Psychological Medicine

Original Articles

Facial emotion recognition in borderline personality disorder

A. R. Darosa1, K. K. Zakzanisa1 and A. C. Ruoccoa1 c1

a1 Department of Psychology, University of Toronto Scarborough, Toronto, Canada


Background Emotion dysregulation represents a core symptom of borderline personality disorder (BPD). Deficits in emotion perception are thought to underlie this clinical feature, although studies examining emotion recognition abilities in BPD have yielded inconsistent findings.

Method The results of 10 studies contrasting facial emotion recognition in patients with BPD (n = 266) and non-psychiatric controls (n = 255) were quantitatively synthesized using meta-analytic techniques.

Results Patients with BPD were less accurate than controls in recognizing facial displays of anger and disgust, although their most pronounced deficit was in correctly identifying neutral (no emotion) facial expressions. These results could not be accounted for by speed/accuracy in the test-taking approach of BPD patients.

Conclusions Patients with BPD have difficulties recognizing specific negative emotions in faces and may misattribute emotions to faces depicting neutral expressions. The contribution of state-related emotion perception biases to these findings requires further clarification.

(Received June 19 2012)

(Revised October 05 2012)

(Accepted October 16 2012)

(Online publication November 13 2012)

Key words

  • Affect perception;
  • borderline personality disorder;
  • emotion perception;
  • emotion recognition


c1 Address for correspondence: A. C. Ruocco, Ph.D., C.Psych., Department of Psychology, University of Toronto Scarborough, Toronto, Ontario, Canada M1C 1A4. (Email: