Abstract
Borderline personality disorder (BPD) is characterized by impairments in the cognitive control of negative information. These impairments in cognitive control are presumably due to blunted activity of the dorsolateral prefrontal cortex (dlPFC) along with enhanced activations of the limbic system. However, the impact of an excitatory stimulation of the dlPFC still needs to be elucidated. In the present study, we therefore assigned 50 patients with BPD and 50 healthy controls to receive either anodal or sham stimulation of the right dlPFC in a double-blind, randomized, between-subjects design. Participants performed a delayed working memory task with a distracter period during which a grey background screen, or neutral, or negative stimuli were presented. This experimental paradigm was first evaluated in a pilot study with 18 patients with BPD and 19 healthy controls. In both studies, patients with BPD showed an impairment of cognitive control when negative distracters were presented in the delay period of a working memory task. However, excitatory stimulation of the right dlPFC did not ameliorate cognitive control of negative stimuli in BPD, which raises questions about the specific role of the right dlPFC for the understanding of BPD psychopathology. Methodological limitations are discussed.
Highlights
L participants underwent diagnostic screening with German versions of the Structured Clinical Interview for DSM-IV Axis-I Mental Disorders and Axis-II Personality Disorders[32,42]
In Study 2, we investigated whether excitatory stimulation of the right dlPFC results in an attenuation of this valence-dependent interference effect in patients with BPD, i.e., we examined the three-way interaction of valence by group and stimulation
Fifty in- and outpatients with BPD and 50 healthy controls matched for age, gender, and intelligence were enrolled in this study
Summary
L participants underwent diagnostic screening with German versions of the Structured Clinical Interview for DSM-IV Axis-I Mental Disorders and Axis-II Personality Disorders[32,42]. Clinical psychologists holding at least a bachelor’s degree in psychology conducted the clinical interviews. Interviewers were trained in the use of these instruments and supervised by the senior author. We did assess interrater reliabilities of this procedure for SCID-II personality disorder diagnoses in our research group[33]. We found acceptable interrater reliabilities of κ = 0.82 for a diagnosis of BPD, and acceptable internal consistencies with Cronbach’s α = 0.88 for the sum of BPD criteria. Participants recruited via media advertisements were initially screened by telephone, before undergoing the clinical interview in the lab directly before the experiment
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