Objectives. The present study explores the relationship between the mentalization of distinct affect categories and the severity of borderline personality disorder (BPD) symptoms. Mentalization is assessed by both the level of verbal elaboration (VE) achieved by discrete affects (explicit mentalization) and the proportion of these individual affects in verbal expression (implicit mentalization).
Design and methods. Sixty-four outpatients completed a series of questionnaires and took part in an interview designed to produce eight relationship episodes that involved four basic emotions: sadness, joy, anger, and fear (two of each). Affect mentalization was assessed with the Grille de l’Élaboration Verbale de l’Affect (GEVA), an observer-rated measure of levels of elaboration of verbalized affect, and the measure of affect content (MAC), which identifies the content of the verbalized affect (e.g., anger). Diagnostic criteria were obtained with the BPD scale of the Structured Clinical Interview for DSM-IV (SCID-II) questionnaire. Alexithymia was assessed with the 20-item Toronto Alexithymia Scale (TAS-20).
Results. The severity of BPD symptoms was related to lower levels of VE of sadness. It was also associated with a higher frequency of hostility directed against others. The level of VE of sadness and the proportion of hostility showed incremental predictive value of borderline symptomatology over demographic information, the presence of a depressive disorder and alexithymia.
Conclusions. These findings point to an association between the severity of BPD symptoms and a difficulty mentalizing specific affective domains largely recognized as being central to borderline pathology, namely sadness and hostility.