Alexithymia in borderline personality disorder is not associated with deficits in automatic visual processing of negative emotional stimuli

Previous studies have suggested that alexithymia may be related to impairments in automatic emotion processing. While it is well established that alexithymia is highly prevalent in individuals with borderline personality disorder (BPD), it is unknown whether this is reflected by an altered automatic processing of emotional stimuli. In the present study we investigated visually evoked event-related potentials using neutral and negative images from the International Affective Pictures System in 26 BPD patients and 26 healthy controls. In line with previous reports, all subjects showed increased late positive potentials (LPP) for negative compared to neutral images. There were, however, no between-group differences at any time point. Crucially, there was no difference between alexithymic and non-alexithymic BPD patients in the expression of LPP. Our study is the first to show that automatic emotion processing in the visual domain appears to be normal in BPD and unaffected by alexithymia.