Trust beliefs, biases, and behaviors in borderline personality disorder: Empirical findings and relevance to epistemic trust

Purpose of Review: This review summarizes empirical research on trust in BPD, including three primary areas: the prevalence of paranoia, trustworthiness appraisals, and trust-related behaviors in economic exchange paradigms. Connections to the largely theoretical study of epistemic trust in BPD are highlighted. Recent Findings: In trust appraisal paradigms, people with BPD have a bias to rate others as untrustworthy. In behavioral exchange games, they report lower trust in partners and are more likely to rupture cooperation. Recent research has suggested potential explanations for these findings, including differences in affective processing, aberrant social norms and expectations, and difficulty attending to and incorporating social cues. Summary: People with BPD commonly experience paranoia, generally regard others as untrustworthy, and act accordingly. Future research is needed to understand the mechanisms of altered trust processing and to integrate empirical research with recent theoretical research on epistemic trust.

The behavioral exchange model of marital treatment

The goal of the therapeutic contract is to increase the frequency and range of mutual positive reinforcement dispensed by the husband and wife