Psychological Medicine

Original Articles

Enhanced ‘Reading the Mind in the Eyes’ in borderline personality disorder compared to healthy controls

E. A. Fertucka1 c1, A. Jekala1, I. Songa2, B. Wymana1a2, M. C. Morrisa1, S. T. Wilsona1, B. S. Brodskya1 and B. Stanleya1a3

a1 Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York, NY, USA

a2 Department of Psychology, New York University, New York, NY, USA

a3 Department of Psychology, City University of New York, John Jay College, New York, NY, USA


Background Borderline personality disorder (BPD) is partly characterized by chronic instability in interpersonal relationships, which exacerbates other symptom dimensions of the disorder and can interfere with treatment engagement. Facial emotion recognition paradigms have been used to investigate the bases of interpersonal impairments in BPD, yielding mixed results. We sought to clarify and extend past findings by using the Reading the Mind in the Eyes Test (RMET), a measure of the capacity to discriminate the mental state of others from expressions in the eye region of the face.

Method Thirty individuals diagnosed with BPD were compared to 25 healthy controls (HCs) on RMET performance. Participants were also assessed for depression severity, emotional state at the time of assessment, history of childhood abuse, and other Axis I and personality disorders (PDs).

Results The BPD group performed significantly better than the HC group on the RMET, particularly for the Total Score and Neutral emotional valences. Effect sizes were in the large range for the Total Score and for Neutral RMET performance. The results could not be accounted for by demographics, co-occurring Axis I or II conditions, medication status, abuse history, or emotional state. However, depression severity partially mediated the relationship between RMET and BPD status.

Conclusions Mental state discrimination based on the eye region of the face is enhanced in BPD. An enhanced sensitivity to the mental states of others may be a basis for the social impairments in BPD.

(Received December 01 2008)

(Revised April 06 2009)

(Accepted April 11 2009)

(Online publication May 22 2009)


c1 Address for correspondence: E. A. Fertuck, Ph.D., New York State Psychiatric Institute, Department of Psychiatry, Unit 42, 1051 Riverside Drive, New York, NY 10032, USA. (Email: