Facial emotion recognition in borderline personality disorder: The impact of self-injury and social rejection

Introduction This study examined facial emotion recognition (FER) in individuals with borderline personality disorder (BPD) features, with and without a history of non-suicidal self-injury (NSSI), compared to a control group (CTRL). We assessed seven emotions (anger, disgust, fear, happiness, neutrality, sadness, and pain) and evaluated the effects of social exclusion. Method Participants completed a FER task before and after Cyberball; all participants received the exclusion condition. Measures included accuracy, reaction time, and confidence. Participants also completed the PAI-BOR, RSQ, BDI-II, and BAI. Results At baseline, individuals in the BPD + NSSI group showed reduced accuracy in recognizing negative emotions (anger, disgust, and pain) and had slower response times than CTRL. Higher rejection sensitivity was linked to slower identification of emotional cues. Unexpectedly, social exclusion did not worsen negative biases. Instead, the BPD + NSSI group showed improved recognition of pain and happy expressions, and the most significant reductions in reaction time. No evidence of a global speed–accuracy trade-off emerged; slower responses in clinical groups appeared to reflect greater processing demands rather than deliberate caution. Conclusion Findings suggest emotional sensitivity and processing efficiency in BPD, particularly among those with NSSI. Social exclusion may temporarily enhance perceptual processing in this subgroup. Interventions may benefit from targeting processing efficiency and metacognitive calibration.