Generalizable links between borderline personality traits and functional connectivity

Abstract

Symptoms of borderline personality disorder (BPD) often manifest in adolescence, yet the underlying relationship between these debilitating symptoms and the development of functional brain networks is not well understood. Here we aimed to investigate how multivariate patterns of functional connectivity are associated with borderline personality traits in large samples of young adults and adolescents. We used functional Magnetic Resonance Imaging (fMRI) data from young adults and adolescents from the Human Connectome Project: Young Adults (HCP-YA; N=870, ages 22-37 years, 457 female) and Development (HCP-D; N=223, ages 16-21 years, 121 female). A previously validated BPD proxy score was derived from the NEO Five Factor Inventory (NEO-FFI). A ridge regression model with cross-validation and nested hyperparameter tuning was trained and tested in HCP-YA to predict BPD scores in unseen data from regional functional connectivity. The trained model was further tested on data from HCP-D without further tuning. Finally, we tested how the connectivity patterns associated with BPD aligned with age-related changes in connectivity. Multivariate functional connectivity patterns significantly predicted out-of-sample BPD scores in unseen data in young adults (HCP-YA; pperm=0.001) and older adolescents (HCP-D; pperm=0.001). Regional predictive capacity was heterogeneous; the most predictive regions were found in functional systems relevant for emotion regulation and executive function, including the ventral attention network. Finally, regional functional connectivity patterns that predicted BPD cores aligned with those associated with development in youth. Individual differences in functional connectivity in developmentally-sensitive regions are associated with borderline personality traits.