Mouse-tracking reveals cognitive conflict during negative impression formation in women with Borderline Personality Disorder or Social Anxiety Disorder

Individuals with Borderline Personality Disorder (BPD) or Social Anxiety Disorder (SAD) suffer from substantial interpersonal dysfunction and have difficulties establishing social bonds. A tendency to form negative first impressions of others could contribute to this by way of reducing approach behavior. We tested whether women with BPD or SAD would show negative impression formation compared to healthy women (HCs). We employed the Thin Slices paradigm and showed videos of 52 authentic target participants to 32 women with BPD, 29 women with SAD, and 37 HCs. We asked participants to evaluate whether different positive or negative adjectives described targets and expected BPD raters to provide the most negative ratings, followed by SAD and HC. BPD and SAD raters both agreed with negative adjectives more often than HCs (e.g., 'Yes, the person is greedy'), and BPD raters rejected positive adjectives more often (e.g., 'No, the person is not humble.'). However, BPD and SAD raters did not differ significantly from each other. Additionally, we used the novel process tracing method mouse-tracking to assess the cognitive conflict (via trajectory deviations) raters experienced during decision-making. We hypothesized that HCs would experience more conflict when making unfavorable (versus favorable) evaluations and that this pattern would flip in BPD and SAD. We quantified cognitive conflict via maximum absolute deviations (MADs) of the mouse-trajectories. As hypothesized, HCs showed more conflict when rejecting versus agreeing with positive adjectives. The pattern did not flip in BPD and SAD but was substantially reduced, such that BPD and SAD showed similar levels of conflict when rejecting and agreeing with positive adjectives. Contrary to the hypothesis for BPD and SAD, all three groups experienced substantial conflict when agreeing with negative adjectives. We discuss therapeutic implications of the combined choice and mouse-tracking results.