Modulation of Trust in Borderline Personality Disorder by Script-Based Imaginal Exposure to Betrayal

• Published in: Journal of personality disorders Vol. 37; no. 5; p. 508
• Main Authors: Shapiro-Thompson, Rosa, Shah, Tanya V, Yi, Caroline, Jackson, Nasir, Trujillo Diaz, Daniel, Fineberg, Sarah K
• Format: Journal Article
• Language: English
• Published: United States 01.10.2023
• Subjects: Betrayal; Borderline Personality Disorder; Humans; Trust; trust; social learning; script-driven imagery; confederate; borderline personality disorder; reinforcement learning
• ISSN: 1943-2763
• DOI: 10.1521/pedi.2023.37.5.508

Interpersonal and trust-related difficulties are central features of borderline personality disorder (BPD). In this study, we applied script-driven betrayal imagery to evoke mistrustful behavior in a social reinforcement learning task. In 21 BPD and 20 healthy control (HC) participants, we compared this approach to the standard confederate paradigm used in research studies. The script-driven imagery evoked a transient increase in negative affect and also decreased trusting behavior to a similar degree in both groups. Across conditions, we also replicated previously reported between-group differences in negative affect (increased in BPD) and task behavior (more sensitive to social cues in BPD). These results support the validity of script-driven imagery as an alternative social task stimulus. This script-driven imagery approach is appealing for clinical research studies on reinforcement learning because it eliminates deception, scales easily, and evokes disorder-specific states of social difficulty.