Abstract
Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results. Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance. Here we used functional magnetic resonance imaging (fMRI) to investigate how task-irrelevant emotional stimuli (fearful faces) affect performance and fronto-limbic neural activity patterns during attention-demanding cognitive processing in 16 female, unmedicated BPD patients relative to 24 age-matched healthy controls. In a modified flanker task, emotionally negative, socially salient pictures (fearful vs. neutral faces) were presented as distracters in the background. Patients, but not controls, showed an atypical response pattern of the right amygdala with increased activation during emotional interference in the (difficult) incongruent flanker condition, but emotion-related amygdala deactivation in the congruent condition. A direct comparison of the emotional conditions between the two groups revealed that the strongest diagnosis-related differences could be observed in the dorsal and, to a lesser extent, also in the rostral anterior cingulate cortex (dACC, rACC) where patients exhibited an increased neural response to emotional relative to neutral distracters. Moreover, in the incongruent condition, both the dACC and rACC fMRI responses during emotional interference were negatively correlated with trait anxiety in the patients, but not in the healthy controls. As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.
Highlights
Borderline personality disorder (BPD) is a severe mental disorder characterized by behavioral impulsivity, instability in interpersonal relationships, repetitive suicidal behavior, aggression, autoaggressive behavior, and identity disturbance (Lieb et al, 2004; Mauchnik and Schmahl, 2010)
As higher trait anxiety was associated with longer reaction times (RTs) in the borderline personality disorder (BPD) patients, we suggest that in BPD patients the anterior cingulate cortex (ACC) might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety
The analyses of variance (ANOVA) on RTs yielded a significant main effect of congruency and of emotion [F(1, 38) = 81.51, p < 0.001 and F(1, 38) = 17.78, p < 0.001, respectively], as well as a significant congruency by emotion interaction [F(1, 38) = 6.19, p = 0.017], with RTs being longer in incongruent compared to congruent and emotional compared to neutral trials, yielding their maximum in the incongruent emotional condition
Summary
Borderline personality disorder (BPD) is a severe mental disorder characterized by behavioral impulsivity, instability in interpersonal relationships, repetitive suicidal behavior, aggression, autoaggressive behavior, and identity disturbance (Lieb et al, 2004; Mauchnik and Schmahl, 2010). Most of these behavioral patterns are assumed to result from affective instability, which in turn might reflect a general emotional hyperreactivity, and dysfunction in emotion regulation. A better understanding of the underlying neural mechanisms might help to further improve therapeutic strategies for this debilitating psychiatric disorder (Brendel et al, 2005; Koenigsberg et al, 2009)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
