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Abstract Background Interpersonal impairments in patients diagnosed with borderline personality disorder (BPD) are characterized by the fear of being rejected and high levels of loneliness. Potential underlying factors are alterations in the processing of social interactions and the associated perceptions of social partners. In this regard, BPD patients tend to attribute the cause of negative rather than positive events to their own person and to perceive others as less trustworthy than healthy controls (HCs). To date, no study has investigated whether the effect of experimentally influenced causal attributions of social interactions on the perception of a social partner differs between BPD patients and HCs. Methods A new virtual reality paradigm was developed to investigate the perception of benevolence following the induction of social rejection and acceptance, while experimentally manipulating whether an external cause for this behavior was provided. The data of 62 participants (32 HCs, 30 BPD patients) were analyzed using linear mixed-effects models. Associations of benevolence ratings with attributional style, rejection sensitivity, self-esteem, childhood trauma, and loneliness were investigated via correlational and multiple linear regression analyses. Results Across both groups, a social partner was rated as less benevolent following rejection than following acceptance. An external explanation mitigated this negative effect of rejection. Overall, benevolence ratings were lower in BPD patients than in HCs. This group difference was stronger following acceptance than following rejection. Independent of acceptance and rejection, an external explanation was associated with a higher level of benevolence only in the HC group. No associations of the effects of the experimental conditions with attributional style, childhood trauma, rejection sensitivity, self-esteem, or loneliness were found. Conclusion Our findings indicate that acceptance and provided external explanations for rejection have a less positive impact on the perception of a social partner’s attitude toward oneself in BPD patients than in HCs. More research is needed to identify predictors of benevolence perception and which steps of social information processing are altered. The therapeutic implications include the importance of strengthening the perception and enjoyment of being accepted as well as improving the mentalizing ability of BPD patients.

Abstract Background Attributions are the processes by which individuals explain the causes of positive and negative events. A maladaptive attributional style has been associated with reduced self-esteem, psychosocial functioning, and mental health. Although many psychosocial interventions target an individual’s attributional style in mental disorders, studies of its alterations in Borderline Personality Disorder (BPD) are sparse. This study aimed to investigate the attributional style in patients with BPD in comparison to healthy control individuals (HC) and its association with self-esteem and psychosocial functioning. Methods The participants (32 patients with a diagnosis of BPD, 32 HC, groups were balanced for sex, age and education) assessed their attributional style in regard to locus of control, stability and globality for positive and negative scenarios. Attributional style was compared between groups and linked to self-reports of self-esteem, loneliness and psychosocial functioning in different social domains while controlling for BPD and depressive symptom severity. Results Individuals diagnosed with BPD reported a maladaptive attributional style for both positive and negative events. This was found to be strongly related with lower self-esteem and higher levels of loneliness, but not with psychosocial dysfunctions assessed in different social domains. The severity of BPD and depressive symptoms did not fully explain the association of attributional style with self-esteem and loneliness. In contrast, correcting for acute psychopathology actually strengthened the relationship between self-esteem and maladaptive inferring causality for positive events. Conclusion The differential association of attributional style for positive and negative events with self-esteem and psychosocial functioning highlights the importance of considering the different facets of inferring causality during psychosocial interventions. Our findings suggest that the significance of cognitive alterations may change with remission of acute BPD and depressive psychopathology, depending on the valence of an event.