Theory of mind disturbances in borderline personality disorder: A meta-analysis. (December 2018)

• Record Type: Journal Article
• Authors: Németh, Nándor; Mátrai, Péter; Hegyi, Péter; Czéh, Boldizsár; Czopf, László; Hussain, Alizadeh; Pammer, Judith; Szabó, Imre; Solymár, Margit; Kiss, Loránt; Hartmann, Petra; Szilágyi, Ágnes Lilla; Kiss, Zoltán; Simon, Maria
• Is Part Of: Psychiatry research. Volume 270(2018)
• Page Start: 143
• Page End: 153
• Publication Date: 2018-12
• Subjects: Social cognition -- Mentalizing -- Mental state decoding -- Affective -- Cognitive -- ToM task -- Faux pas task -- Anxiety disorder; ATT advanced ToM test -- BPD borderline personality disorder -- CAMS cartoon-based assessment of mentalizing skills -- EAT expression attribution test -- FER facial emotional recognition -- FBPST false-belief picture sequencing task -- FPT faux pas task -- HC healthy controls -- JAT joke-appreciation task -- MA meta-analysis -- MASC movie for the assessment of social cognition -- MDD major depressive disorder -- MDE major depressive episode -- MET multifaceted empathy test -- MSAT mental state attribution tasks -- NTT non-verbal ToM tasks -- RMET reading the mind in the eyes test -- TASIT the awareness of social inference test -- ToM theory of mind; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.08.049
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: In general, BPD patients have ToM deficits. BPD patients are impaired in cognitive ToM and in reasoning, but not in decoding mental states. BPD patients' affective ToM performance is largely task dependent. The Faux Pas Task is the most sensitive task to detect ToM deficits in BPD. Comorbid anxiety disorders can enhance overall and affective ToM in BPD. Abstract: Impairments of theory of mind (ToM) are widely accepted underlying factors of disturbed relatedness in borderline personality disorder (BPD). The aim of this meta-analysis a was to assess the weighted mean effect sizes of ToM performances in BPD compared to healthy controls (HC), and to investigate the effect of demographic variables and comorbidities on the variability of effect sizes across the studies. Seventeen studies involving 585 BPD patients and 501 HC were selected after literature search. Effect sizes for overall ToM, mental state decoding and reasoning, cognitive and affective ToM, and for task types were calculated. BPD patients significantly underperformed HC in overall ToM, mental state reasoning, and cognitive ToM, but had no deficits in mental state decoding. Affective ToM performance was largely task dependent in BPD. Comorbid anxiety disorders had a positive moderating effect on overall and affective ToM in BPD. Our results support the notion that BPD patients' have specific ToM impairments. Further research is necessary to evaluate the role of confounding factors, especially those of clinical comorbidities, neurocognitive functions, and adverse childhood life events. Complex ToM tasks with high contextual demands seem to be the most appropriate tests to assess ToM in patients with BPD.