A relational frame approach to perspective taking in persons with Borderline Personality Disorder

Walton et al. (2024) gave adults with Borderline Personality Disorder a lab task that tests perspective-taking. The task is based on Relational Frame Theory, or RFT for short. RFT looks at how people understand points of view through quick word puzzles.

The team also asked each person how good they think they are at taking someone else's perspective. Then they compared the task scores and the self-ratings to a control group.

On the objective RFT task, the BPD group scored just as well as controls. There was no measurable deficit.

Yet when the same people filled out a short survey, they rated their own perspective-taking skills as poor. The mismatch was clear: the test said 'typical,' the clients said 'terrible.'

Ng et al. (2019) saw the same split in kids with ASD or ADHD. Objective neuropsych tests showed social gaps but not attention problems, while parents reported the opposite pattern. Again, the lab score and the rating scale told different stories.

Sasson et al. (2018) found a cousin effect in adults with autism. These clients could not predict how negatively strangers would judge their personality, even though their basic perspective-taking was intact. Both studies warn that self-report or informant-report can drift far from direct test data.

Richards et al. (2017) offers a bright side: youth with ASD were able to self-report their own repetitive behaviors and link them to anxiety. The takeaway trio is (1) ask directly, (2) check the objective score, and (3) do not trust just one source.

If you work with adults who have BPD, do not assume their complaints about 'I never know what people feel' equal a skill deficit. Run a quick RFT probe or role-play first. Pair the cold data with a compassionate chat about the mismatch. This can save you weeks of unnecessary social-skills training and build trust faster.