title: Can't stand the look in the mirror? Self-awareness avoidance in borderline personality disorder.
abstract: BACKGROUND
  Patients with Borderline Personality Disorder (BPD) expect and perceive social rejection stronger than healthy individuals. Shifting ones attention from oneself to others has been suggested as a mechanism to deal with the experience of social rejection. Here, we investigated whether BPD participants avoid increased self-awareness and whether this is done intentionally.
  
  
  METHODS
  Thirty BPD patients and 30 healthy control participants, all naïve of the study's purpose, were asked to choose either a seat facing a mirror (self-awareness) or not facing the mirror (avoidance of self-awareness). Afterwards they were asked to indicate if they have chosen the seat intentionally.
  
  
  RESULTS
  BPD patients avoided as a trend the chair facing the mirror more often than healthy control participants. 90 % of the patients reported that they made their seating decision intentionally in contrast to 26.7 % of the healthy participants (odd ratio = 24.75).
  
  
  CONCLUSIONS
  Results revealed altered reactions to self-awareness cues in BPD. While BPD patients avoided such a cue slightly more often, they were more often aware of their behavior than healthy participants. As possible explanations, a negative body related, shame-prone self-concept as well as a simultaneously increased degree of self-focused attention are suggested.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Dorina
authors.identifier: 0000-0002-5096-7995
authors.initials: D
authors.lastname: Winter
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Koplin
authors.affiliation: Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lis
keywords: Personality disorders; Self-awareness; Self-focused attention; Self-reference; Social rejection