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Schurz M, Berenz JP, Maerz J, Perla R, Buchheim A, Labek K. Brain Activation for Social Cognition and Emotion Processing Tasks in Borderline Personality Disorder: A Meta-Analysis of Neuroimaging Studies. Brain Sci 2024; 14:395. [PMID: 38672044 PMCID: PMC11048542 DOI: 10.3390/brainsci14040395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
The present meta-analysis summarizes brain activation for social cognition and emotion-processing tasks in borderline personality disorder (BPD). We carried out two meta-analyses to elaborate on commonalities and potential differences between the two types of tasks. In the first meta-analysis, we implemented a more liberal strategy for task selection (including social and emotional content). The results confirmed previously reported hyperactivations in patients with BPD in the bilateral amygdala and prefrontal cortex and hypoactivations in bilateral inferior frontal gyri. When applying a stricter approach to task selection, focusing narrowly on social cognition tasks, we only found activation in prefrontal areas, particularly in the anterior cingulate and ventromedial prefrontal cortex. We review the role of these areas in social cognition in healthy adults, suggesting that the observed BPD hyperactivations may reflect an overreliance on self-related thought in social cognition.
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Affiliation(s)
- Matthias Schurz
- Department of Psychology, Faculty of Psychology and Sport Science, and Digital Science Center (DiSC), University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Jan-Patrick Berenz
- Department of Psychology, Faculty of Psychology and Sport Science, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Jeff Maerz
- Department of Psychology, Faculty of Psychology and Sport Science, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Raphael Perla
- Department of Psychology, Faculty of Psychology and Sport Science, and Digital Science Center (DiSC), University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Anna Buchheim
- Department of Psychology, Faculty of Psychology and Sport Science, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
| | - Karin Labek
- Department of Psychology, Faculty of Psychology and Sport Science, University of Innsbruck, Universitätsstrasse 15, 6020 Innsbruck, Austria
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Mitolo M, D'Adda F, Evangelisti S, Pellegrini L, Gramegna LL, Bianchini C, Talozzi L, Manners DN, Testa C, Berardi D, Lodi R, Menchetti M, Tonon C. Emotion dysregulation, impulsivity and anger rumination in borderline personality disorder: the role of amygdala and insula. Eur Arch Psychiatry Clin Neurosci 2024; 274:109-116. [PMID: 37086305 PMCID: PMC10786743 DOI: 10.1007/s00406-023-01597-8] [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: 09/30/2022] [Accepted: 03/20/2023] [Indexed: 04/23/2023]
Abstract
Borderline Personality Disorder (BPD) is a severe mental disorder, characterized by deficits in emotion regulation, interpersonal dysfunctions, dissociation and impulsivity. Brain abnormalities have been generally explored; however, the specific contribution of different limbic structures to BPD symptomatology is not described. The aim of this study is to cover this gap, exploring functional and structural alterations of amygdala and insula and to highlight their contribution to neuropsychiatric symptoms. Twenty-eight BPD patients (23.7 ± 3.42 years; 6 M/22F) and twenty-eight matched healthy controls underwent a brain MR protocol (1.5 T, including a 3D T1-weighted sequence and resting-state fMRI) and a complete neuropsychiatric assessment. Volumetry, cortical thickness and functional connectivity of amygdala and insula were evaluated, along with correlations with the neuropsychiatric scales. BPD patients showed a lower cortical thickness of the left insula (p = 0.027) that negatively correlated with the Anger Rumination Scale (p = 0.019; r = - 0.450). A focused analysis on female patients showed a significant reduction of right amygdala volumes in BPD (p = 0.037), that correlate with Difficulties in Emotion Regulation Scale (p = 0.031; r = - 0.415), Beck Depression Inventory (p = 0.009; r = - 0.50) and Ruminative Response Scale (p = 0.045; r = - 0.389). Reduced functional connectivity was found in BPD between amygdala and frontal pole, precuneus and temporal pole. This functional connectivity alterations correlated with Anger Rumination Scale (p = .009; r = - 0.491) and Barratt Impulsiveness Scale (p = 0.020; r = - 0.447). Amygdala and insula are altered in BPD patients, and these two limbic structures are implicated in specific neuropsychiatric symptoms, such as difficulty in emotion regulation, depression, anger and depressive rumination.
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Affiliation(s)
- M Mitolo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Via Altura 3, 40139, Bologna, Italy
| | - F D'Adda
- Department of Mental Health and Substance Abuse, Local Health Trust of Bologna, Bologna, Italy
| | - S Evangelisti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - L Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
| | - L L Gramegna
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Via Altura 3, 40139, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - C Bianchini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - L Talozzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - D N Manners
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - C Testa
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Via Altura 3, 40139, Bologna, Italy
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - D Berardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - R Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy
| | - M Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - C Tonon
- Functional and Molecular Neuroimaging Unit, IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Via Altura 3, 40139, Bologna, Italy.
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
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Bud S, Nechita D, Szentagotai Tatar A. Emotion regulation strategies in borderline personality disorder: a meta-analysis. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2022.2152668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Samuel Bud
- Evidence-Based Assessment and Psychological Interventions Doctoral School, Babeş-Bolyai University, Cluj-Napoca, Romania
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Diana Nechita
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Aurora Szentagotai Tatar
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
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Cho GY, Waite EE, Ammerman BA, Dixon-Gordon KL. Testing the Influence of Brooding and Anger Rumination on the Association Between Suicidal Outcomes and BPD Features in Undergraduate Students. Arch Suicide Res 2022; 26:290-303. [PMID: 32329411 DOI: 10.1080/13811118.2020.1755920] [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] [Indexed: 10/24/2022]
Abstract
Borderline personality disorder (BPD) symptoms and suicidal behaviors are prevalent among undergraduate students. Although rumination contributes to self-destructive behaviors in BPD, less research examines the role of rumination in distinct suicidal outcomes among individuals with BPD features instead focusing more on self-destructive behaviors as a latent variable. The present study examined the main and interactive effects of BPD features and two forms of rumination (brooding and anger) in the prediction of suicide-related outcomes (ideation and attempts) among college students. Participants (N = 181 undergraduate students, overrecruited for BPD features; 55.2% female) reported their lifetime suicide risk, brooding rumination, anger rumination, and BPD features. Brooding rumination and BPD features were associated with suicidal ideation. Anger rumination was not associated with suicide-related outcomes. Findings suggest that brooding rumination is a potential intervention target for suicidal ideation in undergraduate students whereas further research is required to determine the association between anger rumination and suicidal ideation and attempts.
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Ghinea D, Fuchs A, Parzer P, Koenig J, Resch F, Kaess M. Psychosocial functioning in adolescents with non-suicidal self-injury: the roles of childhood maltreatment, borderline personality disorder and depression. Borderline Personal Disord Emot Dysregul 2021; 8:21. [PMID: 34193286 PMCID: PMC8246665 DOI: 10.1186/s40479-021-00161-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/31/2021] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND There is a lack of studies examining psychosocial functioning in patients with non-suicidal self-injury (NSSI), especially in adolescents, and rates of impaired functioning in existing literature vary considerably. These variations may be attributable to further risk factors that influence psychosocial functioning. Thus, the aim of the study was to examine whether adolescent NSSI patients with childhood maltreatment (CM), a known risk factor for lower psychosocial functioning, may differ from adolescent NSSI patients without CM, and whether these differences may be explained by the severity of comorbid disorders. Specifically, we examined whether severity of borderline personality disorder (BPD), depression and posttraumatic stress disorder may explain differences in psychosocial functioning in NSSI patients with and without CM. METHODS Data of 368 adolescents with NSSI disorder from an outpatient clinic were analyzed using structural equation modeling. Clinicans' rating of the Global Assessment of Functioning Scale (GAF) was collected, in addition to clinical interviews. RESULTS Results indicate that GAF scores were lower among NSSI patients with CM and that the difference in psychosocial functioning between these groups was explained by BPD and depression severity. CONCLUSIONS Psychosocial functioning in NSSI patients varies depending on whether they have experienced CM or not. Specifically, these differences seem to be attributable to higher BPD and depression severity in adolescent NSSI patients with CM. Clinicians should ensure to assess CM and focus on BPD and depression severity in this population. Treatment of BPD and depression may notably reduce psychosocial impairment in NSSI patients with CM.
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Affiliation(s)
- Denisa Ghinea
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Anna Fuchs
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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Cornelisse S, Biermann M, Enning F, Schmahl C, Kleindienst N. [DBT-PTSD-EA: treatment of posttraumatic stress disorder after interpersonal traumatization in childhood in adolescents with borderline personality disorders : A pilot study]. DER NERVENARZT 2021; 92:679-685. [PMID: 34132818 DOI: 10.1007/s00115-021-01151-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent meta-analyses have shown that posttraumatic stress disorder (PTSD) in adolescents and young adults can be effectively treated; however, there is a lack of studies that investigated the efficacy of psychotherapy in the clinically important group of adolescents with PTSD related to childhood sexual and/or physical abuse and co-occurring symptoms of borderline personality disorder (BPD). OBJECTIVE The aim of this study was a first evaluation of the efficacy of a specifically developed trauma-focused treatment (DBT-PTSD-EA) for adolescent patients with PTSD and BPD symptoms after interpersonal violence in childhood and adolescence. METHODS Validated questionnaires including the Davidson trauma scale (DTS), the borderline symptom list (BSL-23) and the Beck depression inventory (BDI-II) were used to assess treatment-related changes in psychopathology in 39 treatment-seeking adolescents with a diagnosis of PTSD and symptoms of BPD after childhood sexual and/or physical abuse. The diagnoses were established from standardized clinical interviews. The analyses were primarily based on pre-to-post comparisons of all patients who were included (intent to treat analyses, ITT). RESULTS AND DISCUSSION Significant improvements were observed in all questionnaires including PTSD severity, intrusive re-experiencing, hyperarousal, PTSD-related avoidance, severity of BPD and depressive symptoms. The pre-post effect sizes were large for the DTS total score (Cohen's d = 1.24) and medium to large for both the BSL-23 (d = 0.69) and the BDI-II (d = 0.72). While these results are very promising, the validity is limited by the lack of a control group.
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Affiliation(s)
- Sven Cornelisse
- Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland.
| | - Miriam Biermann
- Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland
| | - Frank Enning
- Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland.,Klinik für Psychosomatik und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland
| | - Christian Schmahl
- Klinik für Psychosomatik und Psychotherapie, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Deutschland
| | - Nikolaus Kleindienst
- Institut für Psychiatrische und Psychosomatische Psychotherapie, Zentralinstitut für Seelische Gesundheit, J5, 68159, Mannheim, Deutschland
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[Neurobiological principles of borderline personality disorder: integration into the ICD-11 model of personality disorders]. DER NERVENARZT 2021; 92:653-659. [PMID: 34019118 DOI: 10.1007/s00115-021-01133-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is a severe mental disorder associated with far-reaching impairments in the self and interpersonal functioning. The broad database has contributed to the fact that BPD remains the only categorical personality diagnosis in ICD-11, even if coupled to the determination of the severity of impairments. Nevertheless, we need to deal with a dimensional conceptualization of personality disorders-which is also supported by neuroscientific findings-at the latest in 2022 when the ICD-11 comes into effect . OBJECTIVE This narrative review provides an overview of neuroscientific findings regarding impairments in self and interpersonal functioning in patients with BPD. RESULTS Alterations in the medial prefrontal cortex, temporoparietal junction and precuneus mediate deficits in self-referential thought processes and the mentalization of emotions and intentions of others. Enhanced connectivity between the amygdala and midline structures is associated with hypermentalization. At the same time, elevated insula activation seems to underlie the strengthened nonreflective parts of feelings of other people. Frontolimbic alterations are transdiagnostically associated with deficient emotional regulation and negative affectivity and alterations in reward and cognitive control regions are related to impulsivity. CONCLUSION Neuroscientific findings help to have a better understanding of the underlying mechanisms of central functional impairments in BPD and can support the transition to ICD-11 as well as the implementation of new interventions.
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Aberrant functional connectivity profiles of brain regions associated with salience and reward processing in female patients with borderline personality disorder. Brain Imaging Behav 2021; 14:485-495. [PMID: 30847803 DOI: 10.1007/s11682-019-00065-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Recent resting-state functional connectivity studies have shown significant group differences in several networks between patients suffering from borderline personality disorder (BPD) and healthy controls. However, reliable and consistent findings have not been reported yet. Several methodological factors might be responsible for the discrepant findings, including the heterogeneity of patient samples in terms of symptom severity. In the current study, we combined investigations of the whole-brain resting-state functional connectivity patterns of BPD patients with seed-based connectivity measures and then computed the correlation of connectivity measures with borderline symptom severity. Correlation-based connectivity analysis was performed on resting-state functional magnetic resonance imaging (fMRI) data from 26 female BPD patients and 26 healthy controls. Increased intrinsic connectivity was found in clusters involving part of the caudate nucleus and the left insula in the patient group, indicating greater integration of each region. Further seed-based connectivity analyses revealed that with the caudate seed, the patient data exhibited an increased resting-state functional connectivity in the bilateral ventral striatum and the midline prefrontal regions extending to the ACC, a network associated with reward processing. The left insula seed showed significantly increased connectivity with the bilateral fronto-orbital/insula, the inferior parietal lobule and the mid-cingulate cortex, a network involved in attention and salience encoding, in the patient population. Moreover, symptom severity, as assessed with the BSL-95 outside the scanner, was negatively correlated with the coupling of the insula and the striatum in the BPD group. Overall, an increased functional connectivity within two large-scale circuitries underlying reward and salience processing was evident in patients, as compared to healthy participants. When correlated with borderline symptom severity, a reduced connectivity between key regions belonging to the reward system and salience network was observed in the patients. These findings may be helpful for facilitating further understanding of the potential mechanisms underlying the BPD pathophysiology and thereby delineate potential treatment targets.
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Mow JL, Gandhi A, Fulford D. Imaging the "social brain" in schizophrenia: A systematic review of neuroimaging studies of social reward and punishment. Neurosci Biobehav Rev 2020; 118:704-722. [PMID: 32841653 DOI: 10.1016/j.neubiorev.2020.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/20/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize research on the neurobiology of social motivation in SSD, we performed a systematic literature review of neuroimaging studies involving the presentation of social stimuli intended to elicit feelings of reward and/or punishment. Across 11 studies meeting criteria, people with SSD demonstrated weaker modulation of brain activity in regions within a proposed social interaction network, including prefrontal, cingulate, and striatal regions, as well as the amygdala and insula. Firm conclusions regarding neural differences in SSD in these regions, as well as connections within networks, are limited due to conceptual and methodological inconsistencies across the available studies. We conclude by making recommendations for the study of social reward and punishment processing in SSD in future research.
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Affiliation(s)
- Jessica L Mow
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States.
| | - Arti Gandhi
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
| | - Daniel Fulford
- Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, United States; Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, United States
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Makovac E, Fagioli S, Rae CL, Critchley HD, Ottaviani C. Can't get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition. Psychiatry Res Neuroimaging 2020; 295:111020. [PMID: 31790922 DOI: 10.1016/j.pscychresns.2019.111020] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/12/2022]
Abstract
Perseverative cognition (i.e. rumination and worry) describes intrusive, uncontrollable, repetitive thoughts. These negative affective experiences are accompanied by physiological arousal, as if the individual were facing an external stressor. Perseverative cognition is a transdiagnostic symptom, yet studies of neural mechanisms are largely restricted to specific clinical populations (e.g. patients with major depression). The present study applied activation likelihood estimation (ALE) meta-analyses to 43 functional neuroimaging studies of perseverative cognition to elucidate the neurobiological substrates across individuals with and without psychopathological conditions. Task-related and resting state functional connectivity studies were examined in separate meta-analyses. Across task-based studies, perseverative cognition engaged medial frontal gyrus, cingulate gyrus, insula, and posterior cingulate cortex. Resting state functional connectivity studies similarly implicated posterior cingulate cortex together with thalamus and anterior cingulate cortex (ACC), yet the involvement of ACC distinguished between perseverative cognition in healthy controls (HC) and clinical groups. Perseverative cognition is accompanied by the engagement of prefrontal, insula and cingulate regions, whose interaction may support the characteristic conjunction of self-referential and affective processing with (aberrant) cognitive control and embodied (autonomic) arousal. Within this context, ACC engagement appears critical for the pathological expression of rumination and worry.
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Affiliation(s)
- Elena Makovac
- Centre for Neuroimaging Science, Kings College London, London, UK.
| | - Sabrina Fagioli
- Department of Education, University of Roma Tre, Rome, Italy; Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Charlotte L Rae
- School of Psychology, University of Sussex, Falmer, UK; Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Falmer, UK; Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK
| | - Cristina Ottaviani
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy
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Cassiello-Robbins C, Wilner JG, Peters JR, Bentley KH, Sauer-Zavala S. Elucidating the relationships between shame, anger, and self-destructive behaviors: The role of aversive responses to emotions. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019; 12:7-12. [PMID: 31608206 DOI: 10.1016/j.jcbs.2018.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Shame and anger are distinct yet interrelated emotions that have both been implicated in the occurrence of impulsive, self-destructive behavior (ISDB); however, the intricacies of these relations remain sparsely examined. Some research, mostly with anxiety and depression, suggests that an aversive reaction to the experience of negative emotions can result in efforts to escape or avoid such experiences. The current study sought to extend this model to the experience of shame. Consistently, we predicted that aversive reactions to shame would be associated with anger, which would be associated with ISDB. Four hundred and seventy-five undergraduate students completed a series of online questionnaires. Serial mediation was performed and r-square indicated that 35.55% of the variance in impulsive behavior was explained by this model. As predicted, shame had a significant indirect effect on anger through aversive reactions to emotions and on ISDB through aversive reactions to emotions and anger. Unexpectedly the reverse model, with an aversive reaction to anger predicting shame and ISDB, was also significant suggesting possible bidirectional relations between these constructs. This study is among the first to examine a possible mechanism by which shame can lead to ISDB, providing potential points of intervention for treatment.
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Affiliation(s)
| | - Julianne G Wilner
- Center for Anxiety and Related Disorders at Boston University, Boston University
| | - Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Rhode Island Hospital
| | - Kate H Bentley
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School
| | - Shannon Sauer-Zavala
- Center for Anxiety and Related Disorders at Boston University, Boston University
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