Biased thinking assessed by external observers in borderline personality disorder
Article first published online: 16 DEC 2011
© 2011 The British Psychological Society
Psychology and Psychotherapy: Theory, Research and Practice
Volume 86, Issue 2, pages 183–196, June 2013
How to Cite
Kramer, U., Vaudroz, C., Ruggeri, O. and Drapeau, M. (2013), Biased thinking assessed by external observers in borderline personality disorder. Psychology and Psychotherapy: Theo, Res, Pra, 86: 183–196. doi: 10.1111/j.2044-8341.2011.02056.x
- Issue published online: 14 MAY 2013
- Article first published online: 16 DEC 2011
- Received 14 March 2011; revised version received 04 November 2011
Objectives. Biased thinking (to some extent overlapping with the concepts of cognitive distortions and cognitive errors) is a key concept in cognitive therapy of Borderline Personality Disorder (BPD). Specific contents and cognitive processes related to BPD functioning are known. However, most studies are based on self-report measures which present a number of important limitations, in particular the difficulty in assessing non-conscious processes infused by affect. So far, no studies were conducted using valid observer-rated methodology addressing the question of biased thinking in BPD as it unfolds spontaneously in session.
Design. This is a controlled interview study comparing two matched groups, BPD patients and healthy controls.
Methods. A total of N= 25 clinical dynamic interviews with patients presenting with BPD were transcribed and rated using the Cognitive Errors Rating Scale (Drapeau, Perry, & Dunkley, 2008); their cognitive profiles were compared to those of N= 25 healthy controls who underwent the same procedure.
Results. Overall, results indicated that no between-group difference in the frequency of specific biases was found. However, heightened levels of negative cognitive biases, in particular over-generalizing and fortune-telling, were associated with BPD. Furthermore, negative over-generalizing was associated with the number of BPD symptoms.
Conclusions. These results have high levels of ecological validity and are promising for the refinement of cognitive theory of BPD. Clinical implications for assessment and intervention are discussed.