OBJECTIVES For a clinically relevant understanding of facial displays of patients with mental disorders it is crucial to go beyond merely counting frequencies of facial expressions, but include the contextual information of the expression. We assume that patients with different levels of structural integration differ in the contextual embedding of their negative facial expressions of emotions. METHODS Facial affective behaviour of 80 female participants during an OPD interview was analysed using FACS (Facial Action Coding System) and the RFE coding system (Referencesof- Facial-Expression coding system; Bock et al. 2015).Using the RFE coding system, 2192 negative facial expressions of emotions were attributed to different references (e.g., interactive, self-related, object-related) by relying on contextual variables. RESULTS Pure frequency of negative facial affect was not related to level of structural integration. Negative facial expressions of emotions directed towards the interviewer (interactive reference), as well as negative facial expressions directed towards the displayer's whole self were associated with lower levels of structural integration. In contrast, negative facial affects directed to single aspects of the self, to single aspects of objects, or to external situations were associated with higher levels of structural integration. CONCLUSIONS The differentiation of references of facial affective behavior allows a deeper understanding of the connection between facial displays and structural levels of psychic integration.