title: Biased thinking assessed by external observers in borderline personality disorder.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Institute of Psychotherapy, Department of Psychiatry-CHUV, University of Lausanne, Switzerland. Ueli.Kramer@chuv.ch
authors.forename: Ueli
authors.initials: U
authors.lastname: Kramer
authors.forename: Cynthia
authors.initials: C
authors.lastname: Vaudroz
authors.forename: Ornella
authors.initials: O
authors.lastname: Ruggeri
authors.forename: Martin
authors.initials: M
authors.lastname: Drapeau
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy; D005260:Female; D005793:Generalization, Psychological; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009341:Negativism; D011569:Psychiatric Status Rating Scales; D011582:Psychological Theory; D057566:Self Report; D012718:Set, Psychology; D012720:Severity of Illness Index; D013850:Thinking; D055815:Young Adult