Social Cognition and it’s Correlation with Alexithymia and Emotional Dysregulation in Patients with Borderline Personality Disorder

Abstract Background Borderline Personality Disorder (BPD) is a prevalent psychiatric illness characterized by interpersonal instability, self-image disturbances, affective dysregulation, and impulsivity. Despite its high prevalence, BPD often goes underdiagnosed. Social cognitive deficits, including impairments in recognizing facial emotions and mentalizing, have been proposed as potential contributors to the social difficulties observed in individuals with BPD. Objectives This study aimed to compare social cognitive performance between individuals with BPD and healthy controls, and to examine the correlations between social cognition, alexithymia, and emotional dysregulation in BPD. Methods A case-control study was conducted over a nine-month period, involving 30 BPD patients and 30 healthy controls. Participants underwent structured clinical interviews for psychiatric diagnosis, as well as assessments for social cognition using the Reading the Mind in the Eyes Test and the Faux Pas Recognition Test. Additionally, emotional dysregulation and alexithymia were evaluated using the Emotion Regulation Questionnaire and the Toronto Alexithymia Scale, respectively. Results BPD patients demonstrated deficits in recognizing intentions, thoughts, and emotions compared to controls. Significant differences were observed in Faux Pas Recognition and Mind in Eye Test scores, with BPD patients performing worse. Emotional regulation scores, specifically cognitive reappraisal and expressive suppression, were significantly lower in BPD patients. Valence testing indicated higher prevalence of negative valence in BPD patients. Notably, BPD patients exhibited significantly higher scores on the Toronto Alexithymia Scale, particularly in identifying and describing emotions. Conclusion This study highlights distinct social cognitive impairments in individuals with BPD, manifested through difficulties in recognizing emotions and intentions. Moreover, BPD patients demonstrated higher levels of alexithymia and emotional dysregulation. These findings underscore the importance of addressing social cognitive deficits and emotional dysregulation in the assessment and treatment of BPD, aiming to improve social functioning and overall quality of life for affected individuals.