A study of individuals seeking treatment for borderline personality disorder found that there is a gap between their own perceived social preferences and their expectations about the social preferences of others, which can foster a vicious cycle of misunderstanding and disappointment in social relationships. This vicious cycle can then lead to increased feelings of loneliness. The paper was published in General psychiatry.
Borderline personality disorder is a mental health condition characterized by ongoing problems with emotional regulation, self-image, behavior, and relationships. People with this condition frequently experience very intense emotions that change rapidly, sometimes over hours or days.
Common features of this disorder include fear of abandonment, unstable or intense relationships, impulsive behavior, and a changing or uncertain sense of self. Others may feel a chronic sense of emptiness, anger that is difficult to control, and cognitive changes related to doubt and stress.
The condition often begins by late adolescence or early adulthood. Borderline personality disorder can occur along with depression, anxiety, post-traumatic stress disorder, substance use problems, eating disorders, or bipolar disorder, making diagnosis more complex.
Study author Ruben Fonderlin and his colleagues investigated whether individuals with borderline personality disorder differed from non-clinical control participants in their social value orientation and expectations from others. They wanted to know whether the discrepancy between these traits was related to how lonely these people felt.
Social value orientations are people’s relatively stable preferences about how outcomes should be distributed between themselves and others. It ranges from more egocentric preferences, where people place greater emphasis on personal gain, to more prosocial preferences, where people value fairness and good outcomes for everyone. Expectations from others are beliefs about the social value preferences of others.
The authors hypothesized that people with borderline personality disorder may believe that they have fairly prosocial values, but at the same time expect others to be more selfish and unfair. The gap in how people with this disorder perceive themselves and how they perceive others can contribute to feelings of isolation.
The study participants were 60 people diagnosed with borderline personality disorder and 60 healthy people matched on education and gender. Participants in each group consisted of 8 men and 52 women. Participants with borderline personality disorder had more severe symptoms of the disorder and stronger feelings of loneliness compared to a group of healthy participants.
Study participants completed assessments of their own social value orientations and expectations about others’ social values (using a slider task that allocates resources between themselves and strangers), as well as justice sensitivity (both expectations about their own and others’ justice sensitivity) (Justice Sensitivity Inventory). Justice sensitivity is the tendency to recognize and react strongly to injustice experienced as a victim, observer, beneficiary, or perpetrator.
The results showed that the discrepancy between participants’ own social values and their expectations of the social values of others was higher for participants with borderline personality disorder than for normal participants. As expected, participants with borderline personality disorder perceived themselves to be more sociable compared to the control group. The two groups did not differ in their perceptions of others’ social values.
Similarly, participants with borderline personality disorder had significant differences compared to normal participants in how they perceived their own justice sensitivity and how they perceived the justice sensitivity of others, particularly regarding injustices that occur to others. These participants were more likely to consider themselves to be concerned about injustice (especially when observing injustice or benefiting from injustice) than others expected.
Further analysis revealed that participants with borderline personality disorder who perceived themselves as more prosocial tended to feel more lonely. This association was not present in the control group. Loneliness was also associated with the size of the difference between one’s own justice sensitivity and the perceived justice sensitivity of others. However, that was only in the group of participants with borderline personality disorder, and specifically in scenarios where they observed injustice or benefited from injustice.
“The results of this study indicate that individuals generally perceive themselves to be more prosocial and more concerned about injustice than others expect them to be. This misalignment is particularly pronounced in BPD (borderline personality disorder). Increased prosocial preferences and JS (justice sensitivity) tend to make people with BPD particularly sensitive to perceptions of injustice in social interactions, which can lead to more intense emotional reactions such as anger, moral outrage, and guilt.”
Strongly held ideals of prosocial behavior and justice can place excessive demands on the social behavior an individual aspires to. This discrepancy between self and others can make people with borderline personality disorder more likely to feel lonely. “In people with borderline personality disorder, heightened social ideals conflict with pessimistic expectations about the moral behavior of others,” the study authors concluded.
This study contributes to scientific knowledge about borderline personality disorder. However, the authors noted some limitations. The external validity of the findings may be limited because the sample consisted of treatment-seeking individuals and was predominantly female. Furthermore, the lack of clinical control groups (such as patients with other personality disorders) means that it is unclear whether these mechanisms are unique to borderline personality disorder or common to other mental health conditions. Finally, laboratory-based cross-sectional designs do not allow causal inferences from the results.
This paper, “Loneliness in Borderline Personality Disorder: The role of the mismatch between self-view and social expectations in social value orientation and justice sensitivity,” was authored by R. Vonderlin, C. Krauss, S. Hanrath, AS Lerkle, B. Seignes, N. Kleindienst, T. Boritz, S. McMain, T. Theismann, P. Kirsch, M. Beauhues, and S. Rhys.
