How was loneliness related to confidence in judging happy faces among women with borderline personality disorder?

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Researchers asked participants how much happiness and anger they saw in each face and how confident they were in those judgments. This distinguished the intensity of emotion they perceived from their confidence in their assessment.

Compared with healthy controls, patients rated happy faces as less happy and reported lower confidence overall, especially for happy faces. There were no detected differences in assessments of angry or mixed-expression faces, or in ratings of anger. The findings therefore do not support a general difficulty across all the facial expressions tested.

Lower confidence when judging happy faces was associated with stronger loneliness and a greater expectation of social rejection. Lower happiness ratings, by contrast, were associated with greater anger at the time of assessment. These were associations, not evidence that loneliness, rejection expectations, or anger caused the differences.

This small study of female patients does not establish whether the findings extend to other populations or everyday interactions. The authors suggested addressing these patterns in psychotherapy, but the study did not test whether treatment could change them.