Trustworthiness Appraisal in Borderline Personality Disorder The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Masland, Sara Rose. 2016. Trustworthiness Appraisal in Borderline Personality Disorder. Doctoral dissertation, Harvard University, Graduate School of Arts & Sciences. Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:33840646 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA Trustworthiness Appraisal in Borderline Personality Disorder A dissertation presented by Sara Rose Masland To The Department of Psychology in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the subject of Psychology Harvard University Cambridge, Massachusetts May 2016 © 2016 Sara Rose Masland All rights reserved. ! Advisor: Dr. Jill Hooley Author: Sara Rose Masland ! Trustworthiness Appraisal in Borderline Personality Disorder Abstract Borderline personality (BPD) is a highly impairing illness with marked instability across multiple domains, including affect, interpersonal functioning, identity, and behavior. Within the past 15 years, researchers have sought to understand and characterize deficits in social cognition that might contribute to or arise from affective or interpersonal dysfunction. The purpose of this dissertation is to understand one aspect of impaired social cognition in BPD: biased trust processing. Individuals with borderline features rate others as less trustworthy in laboratory tasks and act accordingly. However, little is known about the influence of affect on ratings or behavior, or whether biased processing is related to real-world functioning or is merely an artifact of the laboratory. The main study included two groups of participants: (1) individuals who met 3 or more diagnostic criteria for borderline personality disorder (n =30) and (2) a control group of individuals who met 2 or fewer diagnostic criteria (n = 47). An experimental paradigm was used to determine whether affectively arousing information has undue influence on trustworthiness ratings for individuals with borderline features. Individuals with borderline features made more negative trustworthiness appraisals overall. Additionally, negative affective information had more impact on trustworthiness ratings for individuals in the borderline features group relative to the control group. This effect was not mediated by rejection sensitivity or moderated by childhood trauma. A recognition task was used to examine the influence of momentary trustworthiness perceptions on recognition. Overall, individuals who rated faces as less trustworthy during the affective priming task also rated faces as less trustworthy during the recognition task. This III ! ! indicates some stability in trustworthiness appraisals. Borderline and control groups did not differ in recognition accuracy. However, the borderline group expressed significantly less certainty than the control group about their responses. Incorrect responses in the borderline group, but not the control group, were also rated as less trustworthy than correct responses. Social functioning was examined using multiple measures. A pilot study examined the utility of three new measures of social functioning designed to address perceived flaws in current measures. A group of community participants (N = 100) completed these measures through Amazon’s Mechanical Turk, an online crowdsourcing service. Preliminary findings from this pilot study suggest that these new measures may add meaningfully to our understanding of social functioning impairments in BPD. These new measures were used alongside already validated measures to examine how laboratory-demonstrated trustworthiness processing biases relate to real-world social functioning. Overall, results indicate that despite its reliability and replicability, the finding that individuals with borderline features have biased trustworthiness appraisal may not have much practical significance. Trustworthiness bias does not translate to real-world social functioning, at least in the current study. Taken together, the findings of the current study show that negative trustworthiness appraisal is a robust and replicable bias in individuals with borderline personality features. Consistent with deficits in frontolimbic regulation of affective influence, this bias is augmentable in the context of negative affective information. However, the bias does not appear to relate to real-world social functioning. Further work is needed to determine whether laboratory- demonstrated trust appraisal biases replicate to more ecologically valid scenarios in which negative trust appraisals may have greater influence on social functioning. IV ! ! Acknowledgements ! Any acknowledgment of support for this dissertation and my intellectual growth must begin with a heartfelt thank you to my advisor, Dr. Jill Hooley. Thank you for artfully supporting my independence while also providing ever-helpful guidance. Thank you for your willingness to help me through blundering sentences and to share in the excitement of my accomplishments. I can only hope to emulate your sage counsel and approachability. For their time and invaluable guidance, I thank the members of my dissertation committee--Drs. Matt Nock, Jason Mitchell, and Lois Choi-Kain. I thank Dr. Barbara Held, my undergraduate mentor, for her early and continued support and trust in my potential. Additionally, without Dr. John Weisz I would not be where I am today, and I thank him. For their help with study recruitment, I thank Drs. Karen Jacob and Shauna Dowden. I also thank my lab mates, particularly Tina Chou and Kathryn Fox, for their comradery and support. Thank you also to Sukriti Drabu, research assistant extraordinaire. To the fellow members of my clinical science cohort—Chris Rutt, David Dodell-Feder, and Dianne Hezel—putting aside all the joking that has helped keep me smiling over the past six years—I am deeply grateful for your friendship and support. I cannot imagine a better group of people to have experienced graduate school (and life) alongside. There have been two incredibly supportive people in my home life: my husband, John, and my dog, Crockett. Thank you for tolerating my neglect during busy times and for never failing to make me laugh, even when I stubbornly resist it. You just get it. This research was supported by the Sackler Foundation, the American Psychological Foundation, and the Department of Psychology at Harvard University. V ! ! ! Dedication ! For my brother, who trusted me unfailingly. VI ! ! Table of Contents CHAPTER 1: INTRODUCTION AND RESEARCH QUESTIONS ......................................................................1 CHAPTER 2: METHOD AND SAMPLE CHARACTERISTICS ........................................................................19 RECRUITMENT ...........................................................................................................................................................20 PROCEDURE ...............................................................................................................................................................21 SAMPLE CHARACTERISTICS .......................................................................................................................................32 SUMMARY .................................................................................................................................................................43 CHAPTER 3: AFFECTIVE PRIMING AND TRUSTWORTHINESS APPRAISAL ........................................45 INTRODUCTION ..........................................................................................................................................................46 SUMMARY AND PREDICTIONS ...................................................................................................................................53 METHOD ....................................................................................................................................................................54 RESULTS ....................................................................................................................................................................56 DISCUSSION ...............................................................................................................................................................74 CHAPTER 4: FACE RECOGNITION AND TRUSTWORTHINESS APPRAISAL .........................................79 INTRODUCTION ..........................................................................................................................................................80 METHOD ....................................................................................................................................................................85 RESULTS ....................................................................................................................................................................86 DISCUSSION ...............................................................................................................................................................95 CHAPTER 5: MEASURING SOCIAL FUNCTIONING ......................................................................................99