Neural correlates of fears of abandonment and rejection in borderline personality disorder

Liana Romaniuk,Jeremy Hall,Merrick Pope,Douglas Steele,Katie Nicol

doi:10.12688/wellcomeopenres.10331.1

Liana Romaniuk, Jeremy Hall + Show 3 more

Open Access

https://doi.org/10.12688/wellcomeopenres.10331.1

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Abstract

Background: Borderline personality disorder (BPD) is a prevalent and disabling psychiatric condition commonly associated with early life adversity. Social difficulties are a prominent symptom of BPD, particularly a fear of abandonment and rejection. There has recently been a growing interest in the neural basis of these social symptoms and their relationship to early experience. Methods: In the current study, we examined social brain function and learning in BPD using functional MRI. Participants with BPD (n=20) and healthy controls (n=16) completed a computerized parametric social exclusion task (the “Cyberball” task). Brain activation was compared between groups and related to social symptom status and experiences of childhood trauma. Additional analyses were conducted using a reinforcement learning model treating social inclusion as a rewarding event. Results: Participants with BPD demonstrated a group effect of decreased right temporoparietal junction (TPJ) activation (p < 0.013, FWE-corrected). Increased fear of abandonment in BPD was associated with reduced inclusion-related activation of the inferior frontal gyrus (p = 0.003, FWE-corrected). Across all participants, TPJ inclusion-related activation was modified by prior experience of childhood physical neglect (p < 0.001, FWE-corrected). Reinforcement learning modelling revealed decreased midbrain responses to social inclusion in BPD participants (p = 0.028, FWE-corrected within midbrain mask), with decreased anticipatory midbrain activation in anticipation of social inclusion specifically associated with fears of abandonment (p = 0.019, FWE-corrected within a midbrain mask). Conclusions: The findings demonstrate alterations in social brain function and social reinforcement learning in BPD, which are influenced by both early life experience and symptom status.

Highlights

Borderline personality disorder (BPD) is a common and serious disorder associated with significant impact on the individual, their families and a wide range of healthcare providers[1,2,3]
Main effect of inclusion on brain activation Examining the main effect of increasing inclusion on brain activation across the groups revealed robust activation of several brain regions known to be engaged during social cognition, including the inferior frontal gyrus (IFG), inferior parietal lobule/temporoparietal junction (TPJ), anterior cingulate cortex, caudate and thalamus (Supplementary Figure 3)
Relationship of childhood trauma to brain activation We investigated whether experiences of childhood trauma correlated with neural responses to increasing inclusion

Summary

Introduction

Borderline personality disorder (BPD) is a common and serious disorder associated with significant impact on the individual, their families and a wide range of healthcare providers[1,2,3]. Social difficulties are a core feature of BPD4, and include marked fears of abandonment and social rejection[3,5,6,7,8]. These factors underlying their characteristically disturbed relationships have been proposed to be a phenotype of this personality disorder[9]. Reinforcement learning modelling revealed decreased midbrain responses to social inclusion in BPD participants (p = 0.028, FWE-corrected within midbrain mask), with decreased anticipatory midbrain activation in anticipation of social inclusion associated with fears of abandonment (p = 0.019, FWE-corrected within a midbrain mask). Conclusions: The findings demonstrate alterations in social brain function and social reinforcement learning in BPD, which are Invited Reviewers version 1

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