Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: a preliminary report

Schmahl, Christian; Elzinga, Bernet M.; Ebner, Ulrich; Simms, Timothy; Sanislow, Charles A.; Vermetten, Eric; McGlashan, Thomas H.; Bremner, J. Douglas

doi:10.1016/j.psychres.2004.01.005

Cited by 108 publications

(82 citation statements)

References 29 publications

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“…Activation in these systems in the face of diminished "top-down" regulation can lead to disinhibited anger and aggression. Enhanced responses of the amygdala have been reported in patients with borderline personality disorder toward negatively valenced pictures (42), faces with neutral, positive, and negative emotions (43), and traumatic scenes (44) relative to healthy comparison subjects. In more recent studies from our laboratory, increased activation of the amygdala was demonstrated in borderline personality disorder patients toward negative pictures versus a resting state (40,45).…”

Section: Limbic System/subcortical Structuresmentioning

confidence: 99%

Neurobiology of Aggression and Violence

Siever¹

2008

AJP

793

619

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Acts of violence account for an estimated 1.43 million deaths worldwide annually. While violence can occur in many contexts, individual acts of aggression account for the majority of instances. In some individuals, repetitive acts of aggression are grounded in an underlying neurobiological susceptibility that is just beginning to be understood. The failure of "top-down" control systems in the prefrontal cortex to modulate aggressive acts that are triggered by anger provoking stimuli appears to play an important role. An imbalance between prefrontal regulatory influences and hyper-responsivity of the amygdala and other limbic regions involved in affective evaluation are implicated. Insufficient serotonergic facilitation of "top-down" control, excessive catecholaminergic stimulation, and subcortical imbalances of glutamatergic/ gabaminergic systems as well as pathology in neuropeptide systems involved in the regulation of affiliative behavior may contribute to abnormalities in this circuitry. Thus, pharmacological interventions such as mood stabilizers, which dampen limbic irritability, or selective serotonin reuptake inhibitors (SSRIs), which may enhance "top-down" control, as well as psychosocial interventions to develop alternative coping skills and reinforce reflective delays may be therapeutic.Human aggression and violence are, unfortunately, ubiquitous phenomena with substantial costs to our society. The detrimental effects of aggression and violence are documented daily in the media. Aggression-defined as hostile, injurious, or destructive behavior often caused by frustration-can be collective or individual. The mental health professional is often called upon to evaluate pathological forms of individual aggression in the clinical, forensic, and school setting, yet the causes and treatment of pathological aggression and violence are poorly understood and understudied (1). While the underpinnings of human aggression are clearly multifactorial, including political, socioeconomic, cultural, medical, and psychological factors, it is also clear that some forms of pathological aggression, such as impulsive aggression (which occurs in the context of emotional arousal and provocation), have an underlying neurobiology that we are only beginning to understand. In this overview, after defining aggression, its prevalence, and its phenomenology, we will address the neurobiology of aggression, particularly pathological forms of impulsive aggression, by discussing the circuitry, both cortical and subcortical, as well as the role of neuromodulators in the initiation and suppression of aggression.Address correspondence and reprint requests to Dr. Siever, Department of Psychiatry (OOMH), 130 West Kingsbridge Rd., Bronx, NY 10468; Larry.Siever@va.gov. Dr. Siever reports no competing interests. NIH Public Access Definitions of AggressionAggression may be classified in a number of ways, for example, by the target of aggression (e.g., self-directed or other-directed), mode of aggression (e.g., physical or verbal, direct ...

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Section: Limbic System/subcortical Structuresmentioning

confidence: 99%

Neurobiology of Aggression and Violence

Siever¹

2008

AJP

793

619

View full text Add to dashboard Cite

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“…As patients with BPD have often suffered from negative emotional experiences in their past, these studies focused on memories of negative personal experiences such as traumatic or unresolved life events [99,100,101,102] or memories of abandonment [103,104]. …”

Section: Autobiographical Memory: Remembering Emotional Eventsmentioning

confidence: 99%

“…Neurophysiological evidence suggests that, for BPD patients, memories of abandonment may be more arousing than for control participants [104]. In an fMRI study that compared memories of abandonment to neutral memories, Schmahl et al [103] found that increases in blood flow in the bilateral dorsolateral PFC as well as to the right cuneus were greater in women with BPD than in women without BPD.…”

Section: Autobiographical Memory: Remembering Emotional Eventsmentioning

confidence: 99%

Emotions and Memory in Borderline Personality Disorder

Winter

Elzinga²,

Schmahl³

2013

Psychopathology

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Memory processes such as encoding, storage, and retrieval of information are influenced by emotional content. Because patients with borderline personality disorder (BPD) are particularly susceptible to emotional information, it is relevant to understand whether such memory processes are altered in this patient group. This systematic literature review collects current evidence on this issue. Research suggests that emotional information interferes more strongly with information processing and learning in BPD patients than in healthy controls. In general, BPD patients do not seem to differ from healthy control subjects in their ability to memorize emotional information, but they tend to have specific difficulties forgetting negative information. Also, BPD patients seem to recall autobiographical, particularly negative events with stronger arousal than healthy controls, while BPD patients also show specific temporo-prefrontal alterations in neural correlates. No substantial evidence was found that the current affective state influences learning and memory in BPD patients any differently than in healthy control subjects. In general, a depressive mood seems to both deteriorate and negatively bias information processing and memories, while there is evidence that dissociative symptoms impair learning and memory independently of stimulus valence. This review discusses methodological challenges of studies on memory and emotions in BPD and makes suggestions for future research and clinical implications.

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“…Like abuse-related PTSD, BPD patients with a history of early abuse show HPA axis dysfunction, and a functional dysregulation of the prefrontal-limbic axis (Donegan et al 2003 ;Driessen et al 2004 ;Juengling et al 2003 ;Lange et al 2005 ;Schmahl and Bremner 2006 ;Schmahl et al 2002Schmahl et al , 2003aSchmahl et al , 2004a. However, BPD and PTSD patients, even in groups where all subjects were exposed to childhood sexual abuse, have important differences in the types of stimuli that provoke physiological reactivity, with BPD subjects responding to reminders (scripts) of abandonment but not trauma, and PTSD subjects having the opposite response (Schmahl et al 2004a ). These fi ndings are consistent with a common neurobiology and neurocircuitry underlying the trauma-spectrum disorders, including PTSD, DID, BPD, and depression related to early abuse, in women with childhood abuse, although some differences may mediate differences in symptoms.…”

Section: Early Life Stress and Cardiovascular Diseasementioning

confidence: 99%

Neurobiology of Early Life Stress in Women

Bremner

Vaccarino

2014

Psychosocial Stress and Cardiovascular Disease in Women

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Early life stress can have lasting effects on neurobiology and cognition in women that can lead to an array of negative physical and mental health outcomes. Early life stress can lead to chronic posttraumatic stress disorder (PTSD) in adulthood, as well as other mental health disorders like depression and substance abuse. In addition, changes in neurobiology, acting either directly or through associated mental disorders, can have an effect on physical health function. One area that is infl uenced by stress-induced changes in neurobiology and that is a focus of this chapter is cardiovascular disease. Lasting changes in stress-responsive neurohormonal systems, including the hypothalamic-pituitary-adrenal (HPA) axis and noradrenergic systems, are associated with exposure to chronic stress. Childhood abuse also has long-term effects on brain areas involved in memory and emotion, including the hippocampus, amygdala, and medial prefrontal cortex. These brain areas have outputs to peripheral sympathetic and hormonal systems that activate the cardiovascular response to stress. We review in this chapter mechanisms by which early life stress affects neurobiology and in turn can have a deleterious effect on cardiovascular disease outcomes for women in adulthood. Keywords The Effects of Early Life Stress on WomenEarly life stress can have lasting effects on cognitive and neurobiological function in women. As many as one in fi ve or more girls are affected by some form of childhood abuse, whether sexual, physical, or emotional abuse (MacMillan et al. 1997 ;

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Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: a preliminary report

Cited by 108 publications

References 29 publications

Neurobiology of Aggression and Violence

Neurobiology of Aggression and Violence

Emotions and Memory in Borderline Personality Disorder

Neurobiology of Early Life Stress in Women

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