title: The influence of stress on social cognition in patients with borderline personality disorder.
abstract: BACKGROUND
  Borderline personality disorder (BPD) is characterized by severe difficulties in interpersonal relationships and emotional functioning. Theories of BPD suggest that individuals with BPD have heightened emotional sensitivity, increased stress reactivity, and problems in making sense of intentions of others. In this study we investigated stress reactivity in BPD and its interference with social cognition, and tested whether any differences are specific for BPD or are inherent to personality disorders in general.
  
  
  METHODS
  We investigated 22 patients with BPD, 23 patients with Cluster C personality disorder (CPD), and 24 nonpatients on facial emotion recognition and social evaluation before and after stress induction based on the Trier Social Stress Test (TSST).
  
  
  RESULTS
  The results show that stress increased subjective negative emotions in the BPD group to a larger extent than in the other groups, whereas physiological responses were attenuated. Importantly stress induction increased negative evaluations about others, but surprisingly to a similar extent in the BPD and CPD groups as in the nonpatient control group. In addition facial emotion recognition performance was higher after than before stress, but no significant group differences were observed.
  
  
  CONCLUSIONS
  These results suggest that heightened psychological reactivity in BPD co-occurs with attenuated physiological responses to psychosocial stress and that stress affects social cognition to a similar extent in BPD as in others.
authors.affiliation: Centre of Excellence for Neuropsychiatry, Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands; GGZ Centraal, Almere, The Netherlands. Electronic address: jannekedeckers@hotmail.com.
authors.forename: Janneke W M
authors.initials: JW
authors.lastname: Deckers
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jill
authors.initials: J
authors.lastname: Lobbestael
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Guido A
authors.initials: GA
authors.lastname: van Wingen
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Korsakoff Clinic, Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands.
authors.forename: Roy P C
authors.initials: RP
authors.lastname: Kessels
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
authors.forename: Arnoud
authors.initials: A
authors.lastname: Arntz
authors.affiliation: Centre of Excellence for Neuropsychiatry, Vincent Van Gogh Institute for Psychiatry, Venray, The Netherlands; Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands; Pompe Institute for Forensic Psychiatry, Pro Persona, Nijmegen, The Netherlands.
authors.forename: Jos I M
authors.initials: JI
authors.lastname: Egger
mesh_terms: D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000503:physiopathology*; D012938:Social Perception; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult
keywords: Borderline personality disorder; Cluster C personality disorder; Contextual neuropsychology; Cortisol; Social cognition; Trier Social Stress Test (TSST)