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Waite EE, Savalia T, Cohen AL, Haliczer LA, Huffman S, Dixon-Gordon KL. Borderline personality disorder and learning: The influences of emotional state and social versus nonsocial feedback. J Affect Disord 2024; 363:474-482. [PMID: 39032716 DOI: 10.1016/j.jad.2024.07.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/07/2024] [Accepted: 07/14/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Borderline personality disorder (BPD) has been associated with decision-making deficits, yet such deficits may be context dependent, particularly emotional state and social context. Reinforcement learning models offer an avenue to pinpoint decision-making impairments. The current study used reinforcement learning models to examine whether feedback type (social vs. nonsocial) or emotional state (neutral vs. negative) influence the association between BPD and decision making. METHOD Adults (N = 131) with a range of BPD symptoms completed a diagnostic interview and a computerized learning task after neutral and negative emotion inductions. We examined accuracy, learning rate, and exploration. RESULTS We conducted linear models to examine the association between BPD criteria, feedback type, and emotional state on learning parameters and learning accuracy. We found that the negative emotion condition was associated with greater exploration, particularly for those with elevated BPD features. Furthermore, elevated BPD features were associated with impaired accuracy when aiming to avoid loss. A 3-way interaction between BPD, emotion, and feedback indicated that, for people with higher BPD features, learning performance was further impaired when receiving social feedback in the negative emotion condition. LIMITATIONS Several limitations warrant mention, including a relatively homogenous sample, possible co-occurring diagnoses, and methodological consideration with the learning task. CONCLUSIONS The present study underscored the link between BPD and learning impairments. Amplified learning alterations under negative social contexts have important implications for identifying optimal venues to teach new skills (of relevance to treatment) for those with BPD.
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Affiliation(s)
- Elinor E Waite
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States
| | - Tejas Savalia
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States
| | - Andrew L Cohen
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States
| | - Lauren A Haliczer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States
| | - Sarah Huffman
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States
| | - Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, United States.
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Bao C, Zhang Q, He C, Zou H, Xia Y, Yan R, Hua L, Yao Z, Lu Q. Neurophysiological activity following gains and losses among young adults with non-suicidal self-injury: An ERP study. J Psychiatr Res 2024; 179:306-313. [PMID: 39353291 DOI: 10.1016/j.jpsychires.2024.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 08/27/2024] [Accepted: 09/21/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is an increasingly concerning issue that is linked to a range of mental health problems. However, little is known about the potential neurophysiological mechanisms underlying risk decision-making in Major depressive disorder (MDD) patients with NSSI-the present study aimed to fill this important literature gap. METHODS A total of 81 MDD patients (with NSSI: n = 40, without NSSI: n = 41) and 44 matched healthy controls (HC) underwent a modified version of the Iowa Gambling Task (IGT) while an electroencephalogram was recorded. Feedback-related negativity (FRN) and P300 were examined during the feedback stage of the risky decision-making process. RESULTS Behavioural findings revealed that individuals diagnosed with MDD displayed a greater tendency to make risky decisions compared to the control group. Furthermore, MDD patients with NSSI demonstrated a significantly more negative ΔFN (i.e., the difference in neural response to losses compared to gains) than those without NSSI. Further, NSSI patients showed a larger difference ΔFN (loss minus gain), which was associated with enhanced impulsivity. CONCLUSIONS Collectively, the findings suggest that there is an altered processing of risky decision-making in the electrophysiology of patients with MDD who engage in NSSI. The ΔFN may serve as a psychophysiological marker indicating risk for NSSI.
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Affiliation(s)
- Ciqing Bao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Qiaoyang Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213000, China
| | - Chen He
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Haowen Zou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, 210093, China
| | - Yi Xia
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Rui Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Lingling Hua
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, 210096, China.
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Bao C, Zhang Q, Zou H, He C, Yan R, Hua L, Lu Q, Yao Z. The reward positivity mediates the association between adverse childhood experiences and anhedonia in young adults with drug-naïve major depressive disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00249-0. [PMID: 39209021 DOI: 10.1016/j.bpsc.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/20/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Current clinical studies have indicated that major depressive disorder (MDD) with adverse childhood experiences (ACEs) is associated with greater anhedonia. However, little is known about whether the change in reward sensitivity among young MDD individuals with ACEs are related to anhedonia. METHODS We evaluated anhedonia and ACEs of each patient. Then, we performed Iowa gambling task during EEG to measure the reward positivity (RewP) and its difference (ΔRewP) in 86 MDD patients (31 with no or one ACE and 55 with two or more ACEs) and 44 healthy controls (HCs). Furthermore, we constructed a mediation model to assessed whether aberrant ΔRewP could mediate the relationship between ACEs and anhedonia. RESULTS Compared with healthy controls and MDD patients with no or one ACE, MDD patients with two or more ACEs had the most severe symptoms of anhedonia and impaired decision-making, and showed significantly reduced reward sensitivity (most blunted ΔRewP). More importantly, ΔRewP mediated relationship between ACEs and anhedonia in MDD. CONCLUSIONS We found that the ΔRewP partially mediates the association between ACEs and anhedonia in MDD patients, which provides evidence for the neurobiological basis of abnormal changes in the reward system in MDD individuals with early adverse experiences.
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Affiliation(s)
- Ciqing Bao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Qiaoyang Zhang
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Department of Psychology, the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213000, China
| | - Haowen Zou
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, 210093, China
| | - Chen He
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Rui Yan
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Lingling Hua
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing, 210096, China.
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
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Salas F, Nvo-Fernández M, Leiva-Bianchi M, Sáez DA, Páeza GS, García MV, Villacura-Herrera C. Components of event-related potentials and borderline personality disorder: a meta-analysis. Eur J Psychotraumatol 2024; 15:2297641. [PMID: 38214169 PMCID: PMC10791106 DOI: 10.1080/20008066.2023.2297641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/17/2023] [Indexed: 01/13/2024] Open
Abstract
Background: Borderline personality disorder (BPD) is characterized by symptoms associated with difficulties in emotion regulation, altered self-image, impulsivity, and instability in personal relationships. A relationship has been found between BPD symptoms and altered neuropsychological processes. Studies of event-related potentials (ERP) measured with electroencephalogram (EEG) have found neural correlates related to BPD symptoms. Of note is the P300 component, considered a potential mental health biomarker for trauma-associated disorders. However, no meta-analysis has been found to demonstrate this relationship.Objectives: To evaluate the relationship between the P300 component and BPD symptoms. To evaluate the relationship of other ERP components with BPD symptoms.Methods: The method and procedure were adjusted to the PRISMA checklist. The search was performed in three databases: WOS, Scopus and PubMed. A Random Effects Model was used to perform the analysis of the studies. In addition, a meta-regression was performed with % women, Gini and GDP. Finally, a descriptive analysis of the main results found between P300, other ERP components (LPP, P100 and ERN/Ne) and BPD symptoms was performed.Results: From a review of 485 articles, a meta-analysis was performed with six articles that met the inclusion criteria. A moderate, positive relationship was found between the P300 component and BPD symptoms (REM = .489; p < .001). It was not possible to perform meta-analyses for other ERP components (LPP, P100 and ERN/Ne) due to the low number of articles found.Conclusion: The idea that P300 could be considered for use as a biomarker to identify altered neural correlates in BPD is reinforced. In addition, a moderating effect of inequality (Gini) was detected.
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Affiliation(s)
- Fabiola Salas
- Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Marcelo Nvo-Fernández
- Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Marcelo Leiva-Bianchi
- Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Daniela Avello Sáez
- School of Occupational Therapy, Faculty of Health, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Geraldy Sepúlveda Páeza
- Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Marc Via García
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
| | - Cesar Villacura-Herrera
- Laboratory of Methodology for Behavioral Sciences and Neurosciences, Faculty of Psychology, Universidad de Talca, Talca, Chile
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Talca, Chile
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Waite EE, DeFontes C, Weiss NH, Karnedy C, Woods SE, Haliczer LA, Dixon-Gordon KL. Borderline personality disorder and multidimensional impulsivity: The roles of positive and negative emotion dysregulation. J Affect Disord 2024; 344:635-643. [PMID: 37832740 DOI: 10.1016/j.jad.2023.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Risky, self-destructive impulsivity and emotion dysregulation are core features of borderline personality disorder (BPD). Yet impulsivity is multidimensional and has rarely been comprehensively assessed in BPD. Impulsivity has been linked to negative emotion dysregulation, yet explorations of the role of positive emotion dysregulation have been neglected. The current study attempts to extend existing literature by identifying the pattern of associations of specific domains of impulsivity, using both self-report and behavioral measures in BPD, and the role of both negative and positive emotion dysregulation in this link. METHODS Adults with BPD (n = 48), subthreshold BPD (n = 37), and without BPD (n = 78) completed a diagnostic interview, self-report measures, and multiple behavioral tasks. We examined correlations between primary variables, then examined the role of negative and positive emotion dysregulation in the association between BPD and specific domains of impulsivity. RESULTS Negative emotion dysregulation accounted for the link between BPD and negative urgency, (lack of) premeditation, and (lack of) perseverance, while positive emotion dysregulation accounted for the relation between BPD and sensation seeking. LIMITATIONS Key limitations of this study include using a relatively homogeneous sample and using abbreviated versions of one behavioral task, among others discussed. CONCLUSIONS These findings locate the precise impulsivity impairments in BPD and highlight the differential roles of negative and positive emotion dysregulation. Understanding the impulsivity deficits associated with BPD will further explain the impulsive behaviors associated with this disorder, and the contexts in which they occur, which may streamline clinical treatments.
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Affiliation(s)
- Elinor E Waite
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Clara DeFontes
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Nicole H Weiss
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States; Department of Psychology, University of Rhode Island, United States
| | - Colten Karnedy
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Sherry E Woods
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Lauren A Haliczer
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Katherine L Dixon-Gordon
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States.
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Vijayapriya CV, Tamarana R. Effectiveness of internet-delivered dialectical behavior therapy skills training on executive functions among college students with borderline personality traits: a non-randomized controlled trial. RESEARCH IN PSYCHOTHERAPY (MILANO) 2023; 26:694. [PMID: 37905964 PMCID: PMC10690726 DOI: 10.4081/ripppo.2023.694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023]
Abstract
Given the enormous influence of emotions on cognitive processes, individuals with borderline personality disorder (BPD) suffer from marked deficits in higher-order thinking abilities. Considering the prevalence of BPD among college students, this study aimed to investigate the changes in perceived executive functioning among college students with traits/presence of BPD undergoing internet-delivered dialectical behavior therapy skills training (DBT-ST) that included the mindfulness and emotion regulation modules. An internet-delivered version of DBT-ST was opted for, as technological advancements in the present era promote the use of online platforms for psychotherapy. This non-randomized controlled trial consisted of 36 college students with traits/presence of BPD. The intervention group attended 13 sessions of DBT-ST, and the control group attended 13 sessions of behavioral activation. Perceived executive functioning was assessed using the Behavior Rating Inventory of Executive Functions for Adults. A 2-way repeated measures analysis of variance was used to evaluate the treatment impact on the outcome variable. Results showed that the DBT-ST group had larger improvements in their abilities to initiate, plan, and organize current and future-oriented task demands and to organize their everyday environment, compared to the control group. Both, the DBT-ST group and the control group demonstrated improvements in emotional control, working memory, and their abilities to shift and task monitor. Findings suggest that the internet-delivered version of DBT-ST, consisting of the mindfulness and emotion regulation modules, can foster notable improvements in executive functions among college students with traits/presence of BPD. Improved executive functioning is one of the several multifaceted outcomes of dialectical behavior therapy.
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Asquith E, Bould K, Catling JC, Day EJ, Holt A. Behaviour regulation and the role of mental health in non-alcoholic fatty liver disease. BMC Gastroenterol 2023; 23:306. [PMID: 37700260 PMCID: PMC10496395 DOI: 10.1186/s12876-023-02941-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND AND AIMS Non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease in wealthy societies, and is responsible for a significant rise in liver morbidity and mortality. Current treatments prioritise lifestyle interventions, predominantly diet and exercise management, but patients frequently fail to make the necessary behavioural adjustments. The current study seeks to identify those factors which influence patients' behaviour with respect to adherence to treatment regimes. METHODS Novel areas of interest were investigated; locus of control, behavioural regulation and a range of mental health measures, due to their links to either poor lifestyle choices or abnormal eating as identified in previous literature. Data was gathered using self-report questionnaires, from 96 participants, who were split into three groups, NAFLD patients, non-NAFLD liver disease patients and healthy controls RESULTS: Data was analysed using a MANOVA, and followed up with a Tukey post-hoc test. Three factors were found to be significant by group; cognitive restraint, uncontrolled eating and SAPAS score (a measure of personality disorders). An association between personality disorders and NAFLD was identified. CONCLUSION It is suggested that NAFLD patients are screened for personality disorders and, if identified, treated prior to the commencement of diet and exercise management.
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Affiliation(s)
- E Asquith
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - K Bould
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - J C Catling
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - E J Day
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - A Holt
- Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK
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The Role of Cognitive Deficits in Borderline Personality Disorder with Early Traumas: A Mediation Analysis. J Clin Med 2023; 12:jcm12030787. [PMID: 36769436 PMCID: PMC9917894 DOI: 10.3390/jcm12030787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
(1) Background: although studies of cognitive functions are still limited in borderline personality disorder (BPD), the initial evidence suggested that BPD patients have deficits of executive functions and social cognition. In addition, patients who report physical and psychic traumatic experiences in childhood and adolescence show considerable neurocognitive impairment and severe BPD symptoms. The present study has a twofold aim: (1) to evaluate the differences in neurocognitive performances between BPD patients and healthy controls and (2) to verify in the BPD patients group whether neurocognitive deficits have the role of mediating the effect of early traumas on BPD psychopathology. (2) Methods: 69 subjects were enrolled: 38 outpatients with a diagnosis of BPD (DSM-5) and 31 healthy controls. BPD patients were tested with the Borderline Personality Disorder Severity Index (BPDSI), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). All subjects were evaluated with the Iowa Gambling task (IGT), the Berg card sorting test (BCST), the Tower of London task (ToL), and the Reading-the-mind-in-the-eyes-test (RMET). Statistical analysis was performed with the analysis of variance to compare the cognitive performances between BPD patients and controls. A mediation analysis was conducted with the Sobel Test in the BPD patients group. The significance level was p ≤ 0.05. (3) Results: significant differences between the two groups were found for several parameters of all the cognitive tests examined: BCST, IGT, ToL, and RMET. Mediation analysis with the Sobel test demonstrated that the percentage of correct answers in the BCST (BCSTc) and the RMET score significantly mediated the relation between the CTQ total score and BPDSI total score. (4) Conclusions: BPD patients showed an impairment of the following executive functions: set shifting, decision making, planning and problem solving, and social cognition abilities, in comparison with controls. Our results suggested that the effect of early trauma on BPD psychopathology was mediated by a deficit in two cognitive domains: cognitive flexibility and social cognition.
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An exploratory study of functional brain activation underlying response inhibition in major depressive disorder and borderline personality disorder. PLoS One 2023; 18:e0280215. [PMID: 36608051 PMCID: PMC9821521 DOI: 10.1371/journal.pone.0280215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
Cognitive control is associated with impulsive and harmful behaviours, such as substance abuse and suicidal behaviours, as well as major depressive disorder (MDD) and borderline personality disorder (BPD). The association between MDD and BPD is partially explained by shared pathological personality traits, which may be underpinned by aspects of cognitive control, such as response inhibition. The neural basis of response inhibition in MDD and BPD is not fully understood and could illuminate factors that differentiate between the disorders and that underlie individual differences in cross-cutting pathological traits. In this study, we sought to explore the neural correlates of response inhibition in MDD and BPD, as well as the pathological personality trait domains contained in the ICD-11 personality disorder model. We measured functional brain activity underlying response inhibition on a Go/No-Go task using functional magnetic resonance imaging in 55 female participants recruited into three groups: MDD without comorbid BPD (n = 16), MDD and comorbid BPD (n = 18), and controls with neither disorder (n = 21). Whereas response-inhibition-related activation was observed bilaterally in frontoparietal cognitive control regions across groups, there were no group differences in activation or significant associations between activation in regions-of-interest and pathological personality traits. The findings highlight potential shared neurobiological substrates across diagnoses and suggest that the associations between individual differences in neural activation and pathological personality traits may be small in magnitude. Sufficiently powered studies are needed to elucidate the associations between the functional neural correlates of response inhibition and pathological personality trait domains.
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Parr AC, Calancie OG, Coe BC, Khalid-Khan S, Munoz DP. Impulsivity and Emotional Dysregulation Predict Choice Behavior During a Mixed-Strategy Game in Adolescents With Borderline Personality Disorder. Front Neurosci 2022; 15:667399. [PMID: 35237117 PMCID: PMC8882924 DOI: 10.3389/fnins.2021.667399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
Impulsivity and emotional dysregulation are two core features of borderline personality disorder (BPD), and the neural mechanisms recruited during mixed-strategy interactions overlap with frontolimbic networks that have been implicated in BPD. We investigated strategic choice patterns during the classic two-player game, Matching Pennies, where the most efficient strategy is to choose each option randomly from trial-to-trial to avoid exploitation by one’s opponent. Twenty-seven female adolescents with BPD (mean age: 16 years) and twenty-seven age-matched female controls (mean age: 16 years) participated in an experiment that explored the relationship between strategic choice behavior and impulsivity in both groups and emotional dysregulation in BPD. Relative to controls, BPD participants showed marginally fewer reinforcement learning biases, particularly decreased lose-shift biases, increased variability in reaction times (coefficient of variation; CV), and a greater percentage of anticipatory decisions. A subset of BPD participants with high levels of impulsivity showed higher overall reward rates, and greater modulation of reaction times by outcome, particularly following loss trials, relative to control and BPD participants with lower levels of impulsivity. Additionally, BPD participants with higher levels of emotional dysregulation showed marginally increased reward rate and increased entropy in choice patterns. Together, our preliminary results suggest that impulsivity and emotional dysregulation may contribute to variability in mixed-strategy decision-making in female adolescents with BPD.
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Affiliation(s)
- Ashley C. Parr
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Child and Youth Mental Health, Kingston Health Sciences Centre, Kingston, ON, Canada
- *Correspondence: Ashley C. Parr,
| | - Olivia G. Calancie
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- Division of Child and Youth Mental Health, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Brian C. Coe
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
| | - Sarosh Khalid-Khan
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- Division of Child and Youth Mental Health, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Douglas P. Munoz
- Centre for Neuroscience Studies, Queen’s University, Kingston, ON, Canada
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
- Douglas P. Munoz,
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11
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Modeling the relationship between Overgeneral Autobiographical Memory and problem solving in people with borderline personality disorder: The mediating role of metacognitive awareness. JOURNAL OF COGNITIVE PSYCHOLOGY 2021. [DOI: 10.52547/jcp.9.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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12
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Zarnowski O, Ziton S, Holmberg R, Musto S, Riegle S, Van Antwerp E, Santos-Nunez G. Functional MRI findings in personality disorders: A review. J Neuroimaging 2021; 31:1049-1066. [PMID: 34468063 DOI: 10.1111/jon.12924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022] Open
Abstract
Personality disorders (PDs) have a prevalence of approximately 10% in the United States, translating to over 30 million people affected in just one country. The true prevalence of these disorders may be even higher, as the paucity of objective diagnostic criteria could be leading to underdiagnosis. Because little is known about the underlying neuropathologies of these disorders, patients are diagnosed using subjective criteria and treated nonspecifically. To better understand the neural aberrancies responsible for these patients' symptoms, a review of functional MRI literature was performed. The findings reveal that each PD is characterized by a unique set of activation changes corresponding to individual structures or specific neural networks. While unique patterns of neural activity are distinguishable within each PD, aberrations of the limbic/paralimbic structures and default mode network are noted across several of them. In addition to identifying valuable activation patterns, this review reveals a void in research pertaining to paranoid, schizoid, histrionic, narcissistic, and dependent PDs. By delineating patterns in PD neuropathology, we can more effectively direct future research efforts toward enhancing objective diagnostic techniques and developing targeted treatment modalities. Furthermore, understanding why patients are manifesting certain symptoms can advance clinical awareness and improve patient outcomes.
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Affiliation(s)
- Oskar Zarnowski
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Shirley Ziton
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Rylan Holmberg
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Sarafina Musto
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Sean Riegle
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Emily Van Antwerp
- West Virginia School of Osteopathic Medicine, Lewisburg, West Virginia, USA
| | - Gabriela Santos-Nunez
- University of Massachusetts Memorial Medical Center, Radiology Department, Worcester, Massachusetts, USA
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13
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Berenson KR, Van De Weert SM, Nicolaou S, Campoverde C, Rafaeli E, Downey G. Reward and Punishment Sensitivity in Borderline and Avoidant Personality Disorders. J Pers Disord 2021; 35:573-588. [PMID: 32163026 DOI: 10.1521/pedi_2020_34_475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors compared self-reported and behavioral responses to reward and punishment in individuals diagnosed with borderline personality disorder (BPD) or avoidant personality disorder (APD) relative to a healthy comparison (HC) group. As predicted, self-reported sensitivity to reward was significantly higher in the BPD group than in the APD and HC groups. Also as predicted, self-reported sensitivity to punishment was significantly elevated in both disordered groups but significantly higher in APD than in BPD. These hypothesized patterns were also evident in responses to behavioral tasks: Participants with BPD made more errors of commission and fewer errors of omission than HC participants on a passive avoidance learning task, and participants with APD showed greater reactivity to losses than other participants on a probabilistic reversal learning task. Results help characterize differences between these two disorders.
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Affiliation(s)
- Kathy R Berenson
- Department of Psychology, Gettysburg College, Gettsyburg, Pennsylvania
| | | | | | - Cindy Campoverde
- Department of Psychology, Gettysburg College, Gettsyburg, Pennsylvania
| | - Eshkol Rafaeli
- Department of Psychology, Barnard College, New York, New York, and Department of Psychology, Bar-Ilan University, Israel
| | - Geraldine Downey
- Department of Psychology, Columbia University, New York, New York
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14
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Xu S, Sun Y, Huang M, Huang Y, Han J, Tang X, Ren W. Emotional State and Feedback-Related Negativity Induced by Positive, Negative, and Combined Reinforcement. Front Psychol 2021; 12:647263. [PMID: 34040560 PMCID: PMC8141566 DOI: 10.3389/fpsyg.2021.647263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/25/2021] [Indexed: 12/02/2022] Open
Abstract
Reinforcement learning relies on the reward prediction error (RPE) signals conveyed by the midbrain dopamine system. Previous studies showed that dopamine plays an important role in both positive and negative reinforcement. However, whether various reinforcement processes will induce distinct learning signals is still unclear. In a probabilistic learning task, we examined RPE signals in different reinforcement types using an electrophysiology index, namely, the feedback-related negativity (FRN). Ninety-four participants were randomly assigned into four groups: base (no money incentive), positive reinforcement (presentation of money rewards), negative reinforcement (removal of money losses), and combined reinforcement (money rewards and removal of money losses) groups. In addition, in order to evaluate the engagement of emotional activity in the different reinforcement processes, Positive and Negative Affect Schedule-Expanded Form (PANAS-X) scales were applied before and after the experiment to detect the emotional changes. The results showed that there was no difference between groups in the dopamine-related learning bias. However, compared to the other three groups, negative reinforcement elicited smaller FRN (the difference-wave measure) during the learning, stronger positive affect and joviality, and less fatigue after the learning, in which the difference between the negative and positive reinforcement groups was smaller. The results indicated that pure avoidance motivation may induce distinct emotional fluctuations, which influence the feedback processing.
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Affiliation(s)
- Shuyuan Xu
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Yuyan Sun
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Min Huang
- School of Foreign Studies, Anhui Polytechnic University, Wuhu, China
| | - Yanhong Huang
- School of Foreign Studies, Anhui Polytechnic University, Wuhu, China
| | - Jing Han
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
| | - Xuemei Tang
- School of Foreign Studies, Anhui Polytechnic University, Wuhu, China
| | - Wei Ren
- MOE Key Laboratory of Modern Teaching Technology, Shaanxi Normal University, Xi'an, China
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Towards a Functional Neuromarker of Impulsivity: Feedback-Related Brain Potential during Risky Decision-Making Associated with Self-Reported Impulsivity in a Non-Clinical Sample. Brain Sci 2021; 11:brainsci11060671. [PMID: 34063798 PMCID: PMC8224100 DOI: 10.3390/brainsci11060671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Risk-taking is part of the multidimensional nature of impulsivity, consisting of an active engagement in behaviors or choices with potentially undesirable results, with probability as the cost for an expected reward. In order to understand the neurophysiological activity during risky behavior and its relationship with other dimensions of impulsivity, we have acquired event-related-potential (ERP) data and self-reported impulsivity scores from 17 non-clinical volunteers. They underwent high-resolution electroencephalography (HR-EEG) combined with an adapted version of the Balloon Analogue Risk Task (BART), and completed the Barratt Impulsiveness Scale (BIS-10) and the Urgency, Premeditation, Perseverance, Sensation Seeking, Impulsive Behavior Scale (UPPS). The ERP components were sensitive to valence (FRN, P300) and risk/reward magnitude (SPN, RewP). Our main finding evidenced a positive correlation between the amplitude of the P300 component following positive feedback and both the global UPPS score and the (lack of) perseverance UPPS subscale, significant for several adjacent electrodes. This finding might suggest an adaptive form of impulsive behavior, which could be associated to the reduction on the difference of the P300 amplitude following negative and positive feedback. However, further investigation with both larger clinical and non-clinical samples is required.
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16
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Xi C, Liu Z, Zhong M, Yang H, Peng W, Yi J. Impaired set-shifting in drug-naïve patients with borderline personality disorder: an event-related potentials study. J Affect Disord 2021; 280:64-71. [PMID: 33202339 DOI: 10.1016/j.jad.2020.10.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/12/2020] [Accepted: 10/31/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neurocognitive impairments might play a key role in the development of Borderline Personality Disorder (BPD), however, the pathophysiological mechanism underlying cognitive impairment of BPD is largely unknown. This study was aimed to examine the electrophysiological mechanism of deficits in set-shifting processing in patients with BPD. METHODS Twenty-seven drug-naïve patients with BPD and twenty-four healthy controls were recruited. Demographic variables and clinical characteristics of all subjects were collected. Behavioral data and event-related potentials (ERPs) were recorded when subjects were performing the task-switching paradigm, which was applied to investigate the set-shifting function. The P2, N2 and P3 components in the task-switching paradigm would be analyzed. RESULTS Patients with BPD had significantly higher level of impulsivity, depression and anxiety than healthy controls. When performing the switching task, the BPD group had lower P2 amplitude and higher N2 amplitude than the control group. In the BPD group, the P2 latency at Fz electrode in repeat task was correlated positively with the level of depression, and P2 latency at Pz electrode in repeat task and switch task both had significantly negative relationships with the the level of anxiety. LIMITATIONS This cross-sectional designed study did not clarify the causal relationship of the electrophysiological characteristics and the development of BPD. CONCLUSIONS Patients with BPD might have abnormal brain activities when overcoming the inhibition of current task and inhibiting the effects of prior task, and their top-down control function might be impaired. These findings provide some useful clues for the underlying pathophysiological mechanism of BPD.
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Affiliation(s)
- Chang Xi
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Zhaoxia Liu
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Mingtian Zhong
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Huihui Yang
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Wanrong Peng
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Jinyao Yi
- Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China; National Clinical Research Center for Mental Disorders, Changsha, 410011, China.
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17
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Flasbeck V, Juckel G, Brüne M. Evidence for Altered Neural Processing in Patients With Borderline Personality Disorder. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Borderline personality disorder (BPD) is characterized by difficulties in emotion regulation, self-identity disturbances, self-injurious behavior, and reduced inhibitory control. Event-related potential (ERP) studies have sought to reveal the neural correlates of cognitive distortions and behavioral alterations in BPD. The article presents an overview of the existing ERP literature pertaining to BPD and discusses whether any one of the electrophysiological findings could serve as a reliable and specific marker for BPD. In short, ERP studies investigating P300 tentatively suggest impaired inhibitory control. Moreover, reduced error- and feedback-related processing and impaired response inhibition seem to be associated with impulsivity and risk-taking behavior in BPD patients. However, these findings are not specific for BPD. Regarding emotional and self-referential information processing, individuals with BPD display heightened vigilance toward social threat impacting their cognitive performance in various social-cognitive tasks demonstrating alterations of early negative and late positive potentials. These multifaceted electrophysiological alterations may be attributed to dysfunctional activity and connectivity of frontal brain regions and the limbic system.
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Affiliation(s)
- Vera Flasbeck
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Germany
| | - Georg Juckel
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, Germany
| | - Martin Brüne
- LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Germany
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18
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Khaleghi A, Pirzad Jahromi G, Zarafshan H, Mostafavi SA, Mohammadi MR. Effects of transcranial direct current stimulation of prefrontal cortex on risk-taking behavior. Psychiatry Clin Neurosci 2020; 74:455-465. [PMID: 32415800 DOI: 10.1111/pcn.13025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/26/2020] [Accepted: 05/10/2020] [Indexed: 01/23/2023]
Abstract
AIM Recent cognitive neuroscience research shows that noninvasive brain stimulation can modify a wide range of behaviors in healthy people. Such regulation effects on human behaviors provide new insights into the neurobiology of cognitive processes and establish causal brain-behavior relations. Here, we aimed to examine the effects of transcranial electrical stimulation (TES) of the prefrontal cortex on risk-taking. METHODS We performed a systematic search on the PubMed, Web of Science, and Cochrane databases with appropriate keywords for original studies reporting the use of TES to modulate risk-taking behavior in healthy individuals. Then, in the meta-analysis phase, a random-effects model was used to measure the pooled effect size (ES). RESULTS Twenty articles were evaluated as eligible studies, including 16 articles on transcranial direct current stimulation (tDCS), two on transcranial alternating current stimulation, one on transcranial pulsed current stimulation, and one on high-definition tDCS. A meta-analysis showed a pooled estimated standardized ES of -0.20 (95% confidence interval [CI], -0.39 to -0.01), which indicates a small ES for active tDCS over the dorsolateral prefrontal cortex (DLPFC) in comparison to sham stimulation (z = 2.31, P = 0.03) in terms of less risky behaviors. Subgroup analysis showed that there is no significant ES for bilateral DLPFC stimulation (d = -0.01; 95%CI, -0.28 to 0.26), but a significant near-medium ES for unilateral DLPFC stimulation (d = -0.41; 95%CI, -0.71 to -0.10). CONCLUSION Our findings support a significant impact of neuroregulation of the DLPFC on risk-taking behavior in healthy individuals. Unilateral noninvasive electrical stimulation of the DLPFC can result in a conservative risk-averse response style, probably through modulating plasticity of the relevant brain networks, including cortical and subcortical structures, as well as increasing subcortical dopaminergic activity.
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Affiliation(s)
- Ali Khaleghi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Gila Pirzad Jahromi
- Neuroscience Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hadi Zarafshan
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Xu F, Huang L. Electrophysiological Measurement of Emotion and Somatic State Affecting Ambiguity Decision: Evidences From SCRs, ERPs, and HR. Front Psychol 2020; 11:899. [PMID: 32477219 PMCID: PMC7240102 DOI: 10.3389/fpsyg.2020.00899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/14/2020] [Indexed: 11/15/2022] Open
Abstract
Twenty-three years ago, the Somatic Marker Hypothesis (SMH) proposed by Damasio was introduced to explain the role of emotion in decision-making, and provided a unique neuroanatomical framework for decision-making and its influence by emotion. The core idea of the SMH is that decision-making is a process that is affected by somatic state signals, including those that express themselves in emotion and feeling. In order to verify the SMH, the Iowa Gambling Task (IGT) was originally designed by Bechara et al. and the skin conductance responses (SCRs) was recorded during the IGT. The initial confirmatory results showed that normal subjects would generate anticipatory SCRs when they received reward or punishment, but patients of the VMPFC lesion entirely failed to generate anticipatory SCRs prior to their selection of a card. With the further development of the SMH–related researches, other electrophysiological methods of measuring somatic state was gradually used to test the SMH, including event-related potentials (ERPs), and heart rate (HR). In this mini review article, we summarize the extant electrophysiological research on the SMH and decision-making under ambiguity, propose an integrative perspective for employing different electrophysiological measurement methods, and indicate the application of electrophysiological measurement based on the SMH in daily social decision-making.
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Affiliation(s)
- Fuming Xu
- School of Education Science, Nanning Normal University, Nanning, China
| | - Long Huang
- School of Psychology, Jiangxi Normal University, Nanchang, China.,School of Humanities and Management, Wannan Medical College, Wuhu, China
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20
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Hüpen P, Wagels L, Weidler C, Kable JW, Schneider F, Habel U. Altered psychophysiological correlates of risk‐taking in borderline personality disorder. Psychophysiology 2020; 57:e13540. [DOI: 10.1111/psyp.13540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/23/2019] [Accepted: 01/09/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine RWTH Aachen University Aachen Germany
- Institute of Neuroscience and Medicine, JARA‐Institute Brain Structure Function Relationship (INM 10) Research Center Jülich Jülich Germany
| | - Lisa Wagels
- Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine RWTH Aachen University Aachen Germany
- Institute of Neuroscience and Medicine, JARA‐Institute Brain Structure Function Relationship (INM 10) Research Center Jülich Jülich Germany
| | - Carmen Weidler
- Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine RWTH Aachen University Aachen Germany
| | - Joseph W. Kable
- Department of Psychology University of Pennsylvania Philadelphia PA USA
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine RWTH Aachen University Aachen Germany
- University Hospital Düsseldorf Düsseldorf Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine RWTH Aachen University Aachen Germany
- Institute of Neuroscience and Medicine, JARA‐Institute Brain Structure Function Relationship (INM 10) Research Center Jülich Jülich Germany
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21
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Vega D, Torrubia R, Marco-Pallarés J, Soto A, Rodriguez-Fornells A. Metacognition of daily self-regulation processes and personality traits in borderline personality disorder. J Affect Disord 2020; 267:243-250. [PMID: 32217224 DOI: 10.1016/j.jad.2020.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 01/16/2020] [Accepted: 02/10/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients with Borderline Personality Disorder (BPD) are characterized by impoverished self-regulatory mechanisms and self-image distortions. An intriguing question is to what extent BPD individuals develop accurate perceptions of their self-regulatory everyday functioning. Here, we tackle this issue evaluating their metacognitive abilities. METHODS One hundred and forty-four participants were enrolled in the study and divided into a BPD group and a healthy Control group, with each consisting of 36 participants paired with their corresponding close relatives. We compared self-report evaluations of the participants' self-regulatory processes in daily-life activities and personality traits with external perceptions by close relatives, as a measure of metacognition. The ratings from participants and their informants were compared using an ANCOVA profile analysis. RESULTS Self-report results showed poor self-regulation ability in the daily environment as well as extreme scores in personality-traits in the BPD group in comparison with healthy participants. Further, in the BPD group we found a clear discrepancy between the information provided by patients and their close relatives regarding the processes involved in self-regulation of daily-life activities (but not for personality traits). This discrepancy was related to their clinical status and was not observed in the healthy control group. LIMITATIONS Analysis was based on self-report data, focusing on the difference with informants reports only. Conclusions about the direction of a possible bias on participants' self-perception are limited. CONCLUSIONS Metacognitive deficits might play a key mediating role between the altered cognitive processes responsible for self-regulation and cognitive control and the daily-life consequences in BPD.
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Affiliation(s)
- Daniel Vega
- Psychiatry and Mental Health Department, Hospital of Igualada (Consorci Sanitari de l'Anoia) Igualada, Barcelona 08700, Spain; Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - Rafael Torrubia
- Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - Josep Marco-Pallarés
- Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute- IDIBELL], L'Hospitalet de Llobregat, Barcelona, 08097, Spain; Department of Cognition, Development and Educational Science, Campus Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08097, Spain; Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - Angel Soto
- Psychiatry and Mental Health Department, Hospital of Igualada (Consorci Sanitari de l'Anoia) Igualada, Barcelona 08700, Spain
| | - Antoni Rodriguez-Fornells
- Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute- IDIBELL], L'Hospitalet de Llobregat, Barcelona, 08097, Spain; Department of Cognition, Development and Educational Science, Campus Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona 08097, Spain; Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain.
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22
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McGowan N, Goodwin G, Bilderbeck A, Saunders K. Actigraphic patterns, impulsivity and mood instability in bipolar disorder, borderline personality disorder and healthy controls. Acta Psychiatr Scand 2020; 141:374-384. [PMID: 31916240 PMCID: PMC7216871 DOI: 10.1111/acps.13148] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/02/2020] [Accepted: 01/05/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To differentiate the relation between the structure and timing of rest-activity patterns and symptoms of impulsivity and mood instability in bipolar disorder (BD), borderline personality disorder (BPD) and healthy controls (HC). METHODS Eighty-seven participants (31 BD, 21 BPD and 35 HC) underwent actigraph monitoring for 28 days as part of the Automated Monitoring of Symptom Severity (AMoSS) study. Impulsivity was assessed at study entry using the BIS-11. Mood instability was subsequently longitudinally monitored using the digital Mood Zoom questionnaire. RESULTS BPD participants show several robust and significant correlations between non-parametric circadian rest-activity variables and worsened symptoms. Impulsivity was associated with low interdaily stability (r = -0.663) and weak amplitude (r = -0.616). Mood instability was associated with low interdaily stability (r = -0.773), greater rhythm fragmentation (r = 0.662), weak amplitude (r = -0.694) and later onset of daily activity (r = 0.553). These associations were not present for BD or HCs. Classification analysis using actigraphic measures determined that later L5 onset reliably distinguished BPD from BD and HC but did not sufficiently discriminate between BD and HC. CONCLUSIONS Rest-activity pattern disturbance indicative of perturbed sleep and circadian function is an important predictor of symptom severity in BPD. This appears to validate the greater subjective complaints of BPD individuals that are sometimes regarded as exaggerated by clinicians. We suggest that treatment strategies directed towards improving sleep and circadian entrainment may in the future be investigated in BPD.
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Affiliation(s)
- N.M. McGowan
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - G.M. Goodwin
- Department of PsychiatryUniversity of OxfordOxfordUK,Oxford Health NHS Foundation TrustWarneford HospitalOxfordUK
| | | | - K.E.A. Saunders
- Department of PsychiatryUniversity of OxfordOxfordUK,Oxford Health NHS Foundation TrustWarneford HospitalOxfordUK,NIHR Oxford Health Biomedical Research CentreOxfordUK
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23
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Na E, Jang KM, Kim MS. An Event-Related Potential Study of Decision-Making and Feedback Utilization in Female College Students Who Binge Drink. Front Psychol 2019; 10:2606. [PMID: 31824383 PMCID: PMC6883468 DOI: 10.3389/fpsyg.2019.02606] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/04/2019] [Indexed: 12/31/2022] Open
Abstract
This study investigated the ability to use feedback for decision-making in female college students who binge drink (BD) using the iowa gambling task (IGT) and event-related potentials (ERPs). Twenty-seven binge drinkers and 23 non-binge drinkers (non-BD) were identified based on scores on the Korean version of the Alcohol Use Disorder Test and the Alcohol Use Questionnaire. The IGT consists of four cards, including two cards that result in a net loss, with large immediate gains but greater losses in the long term, and two cards that result in a net gain, with small immediate gains but reduced losses in the long term. Participants were required to choose one card at a time to maximize profit until the end of the task while avoiding losses. The BD group showed a significantly lower total net score than the non-BD group, indicating that the BD group chose more disadvantageous cards. The BD group showed significantly smaller ΔFRN amplitudes [difference in amplitudes of feedback-related negativity (FRN) between gain and loss feedback] but not in P3 amplitudes. Additionally, ΔFRN amplitudes in the fronto-central area were positively correlated with the total net score and net scores for sectors 4 and 5. Thus, total net scores and later performance on the IGT increased as ΔFRN amplitudes from the fronto-central area increased. FRN is known to reflect early feedback evaluation employing a bottom-up mechanism, whereas P3 is known to reflect late feedback processing and allocation of attentional resources using a top-down mechanism. These results indicate that college students who binge drink have deficits in early evaluation of positive or negative feedback and that this deficit may be related to decision-making deficits.
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Affiliation(s)
- Eunchan Na
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Kyoung-Mi Jang
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
| | - Myung-Sun Kim
- Department of Psychology, Sungshin Women's University, Seoul, South Korea
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24
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Umbach R, Leonard NR, Luciana M, Ling S, Laitner C. THE IOWA GAMBLING TASK IN VIOLENT AND NONVIOLENT INCARCERATED MALE ADOLESCENTS. CRIMINAL JUSTICE AND BEHAVIOR 2019; 46:1611-1629. [PMID: 32981980 PMCID: PMC7518041 DOI: 10.1177/0093854819847707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Previous studies have found impaired affective decision-making, as measured by the Iowa Gambling Task (IGT), in various antisocial populations. This is the first study to compare the IGT in violent and nonviolent incarcerated American youth. The IGT was administered to 185 incarcerated adolescent male offenders charged with either nonviolent (38.4%) or violent (61.6%) crimes. General linear mixed models and t tests were used to assess differences between the groups. The full sample performed worse than if they had selected from the decks at random. The violent offenders performed more poorly than the nonviolent offenders overall, primarily because they preferred "disadvantageous" Deck B to a greater degree; however, they did demonstrate some degree of learning by the final block of the task. Adolescent offenders demonstrate impaired affective decision-making. Behavior suggested preferential attention to frequency of loss and amount of gain and inattention to amount of loss.
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25
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Stewart JG, Singleton P, Benau EM, Foti D, Allchurch H, Kaplan CS, Aguirre B, Auerbach RP. Neurophysiological activity following rewards and losses among female adolescents and young adults with borderline personality disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2019; 128:610-621. [PMID: 31318241 DOI: 10.1037/abn0000439] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Borderline personality disorder (BPD) is a complex and debilitating psychiatric illness. Prior research in adults has shown that neurophysiological deficits in feedback processing and learning from rewards may be central to the development of BPD; however, little research has examined these markers in adolescents and young adults with BPD. The present study used event-related potentials and time-frequency decomposition analysis to probe neural responses to wins and losses in a guessing task among 68 females (13 to 23 years old) either with BPD (n = 35) or no history of mental disorders (healthy control [HC]; n = 33). Participants completed a guessing task wherein they won and lost money at equal frequencies while electroencephalogram (EEG) data were acquired. Adolescents and young adults with BPD showed a smaller differentiation between wins and losses in the reward positivity (RewP) relative to HCs. Using time-frequency decomposition, we isolated distinct frequency bands sensitive to wins (delta = < 3Hz) and losses (theta = 4 Hz to 7 Hz). Compared with BPD participants, HCs showed significantly larger delta power to wins, specifically. The groups did not differ in delta power to losses, nor theta power to wins or losses. Collectively, findings implicate altered reward processing in the pathophysiology of BPD and may inform early identification and targeted intervention. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Dan Foti
- Department of Psychological Sciences
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Schouppe S, Van Oosterwijck S, Danneels L, Van Damme S, Van Oosterwijck J. Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies. THE JOURNAL OF PAIN 2019; 21:25-43. [PMID: 31260806 DOI: 10.1016/j.jpain.2019.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022]
Abstract
This systematic review analyzed available literature on functional brain alterations in low back pain (LBP) measured with electroencephalography (EEG), as until now evidence thereof was unclear. Four electronic databases were systematically searched the 10th of March 2018, resulting in 12 included studies. Studies showed a risk of bias of 37.5 to 75% using the Newcastle-Ottawa Scale for case-control studies. Limited evidence reported higher amplitudes of balance-related potentials and early components of somatosensory evoked potentials (SEP) to noxious stimuli, and altered feedback-related negativity and P300 potentials during decision-making in chronic LBP (CLBP). These findings suggest postural strategies requiring a higher cortical attention-demand, increased sensory-discriminative processing of noxious input, and altered decision-making in CLBP. However, further research is warranted as these inferences were based on single studies. Moderate evidence for unaltered amplitude of late-phase SEPs to noxious stimuli and auditory evoked potentials in LBP implies that the affective-emotional processing of stimuli might be unaffected in LBP. Furthermore, moderate evidence indicated disturbed habituation of somatosensory stimuli in LBP. Most studies examined nonspecific or mixed CLBP populations, hence EEG-quantified brain activity in (sub)acute or recurrent LBP still needs to be explored. PERSPECTIVE: This review presents an overview of the current understanding of the functional LBP brain measured with EEG. The limited evidence in current research suggests altered cortical function regarding balance control, somatosensory processing, and decision making in LBP, and highlights opportunities for future EEG-research.
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Affiliation(s)
- Stijn Schouppe
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Belgium, www.paininmotion.be
| | - Sophie Van Oosterwijck
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Lieven Danneels
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Stefaan Van Damme
- Department of Experimental - Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jessica Van Oosterwijck
- SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Belgium, www.paininmotion.be; Research Foundation - Flanders (FWO), Brussels, Belgium
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Li S, Zhang T, Sawyer BD, Zhang W, Hancock PA. Angry Drivers Take Risky Decisions: Evidence from Neurophysiological Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101701. [PMID: 31096546 PMCID: PMC6572592 DOI: 10.3390/ijerph16101701] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 01/19/2023]
Abstract
The present study investigated the risk-taking behaviors of angry drivers, which were coincidentally measured via behavioral and electroencephalographic (EEG) recordings. We manipulated a driving scenario that concerned a Go/No-Go decision at an intersection when the controlling traffic light was in its yellow phase. This protocol was based upon the underlying format of the Iowa gambling task. Variation in the anger level was induced through task frustration. The data of twenty-four drivers were analyzed via behavioral and neural recordings, and P300 was specifically extracted from EEG traces. In addition, the behavioral performance was indexed by the percentage of high-risk choices minus the number of the low-risk choices taken, which identified the risk-taking propensity. Results confirmed a significant main effect of anger on the decisions taken. The risk-taking propensity decreased across the sequence of trial blocks in baseline assessments. However, with anger, the risk-taking propensity increased across the trial regimen. Drivers in anger state also showed a higher mean amplitude of P300 than that in baseline state. Additionally, high-risk choices evoked larger P300 amplitude than low-risk choices during the anger state. Moreover, the P300 amplitude of high-risk choices was significantly larger in the anger state than the baseline state. The negative feedback induced larger P300 amplitude than that recorded in positive feedback trials. The results corroborated that the drivers exhibited higher risk-taking propensity when angry although they were sensitive to the inherent risk-reward evaluations within the scenario. To reduce this type of risk-taking, we proposed some effective/affective intervention methods.
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Affiliation(s)
- Shuling Li
- State Key Laboratory of Automotive Safety and Energy, Department of Industrial Engineering, Tsinghua University, Beijing 100084, China.
| | - Tingru Zhang
- Institute of Human Factors and Ergonomics, College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen 518060, China.
| | - Ben D Sawyer
- Department of Industrial Engineering & Management Systems, University of Central Florida, Orlando, FL 32816, USA.
| | - Wei Zhang
- State Key Laboratory of Automotive Safety and Energy, Department of Industrial Engineering, Tsinghua University, Beijing 100084, China.
| | - Peter A Hancock
- Department of Psychology, University of Central Florida, Orlando, FL 32816, USA.
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Yates JR. Examining the neurochemical underpinnings of animal models of risky choice: Methodological and analytic considerations. Exp Clin Psychopharmacol 2019; 27:178-201. [PMID: 30570275 PMCID: PMC6467223 DOI: 10.1037/pha0000239] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Because risky choice is associated with several psychiatric conditions, recent research has focused on examining the underlying neurochemical processes that control risk-based decision-making. Not surprisingly, several tasks have been developed to study the neural mechanisms involved in risky choice. The current review will briefly discuss the major tasks used to measure risky choice and will summarize the contribution of several major neurotransmitter systems to this behavior. To date, the most common measures of risky choice are the probability discounting task, the risky decision task, and the rat gambling task. Across these three tasks, the contribution of the dopaminergic system has been most studied, although the effects of serotonergic, adrenergic, cholinergic, and glutamatergic ligands will be discussed. Drug effects across these tasks have been inconsistent, which makes determining the precise role of neurotransmitter systems in risky choice somewhat difficult. Furthermore, procedural differences can modulate drug effects in these procedures, and the way data are analyzed can alter the interpretations one makes concerning pharmacological manipulations. By taking these methodological/analytic considerations into account, we may better elucidate the neurochemistry of risky decision-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Flasbeck V, Enzi B, Brüne M. Childhood trauma affects processing of social interactions in borderline personality disorder: An event-related potential study investigating empathy for pain. World J Biol Psychiatry 2019; 20:278-288. [PMID: 28532273 DOI: 10.1080/15622975.2017.1333147] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: Patients with borderline personality disorder (BPD) have difficulties in empathising with others and show disturbances in social interactions. Using a 'Social Interaction Empathy Task', we found that BPD patients judged neutral and psychologically painful conditions as more painful than healthy subjects. Here, we present the neural correlates underlying these differences in empathy for pain. Methods: Female BPD patients and healthy controls completed the 'Social Interaction Empathy Task' during EEG recording. Event-related potentials (ERP) were analysed for an early anterior component and a late latency positivity. Empathic abilities were assessed using the Interpersonal Reactivity Index and early aversive experiences were measured by the Childhood Trauma Questionnaire (CTQ). Results: ERPs in the patient group matched the behaviour results and correlated with the level of personal distress and CTQ. In addition, ERPs of patients were predicted by childhood maltreatment and stress. Conclusions: Taken together, our findings indicate that the observed behavioural differences between patients with BPD and controls might be due to modulatory effects of empathic abilities on the evaluation of pain-related social stimuli, which are supposed to be based on childhood maltreatment.
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Affiliation(s)
- Vera Flasbeck
- a Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital , Ruhr-University , Bochum , Germany
| | - Björn Enzi
- a Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital , Ruhr-University , Bochum , Germany
| | - Martin Brüne
- a Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital , Ruhr-University , Bochum , Germany
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Schauer PA, Rauh J, Leicht G, Andreou C, Mulert C. Altered Oscillatory Responses to Feedback in Borderline Personality Disorder are Linked to Symptom Severity. Brain Topogr 2019; 32:482-491. [PMID: 30689144 DOI: 10.1007/s10548-019-00700-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/17/2019] [Indexed: 11/28/2022]
Abstract
Several studies using electroencephalography (EEG) demonstrate that the processing of feedback in patients suffering from borderline personality disorder (BPD) is altered in comparison to healthy controls. Differences occur in the theta (ca. 5 Hz) and high-beta frequency-ranges (ca. 20 Hz) of oscillations in response to negative and positive feedback, respectively. However, alpha (ca. 10 Hz) and low-beta (ca. 15 Hz) oscillations have also been shown to be involved in feedback processing. We hypothesized that additional alterations might occur in these frequency ranges in BPD. Eighteen patients with BPD and twenty-two healthy controls performed a gambling task while 64-channel-EEG was recorded. Induced oscillatory responses to positive (i.e. gain) and negative (i.e. loss) feedback in the alpha and low-beta frequency range were investigated. No significant differences were found in the alpha frequency range. Regarding the low-beta frequency range a significant Group (i.e. BPD vs. healthy controls) × Valence (i.e. gain vs. loss) interaction in the time frame between 600 and 700 milliseconds after feedback was found. This effect showed a significant correlation with symptom severity (assessed with the BSL-23). The results indicate that feedback processing in BPD could be more heavily altered than previously expected, with more severe symptomatology being linked to stronger alterations in oscillatory responses to feedback in the low-beta range.
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Affiliation(s)
- Paul Alexander Schauer
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Jonas Rauh
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Christina Andreou
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany.,Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany. .,Department of Psychiatry and Psychotherapy, UKGM, Justus-Liebig University Giessen, Giessen, Germany.
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Repetitive Transcranial Magnetic Stimulation in the Treatment of a Difficult to Treat Condition, Borderline Personality Disorder. J Psychiatr Pract 2019; 25:14-21. [PMID: 30633728 DOI: 10.1097/pra.0000000000000350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a serious mental disorder characterized by a pervasive pattern of instability in affect regulation and interpersonal relationships, poor self-image and behavioral control, self-injurious behavior, suicidality, and other high-risk behaviors. It is also characterized by a high mortality rate by suicide. METHODS The published literature on repetitive transcranial magnetic stimulation (TMS), theta-burst stimulation (TBS), and deep TMS in the treatment of BPD were reviewed. RESULTS Four clinical studies (2 randomized trials and 2 case studies) with limited sample sizes found that TMS and TBS were safe and potentially effective in the reduction of symptoms of BPD. CONCLUSIONS Given the limited clinical evidence for efficacy on the basis of the results of these studies, future controlled studies involving larger samples and optimal stimulus parameters should be designed to confirm the short-term and long-term safety and efficacy of repetitive TMS and TBS in the treatment of BPD.
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Stanley B, Perez-Rodriguez MM, Labouliere C, Roose S. A Neuroscience-Oriented Research Approach to Borderline Personality Disorder. J Pers Disord 2018; 32:784-822. [PMID: 29469663 DOI: 10.1521/pedi_2017_31_326] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Traditionally, the study of personality disorders had been based on psychoanalytic or behavioral models. Over the past two decades, there has been an emerging neuroscience model of borderline personality disorder (BPD) grounded in the concept of BPD as a condition in which dysfunctional neural circuits underlie its pathological dimensions, some of which include emotion dysregulation (broadly encompassing affective instability, negative affectivity, and hyperarousal), abnormal interpersonal functioning, and impulsive aggression. This article, initiated at a joint Columbia University- Cornell University Think Tank on BPD with representation from the Icahn School of Medicine at Mount Sinai, suggests how to advance research in BPD by studying the dimensions that underlie BPD in addition to studying the disorder as a unitary diagnostic entity. We suggest that linking the underlying neurobiological abnormalities to behavioral symptoms of the disorder can inform a research agenda to better understand BPD with its multiple presentations.
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Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, Columbia University, New York City
| | | | | | - Steven Roose
- Department of Psychiatry, Columbia University, New York City.,New York State Psychiatric Institute, New York City
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33
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Electrophysiological correlates of near outcome and outcome sequence processing in problem gamblers and controls. Int J Psychophysiol 2018; 132:379-392. [DOI: 10.1016/j.ijpsycho.2017.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/05/2017] [Accepted: 10/26/2017] [Indexed: 11/19/2022]
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Orbitofrontal overactivation in reward processing in borderline personality disorder: the role of non-suicidal self-injury. Brain Imaging Behav 2018; 12:217-228. [PMID: 28247156 DOI: 10.1007/s11682-017-9687-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Borderline Personality Disorder (BPD) is a disabling and difficult-to-treat mental disease. One of its core features is a significant difficulty in affect regulation, which is often accompanied by Non-Suicidal Self-Injury (NSSI). It is suggested that this type of behavior elicits positive emotions and mitigates emotional distress, and therefore can ultimately be reinforced and promoted. In spite of the high prevalence of NSSI behaviors (also in non-BPD samples), their role in modulating reward-related processes has not yet been investigated in BPD patients. In the present study, this lack of research was addressed. A large sample of BPD patients (N = 40), divided into two groups depending on the presence of NSSI, and a group of matched healthy controls underwent functional Magnetic Resonance Imaging (fMRI) while performing a gambling task. Patients who committed NSSI acts exhibited enhanced activation of the orbitofrontal cortex following an unexpected reward, when compared with controls and BPD patients with no NSSI behavior. In addition, the NSSI group showed diminished functional connectivity between the left orbitofrontal cortex and the right parahippocampal gyrus. These findings might suggest impaired ability to update reward associations of potential choices when both BPD and NSSI are present. We propose that the presence of NSSI involves alterations in the reward system independently of BPD, and thus can be considered as a possible phenotype for reward-related alterations.
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35
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Dixon-Gordon KL, Tull MT, Hackel LM, Gratz KL. The Influence of Emotional State on Learning From Reward and Punishment in Borderline Personality Disorder. J Pers Disord 2018; 32:433-446. [PMID: 28594633 DOI: 10.1521/pedi_2017_31_299] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Despite preliminary evidence that individuals with borderline personality disorder (BPD) demonstrate deficits in learning from corrective feedback, no studies have examined the influence of emotional state on these learning deficits in BPD. This laboratory study examined the influence of negative emotions on learning among participants with BPD (n = 17), compared with clinical (past-year mood/anxiety disorder; n = 20) and healthy (n = 23) controls. Participants completed a reinforcement learning task before and after a negative emotion induction. The learning task involved presenting pairs of stimuli with probabilistic feedback in the training phase, and subsequently assessing accuracy for choosing previously rewarded stimuli or avoiding previously punished stimuli. ANOVAs and ANCOVAs revealed no significant between-group differences in overall learning accuracy. However, there was an effect of group in the ANCOVA for postemotion induction high-conflict punishment learning accuracy, with the BPD group showing greater decrements in learning accuracy than controls following the negative emotion induction.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio
| | - Leor M Hackel
- Department of Psychology, Stanford University, Stanford, California
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio
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36
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Chandrakumar D, Feuerriegel D, Bode S, Grech M, Keage HAD. Event-Related Potentials in Relation to Risk-Taking: A Systematic Review. Front Behav Neurosci 2018; 12:111. [PMID: 29970993 PMCID: PMC6018087 DOI: 10.3389/fnbeh.2018.00111] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 01/25/2023] Open
Abstract
Event-related potentials (ERPs) have been used to investigate neural mechanisms underlying risk-related decisions over the last 16 years. We aimed to systematically evaluate associations between risk-taking and ERP components elicited during decisions and following feedback. A total of 79 articles identified from PsychINFO and PubMed databases met the inclusion criteria. Selected articles assessed early ERP components (feedback-related negativity/FRN, error-related negativity/ERN, and medial frontal negativity/MFN) and the mid-latency P3 component, all using gambling paradigms that involved selecting between choices of varying risk (e.g., Iowa Gambling Task, Balloon Analogue Risk Task, and two-choice gambling tasks). The P3 component was consistently enhanced to the selection of risky options and when positive feedback (as compared to negative feedback) was provided. Also consistently, the early negative components were found to be larger following feedback indicating monetary losses as compared to gains. In the majority of studies reviewed here, risk was conceptualized in the context of simple economical decisions in gambling tasks. As such, this narrow concept of risk might not capture the diversity of risky decisions made in other areas of everyday experience, for example, social, health, and recreational risk-related decisions. It therefore remains to be seen whether the risk-sensitivity of the ERP components reviewed here generalizes to other domains of life.
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Affiliation(s)
- Dilushi Chandrakumar
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia
| | - Daniel Feuerriegel
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia.,Decision Neuroscience Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Stefan Bode
- Decision Neuroscience Laboratory, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Megan Grech
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia
| | - Hannah A D Keage
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia
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38
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Manning V, Dowling N, Lee S, Rodda S, Garfield J, Volberg R, Kulkarni J, Lubman D. Problem gambling and substance use in patients attending community mental health services. J Behav Addict 2017; 6:678-688. [PMID: 29254361 PMCID: PMC6034952 DOI: 10.1556/2006.6.2017.077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p < .001) according to short screening tools. Current diagnosis of drug use (OR = 4.31 [CI = 1.98-9.37]), borderline personality (OR = 2.59 [CI = 1.13-5.94]), bipolar affective (OR = 2.01 [CI = 1.07-3.80]), and psychotic (OR = 1.83 [CI = 1.03-3.25]) disorders were significant predictors of problem gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.
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Affiliation(s)
- Victoria Manning
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia,Corresponding author: Victoria Manning; Turning Point, Eastern Health, 110 Church Street, Richmond 3121, VIC, Australia; Phone: +61 3 8413 8413; Fax: +61 3 9416 3420; E-mail:
| | - Nicki. A. Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia,Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Stuart Lee
- Monash Alfred Psychiatry Research Centre, Alfred Health and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Simone Rodda
- Turning Point, Eastern Health, Melbourne, VIC, Australia,School of Psychology, Deakin University, Geelong, VIC, Australia,School of Population Health, University of Auckland, Auckland, New Zealand
| | - Joshua Benjamin Bernard Garfield
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Rachel Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Health and Monash University Central Clinical School, Melbourne, VIC, Australia
| | - Dan Ian Lubman
- Turning Point, Eastern Health, Melbourne, VIC, Australia,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
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Thomsen MS, Ruocco AC, Carcone D, Mathiesen BB, Simonsen E. Neurocognitive Deficits in Borderline Personality Disorder: Associations With Childhood Trauma and Dimensions of Personality Psychopathology. J Pers Disord 2017; 31:503-521. [PMID: 27617651 DOI: 10.1521/pedi_2016_30_265] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study evaluates the severity of neurocognitive deficits and assesses their relations with self-reported childhood trauma and dimensions of personality psychopathology in 45 outpatients with borderline personality disorder (BPD) matched to 56 non-psychiatric controls. Participants completed a comprehensive battery of neurocognitive tests, a retrospective questionnaire on early life trauma and a dimensional measure of personality psychopathology. Patients with BPD primarily showed deficits in verbal comprehension, sustained visual attention, working memory and processing speed. Comorbid posttraumatic stress disorder (PTSD) and an elevated childhood history of physical trauma were each accompanied by more severe neurocognitive deficits. There were no statistically significant associations between neurocognitive function and dimensions of personality psychopathology. These results suggest that patients with BPD display deficits mainly in higher-order thinking abilities that may be exacerbated by PTSD and substantial early life trauma. Potential relationships between neurocognitive deficits and dimensions of personality psychopathology in BPD need further examination.
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Affiliation(s)
- Marianne S Thomsen
- Department of Psychology, University of Copenhagen, Denmark.,Psychiatric Clinic, Psychiatry Roskilde, Region Zealand, Denmark
| | - Anthony C Ruocco
- Department of Psychology, University of Toronto Scarborough, Toronto, Canada
| | - Dean Carcone
- Department of Psychology, University of Toronto Scarborough, Toronto, Canada
| | | | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
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Andreou C, Frielinghaus H, Rauh J, Mußmann M, Vauth S, Braun P, Leicht G, Mulert C. Theta and high-beta networks for feedback processing: a simultaneous EEG-fMRI study in healthy male subjects. Transl Psychiatry 2017; 7:e1016. [PMID: 28140398 PMCID: PMC5299393 DOI: 10.1038/tp.2016.287] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 12/29/2022] Open
Abstract
The reward system is important in assessing outcomes to guide behavior. To achieve these purposes, its core components interact with several brain areas involved in cognitive and emotional processing. A key mechanism suggested to subserve these interactions is oscillatory activity, with a prominent role of theta and high-beta oscillations. The present study used single-trial coupling of simultaneously recorded electroencephalography and functional magnetic resonance imaging data to investigate networks associated with oscillatory responses to feedback during a two-choice gambling task in healthy male participants (n=19). Differential associations of theta and high-beta oscillations with non-overlapping brain networks were observed: Increase of high-beta power in response to positive feedback was associated with activations in a largely subcortical network encompassing core areas of the reward network. In contrast, theta-band power increase upon loss was associated with activations in a frontoparietal network that included the anterior cingulate cortex. Trait impulsivity correlated significantly with activations in areas of the theta-associated network. Our results suggest that positive and negative feedback is processed by separate brain networks associated with different cognitive functions. Communication within these networks is mediated by oscillations of different frequency, possibly reflecting different modes of dopaminergic signaling.
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Affiliation(s)
- C Andreou
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, Basel, Switzerland
| | - H Frielinghaus
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Rauh
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Mußmann
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Vauth
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Braun
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Goulet-Kennedy J, Labbe S, Fecteau S. The involvement of the striatum in decision making. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27069380 PMCID: PMC4826771 DOI: 10.31887/dcns.2016.18.1/sfecteau] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives.
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Affiliation(s)
- Julie Goulet-Kennedy
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Sara Labbe
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Shirley Fecteau
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
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Abstract
PURPOSE OF REVIEW This review summarizes recent executive functions research to better delineate the nosology of personality disorders. RECENT FINDINGS This review indicates that there are consistent impairments in executive functioning in people with personality disorders as compared with matched controls. Only five disorders were considered: borderline, obsessive-compulsive, antisocial, narcissistic, and schizotypal. Significant deficits are observed in decision-making, working memory, inhibition, and flexibility. Relevant data for the remaining personality disorders have not yet been published in relation to the executive functions. SUMMARY People with personality disorders could present a pattern of neurocognitive alterations that suggest a specific impairment of the prefrontal areas. The executive dysfunctions could partially explain the behavioral alterations in people with personality disorders.Further research should adopt broader considerations of effects of comorbidity and clinical heterogeneity, include community samples and, possibly, longitudinal designs with samples of youth.
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Paret C, Jennen-Steinmetz C, Schmahl C. Disadvantageous decision-making in borderline personality disorder: Partial support from a meta-analytic review. Neurosci Biobehav Rev 2016; 72:301-309. [PMID: 27914943 DOI: 10.1016/j.neubiorev.2016.11.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/03/2016] [Accepted: 11/20/2016] [Indexed: 01/27/2023]
Abstract
To achieve long-term goals, organisms evaluate outcomes and expected consequences of their behaviors. Unfavorable decisions maintain many symptoms of borderline personality disorder (BPD); therefore, a better understanding of the mechanisms underlying decision-making in BPD is needed. In this review, the current literature comparing decision-making in patients with BPD versus healthy controls is analyzed. Twenty-eight empirical studies were identified through a structured literature search. The effect sizes from studies applying comparable experimental tasks were analyzed. It was found that (1) BPD patients discounted delayed rewards more strongly; (2) reversal learning was not significantly altered in BPD; and (3) BPD patients achieved lower net gains in the Iowa Gambling Task (IGT). Current psychotropic medication, sex and differences in age between the patient and control group moderated the IGT outcome. Altered decision-making in a variety of other tasks was supported by a qualitative review. In summary, current evidence supports the altered valuation of outcomes in BPD. A multifaceted influence on decision-making and adaptive learning is reflected in this literature.
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Affiliation(s)
- Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany.
| | - Christine Jennen-Steinmetz
- Department of Biostatistics, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
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Paret C, Hoesterey S, Kleindienst N, Schmahl C. Associations of emotional arousal, dissociation and symptom severity with operant conditioning in borderline personality disorder. Psychiatry Res 2016; 244:194-201. [PMID: 27491014 DOI: 10.1016/j.psychres.2016.07.054] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
Those with borderline personality disorder (BPD) display altered evaluations regarding reward and punishment compared to others. The processing of rewards is basal for operant conditioning. However, studies addressing operant conditioning in BPD patients are rare. In the current study, an operant conditioning task combining learning acquisition and reversal was used. BPD patients and matched healthy controls (HCs) were exposed to aversive and neutral stimuli to assess the influence of emotion on learning. Picture content, dissociation, aversive tension and symptom severity were rated. Error rates were measured. Results showed no group interactions between aversive versus neutral scenes. The higher emotional arousal, dissociation and tension, the worse the acquisition, but not reversal, scores were for BPD patients. Scores from the Borderline Symptom List were associated with more errors in the reversal, but not the acquisition phase. The results are preliminary evidence for impaired acquisition learning due to increased emotional arousal, dissociation and tension in BPD patients. A failure to process punishment in the reversal phase was associated with symptom severity and may be related to neuropsychological dysfunctioning involving the ventromedial prefrontal cortex. Conclusions are limited due to the correlational study design and the small sample size.
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Affiliation(s)
- Christian Paret
- Department Neuroimaging, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany; Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany.
| | - Steffen Hoesterey
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Nikolaus Kleindienst
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
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45
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Endrass T, Schuermann B, Roepke S, Kessler-Scheil S, Kathmann N. Reduced risk avoidance and altered neural correlates of feedback processing in patients with borderline personality disorder. Psychiatry Res 2016; 243:14-22. [PMID: 27344588 DOI: 10.1016/j.psychres.2016.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 06/10/2016] [Accepted: 06/12/2016] [Indexed: 12/22/2022]
Abstract
Patients with borderline personality disorder (BPD) show deficits in reward-guided decision making and learning. The present study examined risk-taking behavior in combination with feedback processing. Eighteen BPD patients and 18 healthy controls performed a probabilistic two-choice gambling task, while an electroencephalogram was recorded. Options differed in risk, but were identical in expected value and outcome probability. The feedback-related negativity (FRN) and the feedback-related P300 were analyzed. Healthy controls preferred low-risk over high-risk options, whereas BPD patients chose both option with equal probability. FRN amplitudes were reduced in BPD, but effects of feedback valence and risk did not differ between groups. This suggests attenuated outcome processing in the anterior cingulate cortex, but intact reward prediction error signaling. Furthermore, the modulation of the feedback-related P300 with feedback valence and risk was smaller in BPD patients, and decreased P300 amplitudes were associated with increased behavioral risk-taking behavior. These findings could relate to the reduced ability of BPD patients to learn and adequately adjust their behavior based on feedback information, possibly due to reduced significance of negative feedback.
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Affiliation(s)
- Tanja Endrass
- Department of Psychology, Humboldt-Universität zu Berlin, Germany; Institute of Psychology, Otto-von-Guericke Universität, Magdeburg, Germany.
| | - Beate Schuermann
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Stefan Roepke
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
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46
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Andreou C, Kleinert J, Steinmann S, Fuger U, Leicht G, Mulert C. Oscillatory responses to reward processing in borderline personality disorder. World J Biol Psychiatry 2016. [PMID: 26212791 DOI: 10.3109/15622975.2015.1054880] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Previous electrophysiological studies have confirmed impaired reward processing in patients with BPD. However, it is not clear which aspects of reward processing are affected and which brain regions are involved. The present study investigated both evoked and induced event-related oscillations (EROs) to feedback events (thought to represent different aspects of feedback processing), and used source localization (sLORETA) to assess activity in two areas known to contribute to reward processing, the dorsomedial prefrontal/anterior cingulate cortex (dmPFC/ACC) and the orbitofrontal cortex (OFC). METHODS Eighteen patients with BPD and 22 healthy controls performed a gambling task, while 64-channel electroencephalographic activity was recorded. Evoked and induced theta and high-beta band EROs as well as activity in the two regions of interest were investigated depending on the valence and magnitude of feedback events. RESULTS Theta-band responses to negative feedback were reduced in BPD, an effect that involved only evoked responses and the dmPFC/ ACC region, and was associated with trait impulsivity in patients. sLORETA analyses revealed disturbed evoked responses depending on feedback magnitude in the theta (OFC) and high-beta (dmPFC/ACC and OFC) frequency range. CONCLUSIONS The results indicate multiple dysfunctions of feedback processing in patients with BPD, implicating several distinct subsets of reward-processing mechanisms.
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Affiliation(s)
- Christina Andreou
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Julia Kleinert
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Saskia Steinmann
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Ulrike Fuger
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Gregor Leicht
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Christoph Mulert
- a Department of Psychiatry and Psychotherapy , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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47
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Yates JR, Breitenstein KA, Gunkel BT, Hughes MN, Johnson AB, Rogers KK, Shape SM. Effects of NMDA receptor antagonists on probability discounting depend on the order of probability presentation. Pharmacol Biochem Behav 2016; 150-151:31-38. [PMID: 27642050 DOI: 10.1016/j.pbb.2016.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 02/06/2023]
Abstract
Risky decision making can be measured using a probability-discounting procedure, in which animals choose between a small, certain reinforcer and a large, uncertain reinforcer. Recent evidence has identified glutamate as a mediator of risky decision making, as blocking the N-methyl-d-aspartate (NMDA) receptor with MK-801 increases preference for a large, uncertain reinforcer. Because the order in which probabilities associated with the large reinforcer can modulate the effects of drugs on choice, the current study determined if NMDA receptor ligands alter probability discounting using ascending and descending schedules. Sixteen rats were trained in a probability-discounting procedure in which the odds against obtaining the large reinforcer increased (n=8) or decreased (n=8) across blocks of trials. Following behavioral training, rats received treatments of the NMDA receptor ligands MK-801 (uncompetitive antagonist; 0, 0.003, 0.01, or 0.03mg/kg), ketamine (uncompetitive antagonist; 0, 1.0, 5.0, or 10.0mg/kg), and ifenprodil (NR2B-selective non-competitive antagonist; 0, 1.0, 3.0, or 10.0mg/kg). Results showed discounting was steeper (indicating increased risk aversion) for rats on an ascending schedule relative to rats on the descending schedule. Furthermore, the effects of MK-801, ketamine, and ifenprodil on discounting were dependent on the schedule used. Specifically, the highest dose of each drug decreased risk taking in rats in the descending schedule, but only MK-801 (0.03mg/kg) increased risk taking in rats on an ascending schedule. These results show that probability presentation order modulates the effects of NMDA receptor ligands on risky decision making.
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Affiliation(s)
- Justin R Yates
- Department of Psychological Science, Northern Kentucky University, USA.
| | | | - Benjamin T Gunkel
- Department of Psychological Science, Northern Kentucky University, USA
| | - Mallory N Hughes
- Department of Psychological Science, Northern Kentucky University, USA
| | - Anthony B Johnson
- Department of Psychological Science, Northern Kentucky University, USA
| | | | - Sara M Shape
- Department of Psychological Science, Northern Kentucky University, USA
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48
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Abstract
Borderline personality disorder (BPD) is a severe mental disorder with a multifactorial etiology. The development and maintenance of BPD is sustained by diverse neurobiological factors that contribute to the disorder's complex clinical phenotype. These factors may be identified using a range of techniques to probe alterations in brain systems that underlie BPD. We systematically searched the scientific literature for empirical studies on the neurobiology of BPD, identifying 146 articles in three broad research areas: neuroendocrinology and biological specimens; structural neuroimaging; and functional neuroimaging. We consolidate the results of these studies and provide an integrative model that attempts to incorporate the heterogeneous findings. The model specifies interactions among endogenous stress hormones, neurometabolism, and brain structures and circuits involved in emotion and cognition. The role of the amygdala in BPD is expanded to consider its functions in coordinating the brain's dynamic evaluation of the relevance of emotional stimuli in the context of an individual's goals and motivations. Future directions for neurobiological research on BPD are discussed, including implications for the Research Domain Criteria framework, accelerating genetics research by incorporating endophenotypes and gene × environment interactions, and exploring novel applications of neuroscience findings to treatment research.
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49
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Herbort MC, Soch J, Wüstenberg T, Krauel K, Pujara M, Koenigs M, Gallinat J, Walter H, Roepke S, Schott BH. A negative relationship between ventral striatal loss anticipation response and impulsivity in borderline personality disorder. NEUROIMAGE-CLINICAL 2016; 12:724-736. [PMID: 27766203 PMCID: PMC5067102 DOI: 10.1016/j.nicl.2016.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022]
Abstract
Patients with borderline personality disorder (BPD) frequently exhibit impulsive behavior, and self-reported impulsivity is typically higher in BPD patients when compared to healthy controls. Previous functional neuroimaging studies have suggested a link between impulsivity, the ventral striatal response to reward anticipation, and prediction errors. Here we investigated the striatal neural response to monetary gain and loss anticipation and their relationship with impulsivity in 21 female BPD patients and 23 age-matched female healthy controls using functional magnetic resonance imaging (fMRI). Participants performed a delayed monetary incentive task in which three categories of objects predicted a potential gain, loss, or neutral outcome. Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11). Compared to healthy controls, BPD patients exhibited significantly reduced fMRI responses of the ventral striatum/nucleus accumbens (VS/NAcc) to both reward-predicting and loss-predicting cues. BIS-11 scores showed a significant positive correlation with the VS/NAcc reward anticipation responses in healthy controls, and this correlation, while also nominally positive, failed to reach significance in BPD patients. BPD patients, on the other hand, exhibited a significantly negative correlation between ventral striatal loss anticipation responses and BIS-11 scores, whereas this correlation was significantly positive in healthy controls. Our results suggest that patients with BPD show attenuated anticipation responses in the VS/NAcc and, furthermore, that higher impulsivity in BPD patients might be related to impaired prediction of aversive outcomes. We investigated striatal reward and loss anticipation in patients with Borderline Personality Disorder (BPD) and controls BPD patients relative to controls exhibited reduced ventral striatal / nucleus accumbens (VS/NAcc) anticipation responses In healthy controls, VS responses to gains and losses correlated positively with impulsivity BPD patients exhibited a negative correlation between loss responses and impulsivity. Our results suggest that impulsivity in BPD patients may in part result from impaired anticipation of aversive outcomes.
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Affiliation(s)
- Maike C. Herbort
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychology, Humboldt University, Berlin, Germany
| | - Joram Soch
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Bernstein Center for Computational Neuroscience, Humboldt University, Berlin, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Maia Pujara
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Eppendorf, Hamburg, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Roepke
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Björn H. Schott
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry and Psychotherapy, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Corresponding author at: Leibniz-Institut für Neurobiologie, Brenneckestr. 6, 39118 Magdeburg, Germany.Leibniz-Institut für NeurobiologieBrenneckestr. 6Magdeburg39118Germany
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50
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Saunders KEA, Goodwin GM, Rogers RD. Insensitivity to the Magnitude of Potential Gains or Losses When Making Risky Choices: Women With Borderline Personality Disorder Compared With Bipolar Disorder and Controls. J Pers Disord 2016; 30:530-44. [PMID: 26623536 DOI: 10.1521/pedi_2015_29_216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Poor decision-making is a feature of borderline personality disorder (BPD) and bipolar disorder (BD). Twenty women with BPD, 20 women with BD, and 20 healthy females completed a risky choice task. Those with BPD exhibited altered processing of information about potential gains and losses, with a bias toward large compared to small gains, large compared to small losses, and a tendency to choose outcomes with a negative expected value. This failure to use explicit reinforcement signals was not observed in those with BD. Difficulties using reward information to make decisions may impair day-to-day function. Such impairments offer new treatment targets in BPD.
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Affiliation(s)
- Kate E A Saunders
- University Department of Psychiatry, Warneford Hospital, Oxford, U. K
| | - Guy M Goodwin
- University Department of Psychiatry, Warneford Hospital, Oxford, U. K
| | - Robert D Rogers
- University Department of Psychiatry, Warneford Hospital, Oxford, U. K.,School of Psychology, Bangor University, Gwynedd, U.K
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