Interpretation bias in Cluster-C and borderline personality disorders

A. Arntz*, A. Bouwens, S. Salet

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Cognitive therapy (CT) assumes that personality disorders (PDs) are characterized by interpretational biases that maintain the disorder. Changing interpretations is therefore a major aim of CT of PDs. This study tested whether Borderline PD (BPD), Avoidant and Dependent PD (AV/DEPD), and Obsessive-Compulsive PD (OCPD) are characterized by specific interpretations. Among the 122 participants there were 55 PD patients (17 BPD, 30 AV/DEPD, 29 OCPD diagnoses), 26 axis-1 patients, and 41 nonpatients. Participants put themselves into 10 scripts of negative events and noted feelings, thoughts and behaviors that came to mind. Next, they chose between hypothesized BPD-specific, AV/DEPD-specific, and OCPD-specific interpretations of each event (forced choice). Lastly, participants rated belief in each interpretation. Regression analyses revealed that forced choices and belief ratings supported the CT-model of BPD and AV/DEP: interpretations were specific. The alleged OCPD-beliefs were however not specifically related to OCPD, with relatively high popularity in axis-1 patients and nonpatients. The open responses were classified by judges blind for diagnoses, with the following results. BPD was characterized by low levels of solution-focused and healthy-flexible/accepting responses, and higher levels of criticizing others and malevolent interpretations of others. AV/DEPD was characterized by lower levels of solution-focused responses, and higher levels of self-criticism, negative emotions, guilt and fear of judgment, as well as lower levels of other-criticism. OCPD only showed trends for lower healthy responses, and higher compulsiveness and worry. It is concluded that the assumptions of CT are supported for BPD and AV/DEPD, but not-at least not on the explicit interpretational level-for OCPD. CT of OCPD might need a slightly different approach. (PsycINFO Database Record (c) 2011 APA, all rights reserved) (journal abstract)
Original languageEnglish
Pages (from-to)472-481
Number of pages10
JournalBehaviour Research and Therapy
Issue number8
Publication statusPublished - Aug 2011


  • Personality disorder
  • Interpretation
  • Bias
  • Cognitive theory
  • Cognitive therapy

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