Modulation of Trust in Borderline Personality Disorder by Script-Based Imaginal Exposure to Betrayal

Interpersonal and trust-related difficulties are central features of Borderline Personality Disorder (BPD). In this study, we applied script-driven betrayal imagery to evoke mistrustful behavior in a social reinforcement learning task. We compared this approach to the standard confederate paradigm in twenty-one BPD and twenty healthy control (HC) participants. The script-driven imagery evoked transient negative affect and decreased trusting behavior in both groups. Across conditions, we also replicated previously reported between-group differences in affect and task behavior, results that support the validity of script-driven imagery as an alternative social task stimulus. This approach is appealing for eliminating deception, scaling easily, and evoking disorder-specific states of social difficulty.