1. Neural Response during the Activation of the Attachment System in Patients with Borderline Personality Disorder
- Author
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Horst Kächele, Philipp Martius, Susanne Erk, Henrik Walter, Carol George, Manfred Spitzer, Anna Buchheim, and Dan Pokorny
- Subjects
emotional regulation ,Emotionsregulation ,Corpus amygdaloideum ,Stimulus (physiology) ,600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit ,Amygdala ,behavioral disciplines and activities ,Emotional Instability ,Developmental psychology ,lcsh:RC321-571 ,03 medical and health sciences ,Behavioral Neuroscience ,0302 clinical medicine ,Magnetic resonance imaging ,ddc:150 ,Funktionelle Kernspintomografie ,medicine ,In patient ,Projective test ,Borderline personality disorder ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Biological Psychiatry ,Original Research ,Functional MRI ,Attachment system ,medicine.diagnostic_test ,amygdala ,medicine.disease ,030227 psychiatry ,Psychiatry and Mental health ,Distress ,100 Philosophie und Psychologie::150 Psychologie ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,Neurology ,functional MRI ,Borderline-Persönlichkeitsstörung ,Functional magnetic resonance imaging ,Psychology ,Emotional regulation ,attachment system ,030217 neurology & neurosurgery ,Clinical psychology ,Neuroscience ,borderline personality disorder - Abstract
Individuals with borderline personality disorder (BPD) are characterized by emotional instability, impaired emotion regulation and unresolved attachment patterns associated with abusive childhood experiences. We investigated the neural response during the activation of the attachment system in BPD patients compared to healthy controls using functional magnetic resonance imaging (fMRI). Eleven female patients with BPD without posttraumatic stress disorder (PTSD) and 17 healthy female controls matched for age and education were telling stories in the scanner in response to the Adult Attachment Projective Picture System (AAP), an eight-picture set assessment of adult attachment. The picture set includes theoretically-derived attachment scenes, such as separation, death, threat and potential abuse. The picture presentation order is designed to gradually increase the activation of the attachment system. Each picture stimulus was presented for 2 min. Analyses examine group differences in attachment classifications and neural activation patterns over the course of the task. Unresolved attachment was associated with increasing amygdala activation over the course of the attachment task in patients as well as controls. Unresolved controls, but not patients, showed activation in the right dorsolateral prefrontal cortex (DLPFC) and the rostral cingulate zone (RCZ). We interpret this as a neural signature of BPD patients’ inability to exert top-down control under conditions of attachment distress. These findings point to possible neural mechanisms for underlying affective dysregulation in BPD in the context of attachment trauma and fear.
- Published
- 2016