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Aberrations of self-experience are considered a core feature of Borderline Personality Disorder (BPD). While prominent etiologic accounts of BPD, such as the mentalization based approach, appeal to the developmental constitution of self in early infant-caregiver environments, they often rely on a conception of self that is not explicitly articulated. Moreover, self-experience in BPD is often theorized at the level of narrative identity, thus minimizing the role of embodied experience. In this article, we present the hypothesis that disordered self and interpersonal functioning in BPD result, in part, from impairments in “embodied mentalization,” that manifest foundationally as alterations in minimal embodied selfhood, i.e. the first-person experience of being an individuated embodied subject. This account of BPD, which engages early intersubjective experiences has the potential to integrate phenomenological, developmental, and symptomatic findings in BPD, and is consistent with contemporary theories of brain function.

Personal space (PS) regulation is a key component of effective social engagement. PS varies among individuals and is regulated by brain circuits involving the amygdala and the frontoparietal network. Others have reported that simulated PS intrusions suggest larger preferred interpersonal distance (PID) and a central role of amygdala hyperactivity in PS regulation in Borderline Personality Disorder (BPD). This study is the first report of live interpersonal distance preferences and relation to specific symptoms in BPD. We found a 2-fold larger PID in BPD than control (n=30, n=23). There were no significant differences in PID in BPD subject by medication status or pre-study diagnosis, and no significant correlations between PID and intensity of BPD, mood, anxiety, impulsive, or psychotic symptoms. In summary, PID is larger in BPD than control subjects. Unexpectedly, BPD subject PID did not differ in by medication status and did not correlate with intensity of any of the symptom types tested. We discuss these findings in context of severe attachment disturbances in BPD and the relationship between metaphoric social distance in the attachment framework. Future work is needed to identify neural circuits underlying PS regulation in BPD, individual differences in attachment, and relationship to symptom trajectory., Comment: pre-print

BackgroundOne aspect of selfhood that may have relevance for Borderline Personality Disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion (RHI) to manipulate sense of body ownership in BPD. We extended previous research on illusory body ownership in BPD by testing: 1) two illusion conditions: asynchronous & synchronous stimulation, 2) relationship between Illusion experience and BPD symptoms, and 3) relationship between illusion experience and maladaptive personality traits.MethodsWe measured illusion strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand position), BPD symptoms (DIB-R score), and maladaptive personality traits (PID-5) in 24 BPD and 21 control participants.ResultsFor subjective illusion strength, we found a main effect of group (BPD > HC, F = 11.94 p = 0.001), and condition (synchronous > asynchronous, F(1,43) = 22.80, p < 0.001). There was a group x condition interaction for proprioceptive drift (F(1,43) = 6.48, p = 0.015) such that people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline symptom severity correlated with illusion strength within the BPD group, and this effect was specific to affective symptoms (r = 0.48, p < 0.01). Across all participants, trait psychoticism correlated with illusion strength (r = 0.44, p < 0.01).ConclusionPeople with BPD are more susceptible to illusory body ownership than controls. This is consistent with the clinical literature describing aberrant physical and emotional experience of self in BPD. A predictive-coding framework holds promise to develop testable mechanistic hypotheses for disrupted bodily self in BPD.HighlightsThe rubber hand illusion (RHI) allows measurement of self-disturbance.People with BPD had greater illusion susceptibility and this correlated with affective symptoms.Interoception stabilizes representations of body ownership, and is impaired in BPD.Illusion strength correlates with psychotic traits across levels of psychopathology.Predictive coding frameworks can probe mechanisms of impaired body ownership in psychopathology.