The mediating role of Emotional Intelligence in explaining the causal relations between Theory of Mind and Cognitive Flexibility with Borderline Personality Disorder traits in Adolescents

Subject Areas : Tectonostratigraphy

Mohadeseh Fateminia ¹ , Fariba Hasani ² , Ahmad Borjali ³ , Fatemeh Golshani ⁴

1 - Ph.D. Student of General Psychology, Departent of General Psychology, Central Tehran, Islamic Azad Universit, Tehran, Iran
2 - Assistant Professor, Departent of General Psychology, Central Tehran Branch, Islamic Azad Universit, Tehran, Iran
3 - Professor, Departent of Clinical Psychology, Facult of Psychology and Educational Sciences, Allameh Tabatabai University, Tehran, Iran
4 - Assistant Professor, Departent of General Psychology, Central Tehran Branch, Islamic Azad Universit, Tehran, Iran.

Received: 2022-10-29 Accepted : 2023-02-28 Published : 2023-01-21

Keywords: Emotional intelligence, Cognitive Flexibility, Borderline personality disorder, Theory of mind,

Abstract :

Introduction: People with borderline personality disorder have deficits in cognitive flexibility, theory of mind, and emotional intelligence. The aim of this study was determining the mediating role of emotional intelligence in explaining the causal relations between theory of mind and cognitive flexibility with borderline personality disorder traits in adolescents. Method: The present study was conducted by correlation method and structural equation modeling. The statistical population of the research was made up of all teenagers studying in schools of the 5th education region of Tehran in 2018-2019. 352 people were selected by available sampling method. The participants answered the Borderline Personality Inventory, the Cognitive flexibility questionnaire, the Reading the Minds of the Eyes Test and the Bradberry-Greaves’ Emotional Intelligence individually during one session. The results showed the total path coefficient between theory of mind (β=0.210, P<0.01) and cognitive flexibility (β=0.219, P<0.01) with negative borderline personality disorder traits and at the 0.01 level was significant. The path coefficient between emotional intelligence and borderline personality disorder traits was negative and significant at the 0.01 level (β=0.322, P < 0.01). Indirect path coefficient between theory of mind (P < 0.01, β = -0.113) and cognitive flexibility (P < 0.01, β = -0.109) with negative borderline personality disorder traits and at the level of 0.01 was significant. Therefore, emotional intelligence mediates the relations between theory of mind and cognitive flexibility with borderline personality disorder traits in a negative and significant path. Conclusion: Cognitive and emotional factors can predict the borderline personality disorder traits in adolescents.

References:

References

1- Bozzatello P, Bellino S, Bosia M, Rocca P. Early detection and outcome in borderline personality disorder. Frontiers in psychiatry, 2019, 10, 710. https://doi.org/10.3389/fpsyt.2019.00710

2- Gratz KL, Kiel EJ, Mann AJ, Tull MT. The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness. Journal of affective disorders. 2022, https://doi.org/10.1016/j.jad.2022.06.066

3- Kuo JR, Khoury JE, Metcalfe R, Fitzpatrick S, Goodwill A. An examination of the relationship between childhood emotional abuse and borderline personality disorder features: The role of difficulties with emotion regulation. Child abuse & neglect, 2015, 39, 147-155. https://doi.org/10.1016/j.chiabu.2014.08.008

4- Videler AC, Hutsebaut J, Schulkens JE, Sobczak S, Van Alphen SP. A life span perspective on borderline personality disorder. Current psychiatry reports, 2019, 21(7), 1-8. https://link.springer.com/article/10.1007/s11920-019-1040-1

5- Németh N, Mátrai P, Hegyi P, Czéh B, Czopf L, Hussain A, ... Simon M. Theory of mind disturbances in borderline personality disorder: A meta-analysis. Psychiatry Research, 2018, 270, 143-153. https://doi.org/10.1016/j.psychres.2018.08.049

6- Janke K. Aspects of social cognition and memory in patients with borderline personality disorder (Doctoral dissertation). 2022, http://dx.doi.org/10.17169/refubium-34531

7- Royka A, Santos LR. Theory of Mind in the Wild. Current Opinion in Behavioral Sciences, 2022, 45, 101137. https://doi.org/10.1016/j.cobeha.2022.101137

8- Ahmadi E, Bafandeh H, Dadashi S. Comparision of theory of mind in college students with borderline personality disorder traits and normal counterparts. Rooyesh-e-Ravanshenasi Journal (RRJ), 2018,  7(5), 147-160.‏ http://dorl.net/dor/20.1001.1.2383353.1397.7.5.6.3

9- Normann E, Antonsen BT, Kvarstein EH, Pedersen GF, Vaskinn A, Wilberg T. Are impairments in theory of mind specific to borderline personality disorder?. Journal of personality disorders, 2019, 1-15. https://doi.org/10.1521/pedi_2019_33_417

10- Ortega-Díaz E, García-Campos J, Moya-Martínez A, Ramírez-Cremades C, Rico-Gomis JM, Cuesta-Moreno C, ... Rodríguez-Marín J. Theory of mind in borderline personality disorder: a possible endophenotypic factor?. International Journal of Environmental Research and Public Health, 2021, 18(6), 3193. https://doi.org/10.3390/ijerph18063193

11- Stead VE, Schmidt LA, Crowley MJ, Dyce L, Hall GB, Van Lieshout RJ, Boylan K. Frontal EEG asymmetry moderates the relation between borderline personality disorder features and feelings of social rejection in adolescents. Development and Psychopathology,2022, 1-15. https://doi.org/10.1017/S0954579422000128

12- Dadashi S, Ahmadi E, Bafandeh Gharamaleki H. Investigation of Neuropsychological Dysfunctions and Theory of mind Deficiency in Subjects with Borderline Personality Disorder Traits. Neuropsychology, 2018, 4(13), 139-158. https://dorl.net/dor/20.1001.1.24765023.1397.4.13.10.4

13- Zafaranchizadeh Moqadam M, Mojtabaie M, Bashardoust S. Study of the relationship between dark triad of personality with cold empathy with mediating role of emotional and cognitive theory of mind in individuals with borderline personality disorder symptoms. Journal of Modern Psychological Researches, 2022, 17(65).‏ https://journals.tabrizu.ac.ir/article_14882.html

14- Pineda-Alhucema W, Aristizabal E, Escudero-Cabarcas J, Acosta-Lopez JE, Vélez JI. Executive function and theory of mind in children with ADHD: A systematic review. Neuropsychology Review, 2018, 28(3), 341-358. https://link.springer.com/article/10.1007/s11065-018-9381-9

15- Koudys JW, Ruocco AC. Executive functioning in adults with borderline personality disorder and first-degree biological relatives. The World Journal of Biological Psychiatry, 2021, 1-14. https://doi.org/10.1080/15622975.2021.2012396

16- Vai B, Cazzetta S, Scalisi R, Donati A, Bechi M, Poletti S, ... Benedetti F. Neuropsychological deficits correlate with symptoms severity and cortical thickness in borderline personality disorder. Journal of Affective Disorders, 2021, 278, 181-188. https://doi.org/10.1016/j.jad.2020.09.060

17- Del Pozo MA, Harbeck S, Zahn S, Kliem S, Kröger C. Cognitive distortions in anorexia nervosa and borderline personality disorder. Psychiatry research, 2018, 260, 164-172. https://doi.org/10.1016/j.psychres.2017.11.043

18- Firouzjaei NH, Soltani E, Dastgheib SA. The relationship between cognitive flexibility and cognitive fusion with the borderline personality disorder symptoms. Researcher Bulletin of Medical Sciences, 2020, 25(1), e9-e9. https://journals.sbmu.ac.ir/index.php/rbms/article/view/34714

19- Anupama V, Bhola P, Thirthalli J, Mehta UM. Pattern of social cognition deficits in individuals with borderline personality disorder. Asian journal of psychiatry, 2018, 33, 105-112. https://doi.org/10.1016/j.ajp.2018.03.010

20- Hurtado MM, Triviño M, Arnedo M, Roldán G, Tudela P. Are executive functions related to emotional intelligence? A correlational study in schizophrenia and borderline personality disorder. Psychiatry Research, 2016, 246, 84-88. https://doi.org/10.1016/j.psychres.2016.09.027

21- Alipour A, Arefnasab Z, Babamahmoodi A. Emotional intelligence and prefrontal cortex: a comparative study based on Wisconsin card sorting test (WCST). Iranian journal of psychiatry and behavioral sciences,2011,  5(2), 114. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939963/

22- Tsui CF, Huang J, Lui SS, Au AC, Leung MM, Cheung EF, Chan RC. Facial emotion perception abnormality in patients with early schizophrenia. Schizophrenia Research, 2013, 147(2-3), 230-235. https://doi.org/10.1016/j.schres.2013.04.019

23- Outcalt J, Dimaggio G, Popolo R, Buck K, Chaudoin-Patzoldt KA, Kukla M, ... & Lysaker PH. Metacognition moderates the relationship of disturbances in attachment with severity of borderline personality disorder among persons in treatment of substance use disorders. Comprehensive psychiatry, 2016,64, 22-28. https://doi.org/10.1016/j.comppsych.2015.10.002

24- Chung YS, Barch D, Strube M. A meta-analysis of mentalizing impairments in adults with schizophrenia and autism spectrum disorder. Schizophrenia bulletin, 2014, 40(3), 602-616. https://doi.org/10.1093/schbul/sbt048

25- Kline RB. Principles and practice of structural equation modeling, edition 4, Guilford press, New York & London. 2016.

26- Leichsenring F. Development and first results of the Borderline Personality Inventory: A self-report instrument for assessing borderline personality organization. Journal of Personality Assessment, 1999, 73(1), 45-63. https://doi.org/10.1207/S15327752JPA730104

27- Jackson M, Claridge G. Reliability and validity of a psychotic traits questionnaire (STQ). British Journal of Clinical Psychology, 1991, 30(4), 311-323. https://doi.org/10.1111/j.2044-8260.1991.tb00952.x

28- Rawlings D, Claridge G, Freeman JL. Principal components analysis of the schizotypal personality scale (STA) and the borderline personality scale (STB). Personality and Individual Differences, 2001, 31(3), 409-419. https://doi.org/10.1016/S0191-8869(00)00146-X

29- Mohammadzadeh A. Validation of the borderline personality inventory in Iran. International Journal of Behavioral Sciences, 2011, 5(3), 269-277.‏ https://www.noormags.ir/view/en/articlepage/48738/272

30- Baron‐Cohen S, Wheelwright S, Hill J, Raste Y, Plumb I. The “Reading the Mind in the Eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high‐functioning autism. Journal of child psychology and psychiatry, 2001, 42(2), 241-251. https://doi.org/10.1017/S0021963001006643

31- Saffarinia M, Mohammadi R, Hasanzadeh S. Decision Making Styles and Mindfulness and Mind Reading: The Study of These Structures Relationship in a Non-Clinical Group. Social Cognition, 2016, 5(2), 120-135. https://sc.journals.pnu.ac.ir/article_3274_503.html?lang=en

32- Dennis JP, Vander Wal JS. The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognitive therapy and research, 2010, 34(3), 241-253. https://link.springer.com/article/10.1007/s10608-009-9276-4

33- Shareh H, Farmani A, Soltani E. Investigating the reliability and validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian university students. 2014, https://jpcp.uswr.ac.ir/browse.php?a_id=163&sid=1&slc_lang=fa

34- Ganji H, Mirhashmi M, Thabit M. Preliminary standardization of Bradbury-Graves emotional intelligence test. Quarterly Journal of Applied Psychology, 2015, 1(2): 25-35.

35- Sharp C, Pane H, Ha C, Venta A, Patel AB, Sturek J, Fonagy P. Theory of mind and emotion regulation difficulties in adolescents with borderline traits. Journal of the American Academy of Child & Adolescent Psychiatry, 2011, 50(6), 563-573. https://doi.org/10.1016/j.jaac.2011.01.017

36- Khosravi M, Hassani F. The protective effect of emotional intelligence on suicidality: A multiple mediation model among patients with borderline personality disorder. Personality and individual differences, 2022, 189, 111488. https://doi.org/10.1016/j.paid.2021.111488

37- Avarzamani L, Hosein Mozafarian M, Shahmiri Barzoki H, Rahnejat A, Ebrahimi M. Comparison of emotional intelligence in young male patients with borderline personality disorder or traits and healthy controls. Professional Psychology: Research and Practice. 2021, 52(4) :352-359. https://doi.org/10.1016/j.paid.2021.111488

38- Bakhshizadeh A, Rahanejad AM. Predicting of borderline personality disorder (BPD) based on emotional intelligence, apathy and empathy among the soldiers admitted to a military hospital. Revista Latinoamericana de Hipertensión, 2019, 14(1), 75-82. https://www.redalyc.org/journal/1702/170259294012/170259294012.pdf

39- Shokrollahi Z, khanzadeh M. Designing and testing a structural model of the antecedents of borderline personality disorder symptoms and quality of life in students. Research in Cognitive and Behavioral Sciences,2021,  11(1), 163-180. https://dorl.net/dor/20.1001.1.22517642.1400.11.1.12.0

40- Pourmohammad P, Imani M, Goodarzi MA, Sarafraz MR. Impaired complex theory of mind and low emotional self-awareness in outpatients with borderline personality disorder compared to healthy controls: A cross-sectional study. Journal of Psychiatric Research, 2021, 143, 445-450. https://doi.org/10.1016/j.jpsychires.2021.10.009

41- Kiliç F, Demirdas A, Isik Ü, Akkus M, Atay IM, Kuzugüdenlioglu D. Empathy, alexithymia, and theory of mind in borderline personality disorder. The Journal of Nervous and Mental Disease, 2020, 208(9), 736-741. https://doi.org/10.1097/nmd.0000000000001196

42- Arjmandi Oliya MS, Rezaei A, Kazemei S, Shorabi N. The Mediation Role of Emotional Intelligence in the Relationship between the Dimensions of Mind Theory and Social Skills in Students with Learnin Disabilities. Psychological Methods and Models, 2021, 11(42), 32-47.‏ http://jpmm.marvdasht.iau.ir/m/article_4579.html?lang=en