Underpinnings Of Borderline Personality Disorder Research Articles

Temperamental underpinnings of borderline personality disorder and its facets.

Temperament is claimed to be the basis for personality; therefore, discovering the temperamental underpinnings of borderline personality disorder and its facets is crucial for understanding this personality disorder. In this article, we explore these underpinnings by using a new model of temperament, based on the Regulative Theory of Temperament, the Big Two of temperament, and the Circumplex of Personality Metatraits. Two studies were conducted on adults-the first was in a general population sample (N = 315) and the second was in a clinical sample (N = 113) in people with a diagnosis of borderline personality disorder. The following measurements were used: The Screening Instrument for Borderline Personality Disorder (SI-Bord), the Five-Factor Borderline Inventory-Short Form (FFBI-SF), and the Temperament Metadimensions Questionnaire (TMQ). General borderline was explained by Reactivity (high Sensitivity) and Activity (high Dynamism). At the facet level, the Borderline Internalizing Facet was mainly explained by Reactivity (high Sensitivity), while the Borderline Externalizing Facet was explained by Activity (high Dynamism) in addition to Reactivity (high Sensitivity). The results of our study revealed specific temperamental underpinnings of borderline and its facets. Reactivity underlies all borderline facets, while Activity differentiates between the Borderline Externalizing Facet and Borderline Internalizing Facet.

Borderline personality disorder and its facets in the context of personality metatraits and pathological traits

Borderline personality disorder is characterized by considerable heterogeneity. The present studies attempt to describe this heterogeneity by locating the borderline construct and its facets in the overall personality structure within the Circumplex of Personality Metatraits and by using the pathological personality traits of the ICD-11. Two studies were conducted with adults – a non-clinical group and a clinical group. It turned out that two facets of the borderline can be differentiated: the Borderline Internalizing Facet and Borderline Externalizing Facet, which have distinct personality underpinnings. General borderline was explained by Negative affectivity, Dissociality, Disinhibition and Detachment. At the facet level, the Borderline Internalizing Facet was mainly explained by Negative affectivity and Detachment, while the Borderline Externalizing Facet was explained by Disinhibition and Dissociality. Moreover, in both groups the general borderline was located close to Alpha-Minus (between Alpha-Minus and Gamma-Minus in the non-clinical group and between Alpha-Minus and Delta-Minus in the clinical group) and the Borderline Internalizing Facet and the Borderline Externalizing Facet were located on both sides of the general borderline. The results of our research revealed broader personality underpinnings of borderline personality disorder and distinct personality underpinnings of its facets.

Parsing variability in borderline personality disorder: a meta-analysis of neuroimaging studies

Though a plethora of functional magnetic resonance imaging (fMRI) studies explored the neurobiological underpinnings of borderline personality disorder (BPD), findings across different tasks were divergent. We conducted a systematic review and activation likelihood estimation (ALE) meta-analysis on the fMRI studies conducted in BPD patients compared to healthy controls (HC). We systematically searched PubMed and PsychINFO from inception until July 9th 2020 using combinations of database-specific terms like ‘fMRI’, ‘Neuroimaging’, ‘borderline’. Eligible studies employed task-based fMRI of the brain in participants of any age diagnosed with BPD compared to HC, during any behavioral task and providing a direct contrast between the groups. From 762 entries, we inspected 92 reports full-texts and included 52 studies (describing 54 experiments). Across all experiments, the HC > BPD and BPD > HC meta-analyses did not yield any cluster of significant convergence of differences. Analyses restricted to studies of emotion processing revealed two significant clusters of activation in the bilateral hippocampal/amygdala complex and anterior cingulate for the BPD > HC meta-analysis. Fail-safe N and single study sensitivity analysis suggested significant findings were not robust. For the subgroup of emotional processing experiments, on a restricted number of experiments providing results for each group separately, another meta-analysis method (difference of convergence) showed a significant cluster in the insula/inferior frontal gyrus for the HC > BPD contrast. No consistent pattern of alteration in brain activity for BPD was evidenced suggesting substantial heterogeneity of processes and populations studied. A pattern of amygdala dysfunction emerged across emotion processing tasks, indicating a potential pathophysiological mechanism that could be transdiagnostic.

A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence.

Contemporary theories for the aetiology of borderline personality disorder (BPD) take a lifespan approach asserting that inborn biological predisposition is potentiated across development by environmental risk factors. In this review, we present and critically evaluate evidence on the neurobiology of BPD in childhood and adolescence, compare this evidence to the adult literature, and contextualise within a neurodevelopmental framework. A systematic review was conducted to identify studies examining the neurobiological (i.e. genetic, structural neuroimaging, neurophysiological, and neuropsychological) correlates of BPD symptoms in children and adolescents aged 19 years or under. We identified, quality assessed, and narratively summarised 34 studies published between 1980 and June 2016. Similar to findings in adult populations, twin studies indicated moderate to high levels of heritability of BPD, and there was some evidence for gene-environment interactions. Also consistent with adult reports is that some adolescents with BPD demonstrated structural (grey and white matter) alterations in frontolimbic regions and neuropsychological abnormalities (i.e. reduced executive function and disturbances in social cognition). These findings suggest that neurobiological abnormalities observed in adult BPD may not solely be the consequence of chronic morbidity or prolonged medication use. They also provide tentative support for neurodevelopmental theories of BPD by demonstrating that neurobiological markers may be observed from childhood onwards and interact with environmental factors to increase risk of BPD in young populations. Prospective studies with a range of repeated measures are now required to elucidate the temporal unfurling of neurobiological features and further delineate the complex pathways to BPD.

Fear Conditioning in Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a severe mental disorder causing significant, persistent disability, and with a high lifetime risk of suicide. The limited knowledge about the neurobiological underpinnings of BPD is a critical obstacle for the development of new, more effective treatments. There is high comorbidity and overlap in symptoms and neurobiological findings between BPD, anxiety disorders, and post-traumatic stress disorder (PTSD). Moreover, a wealth of evidence suggests that there are abnormalities in fear processing and emotional learning in BPD. Given these findings, it is surprising that very few studies have used fear conditioning paradigms in BPD patients. What follows is a review of the evidence of symptomatic overlap and comorbidity between BPD, anxiety disorders, and PTSD, and the neurobiological findings that suggest abnormal fear processing in BPD. We also discuss fear conditioning and related paradigms that probe the brain systems involved in fear processing and will review studies using the same methodologies in BPD patients. Finally, we describe potential research and treatment implications, and future directions.

Can teaching staff about the neurobiological underpinnings of borderline personality disorder instigate attitudinal change?

Background There is an abundant literature on the unfavourable attitudes held by staff working in mental health care settings towards patients with borderline personality disorder. The aim of this study was to assess whether attendance at a training session about the neurobiological underpinnings of borderline personality disorder could improve knowledge and produce positive attitudinal change within staff members working in a low secure inpatient setting. Method Staff knowledge and attitudes (Mental Health Locus of Origin, Empathic Concern and Perspective Taking) were assessed at baseline, post-training attendance and at an eight-week follow up. Results Attendance at the training session was associated with significant increases in theoretical knowledge, Perspective Taking and Locus of Origin scores. However, there were no changes observed in Empathic Concern scores. Conclusion This research suggests that a relatively brief training session, that utilises the neurobiological framework, can be effective in facilitating knowledge and attitudinal change for those working with borderline personality disorder. The implications of the findings are discussed along with suggestions for further research.

Gene Expression Profiles in Relation to Tension and Dissociation in Borderline Personality Disorder

The biological underpinnings of borderline personality disorder (BPD) and its psychopathology including states of aversive tension and dissociation is poorly understood. Our goal was to examine transcriptional changes associated with states of tension or dissociation within individual patients in a pilot study. Dissociation is not only a critical symptom of BPD but has also been associated with higher risk for self-mutilation and depression. We conducted a whole blood gene expression profile analysis using quantitative PCR in 31 female inpatients with BPD. For each individual, two samples were drawn during a state of high tension and dissociation, while two samples were drawn at non-tension states. There was no association between gene expression and tension states. However, we could show that Interleukin-6 was positively correlated to dissociation scores, whereas Guanine nucleotide-binding protein G(s) subunit alpha isoforms, Mitogen-activated protein kinase 3 and 8, Guanine nucleotide-binding protein G(i) subunit alpha-2, Beta-arrestin-1 and 2, and Cyclic AMP-responsive element-binding protein were negatively correlated to dissociation. Our data point to a potential association of dissociation levels with the expression of genes involved in immune system regulation as well as cellular signalling/second-messenger systems. Major limitations of the study are the the possibly heterogeneous cell proportions in whole blood and the heterogeneous medication.

Neuroimaging in borderline personality disorder

Neuroimaging has become one of the most important methods in the investigation of the neurobiological underpinnings of borderline personality disorder. Structural and functional imaging studies have revealed dysfunction in different brain regions which seem to contribute to borderline symptomatology. This review presents relevant studies using different methodologies: volumetry of limbic and prefrontal regions, investigations of brain metabolism under resting conditions, studies of serotonergic neurotransmission, and challenge studies using emotional, stressful, and sensory stimuli. Dysfunction in a frontolimbic network is suggested to mediate much, if not all of the borderline symptomatology.