Prefrontal cortical function during interpersonal inclusion and exclusion in borderline personality disorder

Abstract

Borderline personality disorder (BPD) is a condition characterized by interpersonal difficulties and hypersensitivity to rejection. Inefficient recruitment of the prefrontal cortex in persons with BPD has been demonstrated in functional neuroimaging studies involving affective processes, although little is know regarding the neurocognitive basis of interpersonal function in BPD. The present investigation used functional near infrared spectroscopy to examine levels of evoked cerebral blood oxygenation in nine females with BPD and 10 healthy female participants during conditions of interpersonal inclusion and exclusion. BPD participants demonstrated relative decreases in hemodynamic oxygenation of right prefrontal cortex during the inclusion condition compared with healthy controls. During the exclusion condition, all participants reported very high levels of rejection; however, no differences in rejection ratings or cerebral blood oxygenation were observed between BPD and healthy groups. Higher levels of oxygenation in right prefrontal cortex during the inclusion condition were associated with gregarious-extraverted personality traits, whereas lower levels of oxygenation in this region were associated with aloof-introverted traits and fears of abandonment. These findings suggest a role of prefrontal systems in negotiating the relationship between characterologic interpersonal function and social difficulties in BPD, possibly related to deficits in reciprocal social interaction, interpersonal engagement, and awareness of self and others.%%%%Ph.D., Clinical Psychology – Drexel University, 2008