Alexithymia is a multi-faceted construct consisting of: a) difficulties identifying and describing one's emotions, b) difficulty distinguishing emotional feelings from bodily sensations, c) an "externally-oriented thinking style" focused on external realities with limited self-reflective thought towards inner experience, and d) limited imagination and fantasy life (Nemiah et al., 1976).

BackgroundVolatile interpersonal relationships are a core feature of borderline personality disorder (BPD) and lead to devastating disruption of patients’ personal and professional lives. Quantitative models of social decision making and learning hold promise for defining the underlying mechanisms of this problem. In this study, we tested BPD and control subject weighting of social versus nonsocial information and their learning about choices under stable and volatile conditions. We compared behavior using quantitative models.MethodsSubjects (n = 20 BPD, n = 23 control subjects) played an extended reward learning task with a partner (confederate) that requires learning about nonsocial and social cue reward probability (the social valuation task). Task experience was measured using language metrics: explicit emotions/beliefs, talk about the confederate, and implicit distress (using the previously established marker self-referentiality). Subjects’ weighting of social and nonsocial cues was tested in mixed-effect regression models. Subjects’ learning rates under stable and volatile conditions were modeled (Rescorla–Wagner approach) and group × condition interactions tested.ResultsCompared to control subjects, BPD subject debriefings included more mentions of the confederate and less distress language. BPD subjects also weighted social cues more heavily but had blunted learning responses to (nonsocial and social) volatility.ConclusionsThis is the first report of patient behavior in the social valuation task. The results suggest that BPD subjects expect higher volatility than control subjects. These findings lay the groundwork for a neurocomputational dissection of social and nonsocial belief updating in BPD, which holds promise for the development of novel clinical interventions that more directly target pathophysiology.

Light-adapted (LA) electroretinograms (ERGs) from 90 individuals with autism spectrum disorder (ASD), mean age (13.0 ± 4.2), were compared to 87 control subjects, mean age (13.8 ± 4.8). LA-ERGs were produced by a random series of nine different Troland based, full-field flash strengths and the ISCEV standard flash at 2/s on a 30 cd.m -2 white background. A random effects mixed model analysis showed the ASD group had smaller b-and a-wave amplitudes at high flash strengths (p<0.001) and slower b-wave peak times (p<0.001). Photopic hill models showed the peaks of the component Gaussian (p=0.035) and logistic functions (p=0.014) differed significantly between groups. Retinal neurophysiology assessed by LA-ERG provides insight into neural function in ASD and represents a candidate biomarker worthy of additional study.

Personal space regulation is a key component of effective social engagement. Personal space varies among individuals and with some mental health conditions. Simulated personal space intrusions in Borderline Personality Disorder (BPD) reveal larger preferred interpersonal distance in that setting. These findings led us to conduct the first test of live interpersonal distance preferences in symptoms in BPD. With direct observation of subjects' personal space behavior in the stop-distance paradigm, we found a 2-fold larger preferred interpersonal distance in BPD than control (n = 30, n = 23). We discuss this result in context of known biology and etiology of BPD. Future work is needed to identify neural circuits underlying personal space regulation in BPD, individual differences in preferred interpersonal distance in relation to specific symptoms and relationship to recovery status.

Purpose of review We review the literature on the use and potential use of computational psychiatry methods in Borderline Personality Disorder. Recent findings Computational approaches have been used in psychiatry to increase our understanding of the molecular, circuit, and behavioral basis of mental illness. This is of particular interest in BPD, where the collection of ecologically valid data, especially in interpersonal settings, is becoming more common and more often subject to quantification. Methods that test learning and memory in social contexts, collect data from real-world settings, and relate behavior to molecular and circuit networks are yielding data of particular interest. Summary Research in BPD should focus on collaborative efforts to design and interpret experiments with direct relevance to core BPD symptoms and potential for translation to the clinic.

Background: Patch testing is the standard to diagnose allergic contact dermatitis (ACD).Objective: This study assessed the value of patch testing for product changes and quality of life in children with ACD. Methods: In this cross-sectional survey, we used a questionnaire to follow up with families of ACD patients about changes since patch testing and counseling preferences. Eligible participants were 18 years or younger during expanded series or personalized patch tests at the Washington University School of Medicine from 2007 to 2020.Results: Of the 43 enrolled participants, most were positive for multiple allergens (63%) and changed personal products after patch testing (71%). Only 26% of the families consistently read product labels before patch testing, compared with 66% after. Patients saw a mean relative reduction of 49% in severity of rash (8.2-4.2 of 10), 46% in interference with activities (5.7-3.1), and 51% in self-consciousness (7.0-3.4) since patch testing. Families gave favorable feedback for counseling on products to avoid (9.4 of 10 average rating of usefulness), product recommendations (8.5 of 10), and chemical names (7.9 of 10).Conclusions: Patch testing can lead to meaningful improvements in quality of life for most children with ACD. Counseling related to positive patch test results should include discussion of specific products to use and avoid.

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Researchers investigating the psychological processes underlying specific mental health problems often have difficulties achieving large enough samples for adequately powered studies.This can be particularly problematic when studying psychopathology with low base rates in typical samples (i.e., undergraduate and community). A relatively new approach to recruitment and testing employs online crowdsourcing to rapidly measure the characteristics and behavior of large numbers of people. We tested the feasibility of researching borderline personality disorder (BPD) in this manner using one large crowdsourcing site, Amazon Mechanical Turk (MTurk).Specifically, we examined prevalence rates of psychopathology in a large MTurk sample, as well as the demographic, psychosocial, and psychiatric characteristics of individuals who met criteria for BPD. These characteristics were compared across three groups: those who met criteria for BPD currently, those who met criteria for remitted BPD, and those who had never met criteria for BPD. The results suggest that MTurk may be ideally suited for studying individuals with a wide range of pathology, from healthy to intensely symptomatic to remitted.