Scientific article
Open access

Identifying Disease-Specific Neural Reactivity to Psychosocial Stress in Borderline Personality Disorder

Published inBiological psychiatry. Cognitive neuroscience and neuroimaging, vol. 7, no. 11, p. 1137-1148
Publication date2022-11
First online date2021-12-17

Background: Patients with borderline personality disorder (BPD) typically present emotion dysregulation (ED) when faced with adversity. However, it is argued that altered stress response may be more influenced by ED than BPD-specific traits. Here, we investigated this issue with functional magnetic resonance imaging using another ED condition as clinical control, i.e., bipolar disorder (BD), and controlling for ED traits.

Methods: We recruited 17 patients with BD, 24 patients with BPD, and 32 healthy control (HC) subjects. We adapted a functional magnetic resonance imaging-compatible psychosocial stressor task (Montreal Imaging Stress Task) in which participants are placed under time pressure when performing mental calculations and then receive immediate performance feedback (positive, negative, and neutral). ED traits were measured via self-report questionnaires targeting cognitive emotion dysregulation, affective lability, and trait anger and anxiety.

Results: Relative to patients with BD and HC subjects, patients with BPD exhibited overactive corticolimbic reactivity across all conditions, particularly in self-monitoring and emotion regulation regions such as the orbitofrontal cortex and anterior insula, even when controlling for ED. Conversely, patients with BD exhibited hypoactive corticolimbic reactivity to all feedback conditions compared with patients with BPD and HC subjects, even after controlling for ED. HC subjects exhibited significantly lower amygdala/hippocampus activity compared with both clinical groups, although this did not survive when controlling for ED.

Conclusions: This study provides new insight into BPD-specific neural stress responding, suggesting hyperactive self- and emotion-regulatory neural psychosocial stress responding, independent of ED traits. The findings also highlight the importance of considering BPD as a diagnostic profile distinguishable from other ED disorder clinical groups.

  • Clinical
  • Emotion dysregulation
  • Interindividual differences
  • Neuroimaging
  • Psychosocial stress
  • Stress-related disorders
  • Humans
  • Borderline Personality Disorder / pathology
  • Amygdala
  • Magnetic Resonance Imaging
  • Bipolar Disorder
  • Stress, Psychological
Citation (ISO format)
MURRAY, Ryan James et al. Identifying Disease-Specific Neural Reactivity to Psychosocial Stress in Borderline Personality Disorder. In: Biological psychiatry. Cognitive neuroscience and neuroimaging, 2022, vol. 7, n° 11, p. 1137–1148. doi: 10.1016/j.bpsc.2021.11.015
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ISSN of the journal2451-9022

Technical informations

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