A Model of Trust Processes in Borderline Personality Disorder: A Systematic Review.

PURPOSE OF REVIEW: Unstable relationships are a core feature of borderline personality disorder (BPD). Impairments in trust processes (i.e., appraisal and learning regarding others' trustworthiness) can subserve interpersonal problems associated with BPD, but the determinants, mechanisms, consequences, and variations in trust impairments among individuals with BPD remain poorly characterized. Thus, a better understanding of such impairments could help target interventions that address the interpersonal problems of individuals with BPD beyond emotion dysregulation, impulsivity, and aggression. RECENT FINDINGS: We conducted a pre-registered systematic review of empirical studies on trust processes and BPD features (k = 29). Results are organized around a heuristic model of trust processes in BPD comprising the following stages: developmental factors, prior beliefs and dispositions, situation perception, emotional states, trust appraisal, behavioral manifestations, and trust learning. Based on the synthesis of the findings, we recommended directions for future research and clinical assessment and intervention, such as managing trust during the early stages of therapy and considering improvements in trust processes as a central mechanism of change in treating individuals with BPD.

Trust and Rejection Sensitivity in Personality Disorders.

PURPOSE OF REVIEW: We review recent empirical investigations about two core processes subtending impairments in interpersonal functioning and, more precisely, cooperative behaviors in personality disorders: Trust toward others and rejection sensitivity. The main contributions are about borderline and narcissistic personality disorders but we report a little evidence about other personality disorders too (i.e., avoidant, antisocial, and paranoid personality disorders). RECENT FINDINGS: Regarding borderline personality disorder, a misinterpretation of situations as threatening seems to be relevant for both trust and rejection sensitivity. With specific regard to narcissistic personality disorder, results suggest rejection sensitivity and distrust to be plausible risk factors for aggressive outbursts. Empirical findings display specific patterns of disturbances in rejection sensitivity and trust dynamics across different personality disorders. Nonetheless, further studies on personality disorders other than borderline or narcissistic personality disorder are needed. A deeper understanding may provide insight for better clinical management of such impairments among patients with personality disorders.

Gaze towards my choice: Noneconomic social interaction changes interpersonal trust only with positive feedback.

Trust is a crucial foundation of human society, dynamically changing along with interpersonal interactions. Previous research suggested that both gaze behaviors and affective states might influence our trust evaluation. Here, we created an uncertain decision-making environment to investigate how these two aspects change interpersonal trust during social interactions. Specifically, participants made a forced choice between two price-matched goods to determine which one was more expensive. After participants made a choice, the face in the center of the screen would gaze towards or away from the participants' choice, and then participants would receive timely feedback informing whether their choice was correct or not. In Experiment 1 (N = 34), we found people increased their trust ratings for gaze-followers but reduced them for gaze-unfollowers when they received positive feedback, but stayed with their initial judgments when receiving negative feedback. Experiment 2 (N = 20) and Experiment S1 (N = 20) further revealed the same change patterns on participants' trust investments in different conditions. These results suggest that gaze-following behavior can change people's trust evaluations as well as trust behaviors, while affective states induced by different feedback modulate this process in a flexible manner.

The Level of Personality Functioning Scale Applied to Clinical Material From the Structured Interview of Personality Organization (STIPO): Utility in Detecting Personality Pathology.

The Alternative Model for Personality Disorders states that personality pathology involves significant impairment in personality functioning that can be assessed using the Level of Personality Functioning Scale (LPFS). However, the ability of the LPFS to capture impairments typical of personality pathology, rather than of general psychopathology, is still unclear. The authors applied a 12-item version of the LPFS to clinical interviews (i.e., the Structured Interview of Personality Organization [STIPO]) to test whether differences in levels of impairment in domains related to both self- and interpersonal functioning can be detected among patients with personality disorders (n = 33), psychiatric outpatients (n = 30), and nonclinical controls (n = 30). Results show that the 12-item version of the LPFS scored using clinical material gathered through STIPO interviews captures impairments in identity, self-direction, and empathy uniquely linked to personality pathology. However, impairments in intimacy do not differentiate between patients with and without personality disorders.