Behavioral and Neurobiological Correlates of Disturbed Emotion Processing in Borderline Personality Disorder

Abstract

One of the core symptoms of borderline personality disorder (BPD) is emotion dysregulation, which comprises emotion sensitivity, heightened and labile negative affect, deficient appropriate regulation strategies, and a surplus of maladaptive regulation strategies. Although earlier studies provided some evidence for threat hypersensitivity in terms of a negatively biased perception of other people (“negativity bias”) and deficits in the recognition of full-blown anger, i.e., higher error rates and slower reaction times, researchers have only recently started studying effects of interindividual differences (e.g., sex, impulsivity, aggressiveness) and stimulus complexity as well as associations with early adversity, developmental aspects, or the specificity for BPD. Recent data also suggest a deficit in the detection of positive emotions, which needs to be addressed in more detail since it may prevent the patients from recognizing safety signals and from making positive interpersonal experiences. Neurobiologically, threat hypersensitivity has been related to increased and prolonged amygdala responses, while deficient emotion regulation was associated with reduced prefrontal inhibition of the amygdala. First results suggest that these neural alterations may be modulated by psychotherapeutic treatment focusing on emotion regulation.

Towards the automatic detection of social biomarkers in autism spectrum disorder: introducing the simulated interaction task (SIT)

“…It is warranted to carefully define the area of use and evaluate benefits, costs, and risks. The importance of monitoring and characterizing social communication behavior is not limited to ASD, but applies to many other psychiatric conditions, as differences in recognizing and signaling emotions are common phenomena in mental disorders and vary with disorder severity, e.g., in psychosis, 4,65 depression, 5 bipolar disorder, 6 and substance use disorders. 7 Thus, the SIT may serve not only as a diagnostic instrument but also as a tool for measuring treatment-based outcomes in other conditions than ASD.…”

“…1 Difficulties in the encoding of emotions are a defining characteristic of autism spectrum disorder (ASD), 2,3 but have also been reported for other psychiatric disorders. [4][5][6][7] Similarly, differences in signaling emotions are characteristic for ASD 8 and common in many other mental disorders. 9 When diagnosing and monitoring the course of a mental disorder, it is thus crucial to assess a patient's respective deficits with reliable and time-efficient methods.…”

Oxytocin Normalizes Approach–Avoidance Behavior in Women With Borderline Personality Disorder

“…Factors influencing such experiences could be symptoms such as fear of abandonment and impulsive behavior and also deficits in social cognition (e.g., empathy, cooperation, emotion recognition, and regulation) (2,3). A related aspect is hypersensitivity to threatening information when processing emotional states of others (4). Patients with BPD tend to detect subtle signals of threat and to focus their attention on threatening interpersonal cues (4)(5)(6).…”

“…A related aspect is hypersensitivity to threatening information when processing emotional states of others (4). Patients with BPD tend to detect subtle signals of threat and to focus their attention on threatening interpersonal cues (4)(5)(6). Furthermore, faster initial saccades into the eyes-the most threatening part-of angry faces in patients with BPD suggest approach rather than avoidance behavior to interpersonal threat cues (7).…”

Intact Classical Fear Conditioning to Interpersonally Threatening Stimuli in Borderline Personality Disorder

“…BPD affects about 2.7% of the general population [2], and up to 15-20% of psychiatric inpatients, making it the most prevalent personality disorder in clinical settings [3]. BPD is characterized by a hypersensitivity to interpersonal threat cues [4]. Yet, it is unknown if deficits in classical fear conditioning to inter-personally threatening stimuli could help to explain the emergence and maintenance of threat hypersensitivity in patients with BPD.…”