We also could not confirm our secon

We also could not confirm our second hypothesis that patients with BPD would perceive




emotional interactions as being more intense than HC would. This is in line with research reporting an inability to detect a dichotomous or extremely intense evaluation style in BPD patients (Sieswerda et al.,
2013; Veen & Arntz, 2000). Contrary to previous findings of a more extreme evaluation of personality traits we did not detect such an effect in this study as that found when applying the same paradigm to a group of patients with major depressive disorder (Kaletsch et al., 2014). Whereas patients with major depressive disorder may tend to perceive negative emotional interactions more intense, people with
BPD might show differential effects not when observing but only when directly involved in an interaction and therefore making the interaction more personally relevant. The non-significant interaction for the intensity of ratings indicated that patients with BPD rated monadic scenes as being more intense, but only when the depicted emotional scene was negative.

The most important finding in the present study is that patients with BPD were significantly less confident when perceiving and evaluating the depicted emotional scenes. This lack of confidence in perceiving emotional body movements may be based on a history of invalidating, instable, and confusing emotional experiences gained with, for example, attachment figures who provided unreliable emotional responses. This insecurity, in turn, could lead to less confidence in evaluating personal interactions (Fonagy, 2000). Such a pattern of emotion perception combined with a high need for self-protection could lead to insecure or less competent behavior within social interactions, to withdrawal, or to avoidance behavior (Newman, Stevenson, Bergman, & Boyce, 2007). In the long term, feelings of insecurity may lead to lower self-confidence and self-efficacy, negative and instable affect, or states of emotional dysregulation (Fruzzetti, Shenk, & Hoffman, 2005; Johnson et al., 2002).

Interestingly, even though it failed to attain significance the two-way interaction between difficulty and group indicated that patients with PBD became less confident as the depicted emotion became more difficult to recognize. This could imply that patients are more confident when depicted




emotions are strong and expressive, as they often experience them to be for themselves, or people in interactions with patients often might have expressed them, but become less confident, the more subtle and sensitive the expressed emotions are. This might be understood against the background that patients often have a history of violence, abuse and extreme emotions in the past, so that they might be more familiar with this kind of emotion information and therefore might have difficulties in assessing ambiguous, difficult or rather less extreme emotions (Barnow et al., 2005; K. Lieb, M. Zanarini, C. Schmahl, M. Linehan, & M. Bohus, 2004; Zanarini, 2000).