3 A meta-analysis on the association between EA and BPP 83 in describing feelings, and externally oriented thinking. Research has shown that the correlation between the TAS-20 and the BVAQ is of the same magnitude as the correlations of both alexithymia scales to scales measuring emotional awareness [59, 60]. More recently, interest in emotional awareness and alexithymia as important factors in mental processes in psychopathology has rapidly grown [47, 61, 62]. However, scientific research on the role of emotional awareness, including alexithymia, in BPP has long remained scarce and inconclusive. Although it increased in the last years, the previous most recent academic review on alexithymia and BPP included just five studies and showed mixed results [63]. Moreover, that review was not based on a systematic search nor did it meta-analytically assess the strength of the relations across the studies. In response to this gap in the current literature, our study presents the results of a meta-analysis that assessed the relationship between lower emotional awareness (which includes alexithymia) and borderline personality pathology (i.e., the presence of borderline personality disorder or borderline personality symptoms). We tried to include all relevant and methodologically sound studies on the association between emotional awareness and borderline personality pathology. Attempts were made to include different populations, that is, clinical and nonclinical, with different backgrounds and settings. This broader strategy reduced the risk of a statistical “restriction of range” phenomenon when investigating relations between dimensional variables [64]. We also compared different designs, for example, through the examination of differences between categorically diagnosed BPD and healthy and psychiatric controls, and through correlations of borderline personality traits with emotional awareness in healthy and patient samples. Further, we assessed whether measurement instruments with a focus on emotional awareness differ from those measuring alexithymia. Last, we studied whether the specific aspects of alexithymia that are most closely related to emotional awareness, that is, difficulties in identifying and describing emotions, are more strongly related to BPP than other aspects like externally oriented thinking. 2. Method 2.1 Search strategy A systematic search was performed in three online search engines on April 28, 2014: PsycInfo, Web of Science (including MEDLINE), and Scopus. The following terms were chosen after an initial academic exploration on the subject: “borderline personality disorder” in conjunction with “emotional awareness,” “emotional self-awareness,” “emotion recognition,” “alexithymia,” “emotional processing,” “emotional
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