Affective lability and difficulties with regulation are differentially associated with amygdala and prefrontal response in women with Borderline Personality Disorder

Abstract

The present neuroimaging study investigated two aspects of difficulties with emotion associated with Borderline Personality Disorder (BPD1): affective lability and difficulty regulating emotion. While these two characteristics have been previously linked to BPD symptomology, it remains unknown whether individual differences in affective lability and emotion regulation difficulties are subserved by distinct neural substrates within a BPD sample. To address this issue, sixty women diagnosed with BPD were scanned while completing a task that assessed baseline emotional reactivity as well as top-down emotion regulation. More affective instability, as measured by the Affective Lability Scale (ALS2), positively correlated with greater amygdala responses on trials assessing emotional reactivity. Greater difficulties with regulating emotion, as measured by the Difficulties with Emotion Regulation Scale (DERS3), was negatively correlated with left inferior frontal gyrus (IFG4) recruitment on trials assessing regulatory ability. These findings suggest that, within a sample of individuals with BPD, greater bottom-up amygdala activity is associated with heightened affective lability. By contrast, difficulties with emotion regulation are related to reduced IFG recruitment during emotion regulation. These results point to distinct neural mechanisms for different aspects of BPD symptomology.

Borderline Personality Disorder (BPD): In the Midst of Vulnerability, Chaos, and Awe

“…In addition, the finding of reductions in gray matter volume of amygdala in older BPD patients has been interpreted as reflecting a reversible progressive pathology [ 29 ]. Emotional regulation difficulties of BPD patients are related with insufficient capacity of cognitive processes of prefrontal cortex (PFC) activity [ 30 ]. Koenigsberg et al reported hypoactivity in orbitofrontal cortex, ventrolateral cortex, and dorsal anterior cingulate cortex (ACC) in BPD patients compared with healthy individuals [ 31 ].…”

Neurobiological Mechanisms Mediating Emotion Dysregulation as Targets of Change in Borderline Personality Disorder

“…The study by Schmitt et al [15] has challenged the ability to dampen negative affect through reappraising the meaning of social cues and was built on several previous studies (see Bertsch et al, this issue) which reported a deficient prefrontal-limbic coupling when patients with BPD had been instructed to use reappraisal [16-19]. The reappraisal paradigm conducted in a pre/post design picks up a particularly effective cognitive emotion regulation strategy, i.e., to recognize the negative pattern one’s thoughts have fallen into and changing this pattern in order to regulate one’s emotions.…”

Functional Connectivity Density, Local Brain Spontaneous Activity, and Their Coupling Strengths in Patients With Borderline Personality Disorder

“…Functionally, task-based functional magnetic resonance imaging (fMRI) studies have indicated associations between brain activity and psychological processes in BPD ( 12 ). For example, decreased prefrontal regional activity and increased amygdala activity was associated with emotion dysfunction in BPD ( 13 , 14 ). Activation of the insula and amygdala has been associated with interpersonal and social-cognitive deficits ( 15 , 16 ).…”