Background
Borderline personality disorder (BPD) is characterized by an inability to regulate
emotional responses. The amygdala is important in learning about the valence (goodness
and badness) of stimuli and functions abnormally in BPD.
Methods
Event-related functional magnetic resonance imaging (MRI) was employed in three groups:
unmedicated BPD (n = 33) and schizotypal personality disorder (n = 28) participants and healthy control subjects (n = 32) during a task involving an intermixed series of unpleasant, neutral, and pleasant
pictures each presented twice within their respective trial block/run. The amygdala
was hand-traced on each participant's structural MRI scan and co-registered to their
MRI scan. Amygdala responses were examined with a mixed-model multivariate analysis
of variance.
Results
Compared with both control groups, BPD patients showed greater amygdala activation,
particularly to the repeated emotional but not neutral pictures, and a prolonged return
to baseline for the overall blood oxygen level-dependent response averaged across
all pictures. Despite amygdala overactivation, BPD patients showed blunted self-report
ratings of emotional but not neutral pictures. Fewer dissociative symptoms in both
patient groups were associated with greater amygdala activation to repeated unpleasant
pictures.
Conclusions
The increased amygdala response to the repeated emotional pictures observed in BPD
was not observed in schizotypal patients, suggesting diagnostic specificity. This
BPD-related abnormality is consistent with the well-documented clinical feature of
high sensitivity to emotional stimuli with unusually strong and long-lasting reactions.
The finding of a mismatch between physiological and self-report measures of emotion
reactivity in BPD patients suggests they may benefit from treatments targeting emotion
recognition.
Key Words
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Article info
Publication history
Published online: May 07, 2012
Accepted:
March 25,
2012
Received in revised form:
March 19,
2012
Received:
June 22,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
