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The role of impairments in self-other distinction in borderline personality disorder: A narrative review of recent evidence

Journal

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 127, Issue -, Pages 242-254

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2021.04.022

Keywords

Borderline personality disorder; Self-other distinction; Temporoparietal junction; Interpersonal synchrony; Interpersonal attunement; Interoception; Body ownership; Agency

Funding

  1. Research Foundation-Flanders (FWO) [11B9718N]

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Studies suggest that individuals with borderline personality disorder have impairments in maintaining a differentiated sense of self and others, possibly due to deficits in multisensory integration and the ability to switch between self and other representations based on task demands. Furthermore, disruptions in infant-caregiver synchrony during early development may play a role in the development of these impairments.
Impairments in maintaining a differentiated sense of self and other are thought to be a central feature of borderline personality disorder (BPD). However, studies directly focusing on self-other distinction (SOD) in BPD are scarce, and these findings have not yet been integrated with novel insights into the neural mechanism involved in SOD. Here, we present a narrative review of recent behavioral and neuroimaging findings focusing on impairments in SOD in BPD. Behavioral findings of SOD at the embodied level provide preliminary evidence for impairments in multisensory integration in BPD. Furthermore, both behavioral and neuroscientific data converge to suggest that SOD impairments in BPD reflect an inability to shift between self and other representations according to task demands. Research also suggests that disruptions in infant-caregiver synchrony may play a role in the development of these impairments. Based on these findings, we present a new, integrative model linking impairments in SOD to reduced neural and behavioral synchrony in BPD. The implications of these findings for future research and clinical interventions are outlined.

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