title: Understanding Negative Self-Evaluations in Borderline Personality Disorder-a Review of Self-Related Cognitions, Emotions, and Motives.
abstract: Self-conscious emotions, such as guilt, shame, or self-disgust, as well as self-related motives, such as self-enhancement or self-verification, influence how people perceive, evaluate, memorize, and respond to self-related information. They not only influence peoples' concepts of themselves but may also affect their behavior in social environments. In the current review, we describe alterations of self-related processing in borderline personality disorder (BPD). We chose BPD as an example of a mental disorder of which impairments in self-functioning and identity constitute a major feature. Since terminology used in clinical research on self-referential processing is diverse and often confusing, we start with reviewing some of the main concepts in this area of research using a conceptual framework provided from social psychology. Most studies on self-referential processing in BPD focused on descriptions of self-esteem and revealed a negative self-concept, particularly expressed by explicitly reported low self-esteem. Moreover, self-esteem is unstable in BPD and likely reactive to self-relevant cues. BPD patients are prone to negative emotions with respect to themselves, such as self-disgust and shame. First data point to altered self-related motives, too. In conclusion, although explicit self-esteem is widely studied as a global and trait-like feature of BPD, there is a strong lack of studies that take the complexity of the construct self-esteem into account. Further studies on alterations in self-related processes are required to deepen our understanding of impairments of the self-concept in BPD and enable the improvement of psychosocial therapeutic approaches.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. Dorina.Winter@zi-mannheim.de.
authors.forename: Dorina
authors.initials: D
authors.lastname: Winter
authors.affiliation: Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.|Faculty of Health, University of Antwerp, Antwerp, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Bohus
authors.affiliation: Institute of 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
mesh_terms: D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology*; D004644:Emotions; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D009042:Motivation; D012649:Self Concept; D012647:Self-Assessment; D012752:Shame; D055815:Young Adult
keywords: Borderline personality disorder; Guilt; Self; Self-concept; Self-disgust; Self-enhancement; Self-esteem; Self-image; Self-referential processing; Self-verification; Shame