states to others, while impairments in metacognition concern dysfunctional control and monitoring of one's own processes. The present study investigated dysfunctional higher cognition in the population of patients with borderline personality disorder (BPD) by analyzing the accuracy of metacognitive judgments in a mindreading task [reading the mind in the eyes Test (RMET)] and a subsequent metacognitive task based on self-report scales: a confidence rating scale (CR) versus a post-decision wagering scale (PDW). It turned out that people from the BPD group scored lower in the RMET. However, both groups had the same levels of confidence on the PDW scale when giving incorrect answers in the RMET test. As initially hypothesized, individuals with BPD overestimated their confidence in incorrect answers, regardless of the type of metacognitive scales used. The present findings indicate that BPD individuals show dysfunctional patterns between instances of mindreading and metacognition.

Keywords: Borderline personality disorder; Metacognition; Mindreading; Post decision wagering.

Fig. 1

Experimental design and procedure. The facial image was presented on the screen; the green dot in the center encouraged participants to pay attention to the face. Then, participants had to choose one of the four possible expressions presented alongside the photo. Participants then assessed their confidence with metacognitive scales using confidence ratings (CR scale) or imaginary monetary wagers (PDW). The order the of measure of metacognition was randomized across the participants

Fig. 2

Post-hoc comparisons with Bonferroni correction: Mean confidence level for correct responses to positive emotion in HP and BPD groups in CR and PDW conditions

Fig. 3

Post-hoc comparisons with Bonferroni correction: Mean confidence level for incorrect responses to positive emotion in HP and BPD groups in CR and PDW conditions

Fig. 4

Post-hoc comparisons with Bonferroni correction: Mean KCI values for incorrect responses among HP and BPD groups