Altered neurophysiological processing of social rewards in borderline personality disorder: Insights from a social media paradigm

Abstract

Individuals with Borderline Personality Disorder (BPD) have difficulty forming and maintaining relationships and may turn to social media to compensate for their lack of natural social rewards. However, despite evidence of increased social media use in this population, research has yet to explore how individuals with BPD respond to social media-based rewards at the neurophysiological level. To address this, we recorded EEG from 21 BPD patients and 23 age- and gender-matched healthy controls (HC) as they engaged in a novel paradigm in which they received performance-dependent Likes and positive and negative comments on their own Instagram photos. At a behavioral level, BPD patients rated both Likes and positive comments on their photos as less pleasant than healthy controls. At a neural level, Reward Positivity (RewP) amplitudes elicited by the receipt vs. omission of positive feedback did not differ between groups. However, they were robustly correlated with borderline traits within the BPD group, such that patients with more pronounced traits showed a blunted RewP response to positive feedback, which could contribute to their difficulty in deriving pleasure from social rewards. Notably, the association between borderline traits and RewP in the BPD group was weakened when controlling for co-occurring psychopathology, suggesting that broader affective distress may contribute to this relationship. While future studies are warranted to isolate BPD-specific alterations, current findings provide novel insights into the neural mechanisms that may underlie social dysfunction in BPD.