Neural Correlates of the Use of Psychological Distancing to Regulate Responses to Negative Social Cues: A Study of Patients with Borderline Personality Disorder

doi:10.1016/j.biopsych.2009.06.010

Biological Psychiatry

Volume 66, Issue 9, 1 November 2009, Pages 854-863

https://doi.org/10.1016/j.biopsych.2009.06.010 Get rights and content

Background

Emotional instability is a defining feature of borderline personality disorder (BPD); yet, little is understood about its underlying neural correlates. One possible contributing factor to emotional instability is a failure to adequately employ adaptive cognitive regulatory strategies such as psychological distancing.

Methods

To determine whether there are differences in neural dynamics underlying this control strategy between BPD patients and healthy control (HC) subjects, blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging signals were acquired as 18 BPD and 16 HC subjects distanced from or simply looked at pictures depicting social interactions. Contrasts in signal between distance and look conditions were compared between groups.

Results

Borderline personality disorder patients showed a different pattern of activation compared with HC subjects when looking at negative versus neutral pictures. When distancing versus looking at negative pictures, both groups showed decreased negative affect ratings and increased activation of the dorsolateral prefrontal cortex, areas near/along the intraparietal sulcus (IPS), ventrolateral prefrontal cortex, and posterior cingulate/precuneus regions. However, the BPD group showed less BOLD signal change in dorsal anterior cingulate cortex and IPS, less deactivation in the amygdala, and greater activation in the superior temporal sulcus and superior frontal gyrus.

Conclusions

Borderline personality disorder and HC subjects display different neural dynamics while passively viewing social emotional stimuli. In addition, BPD patients do not engage the cognitive control regions to the extent that HCs do when employing a distancing strategy to regulate emotional reactions, which may be a factor contributing to the affective instability of BPD.

Section snippets

Subjects

Subjects were 18 BPD patients (mean age 32.6 ± 10.4 years; 10 female patients) and 16 HC volunteers (mean age 31.8 ± 7.7 years; 9 female volunteers) recruited from outpatient clinics at the Mount Sinai Medical Center and the James J. Peters Veterans Affairs (VA) Medical Center in New York City and advertisements in local newspapers and local postings. Borderline personality disorder subjects met DSM-IV criteria for BPD and had prominent affective instability as indicated by the presence of

Behavioral Results

In postscan debriefing, subjects reported that they implemented the distancing strategy as instructed and did not close their eyes or look away from the images during either the distancing or look conditions. Self-report affect ratings during the scan (Figure 2) demonstrated an overall image type (negative vs. neutral) × instruction (look vs. distance) interaction, as well as main effects for image type and instruction. Interactions with diagnosis were not significant (for statistical test

Discussion

The purpose of the current study was to further understanding of affective instability in BPD by determining whether the neural bases of one kind of reappraisal—known as distancing—were disturbed in BPD.

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Archival ReportNeural Correlates of the Use of Psychological Distancing to Regulate Responses to Negative Social Cues: A Study of Patients with Borderline Personality Disorder

Background

Methods

Results

Conclusions

Section snippets

Subjects

Behavioral Results

Discussion

Clin Psychol Rev

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Neuroimage

Trends Cogn Sci

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Psychiatry Res

Biol Psychiatry

Psychiatry Res

Psychiatry Res

Psychiatry Res

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Neuroimage

Psychiatry Res

Trends Cogn Sci

Neuroimage

Neuroimage

Neuroimage

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Neuroimage

Brain Res Cogn Brain Res

Neuropsychologia

Neuroimage

Neuroimage

Neuron

Trends Cogn Sci

Trends Cogn Sci

Neuropsychologia

Neuroimage

Brain Cogn

Aversive tension in patients with borderline personality disorder: A computer-based controlled field study

Acta Psychiatr Scand

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Am J Psychiatry

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J Pers Disord

Archival Report
Neural Correlates of the Use of Psychological Distancing to Regulate Responses to Negative Social Cues: A Study of Patients with Borderline Personality Disorder