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Krause, A.D. (2017)

Disconnected self: influence of dissociation on emotional distractibility in Borderline Personality Disorder: a neuroimaging approach

Doctoral Thesis
Dissociation, emotion dysregulation, and cognitive disturbances are key features of Borderline Personality Disorder (BPD). The aim of this thesis was to investigate associations between dissociation and activity in networks relevant to affective-cognitive processing in patients with BPD compared to healthy controls. In the first part of this thesis, associations between self-reported dissociation and functional connectivity of the amygdala and anterior cingulate during resting-state and during an Emotional Working Memory Task (EWMT) were examined. The second part of this neuroimaging research combined script-driven imagery with the EWMT and with an Emotional Stroop Task. Findings suggest a detrimental effect of dissociation on cognitive functioning in BPD. After dissociation induction, patients showed reduced activity in the amygdala, posterior cingulate, superior temporal gyrus, and occipital areas (cuneus, fusiform gyrus, lingual gyrus), along with increased activity in frontal...Show moreDissociation, emotion dysregulation, and cognitive disturbances are key features of Borderline Personality Disorder (BPD). The aim of this thesis was to investigate associations between dissociation and activity in networks relevant to affective-cognitive processing in patients with BPD compared to healthy controls. In the first part of this thesis, associations between self-reported dissociation and functional connectivity of the amygdala and anterior cingulate during resting-state and during an Emotional Working Memory Task (EWMT) were examined. The second part of this neuroimaging research combined script-driven imagery with the EWMT and with an Emotional Stroop Task. Findings suggest a detrimental effect of dissociation on cognitive functioning in BPD. After dissociation induction, patients showed reduced activity in the amygdala, posterior cingulate, superior temporal gyrus, and occipital areas (cuneus, fusiform gyrus, lingual gyrus), along with increased activity in frontal areas (inferior frontal gyrus, dlPFC). Altered interactions between the amygdala and the afore-mentioned regions may underlie disturbed information processing during dissociation in BPD. Further research with larger sample sizes and clinical control groups is needed to gain more insight into the neural mechanisms of stress-related dissociation in BPD. A combination of neuroimaging techniques with subjective, behavioral, and psychophysiological measurements may be a helpful step into this direction.Show less
Amygdala
Anterior cingulate cortex
Borderline personality disorder
Dissociation
Emotional distraction
Emotional working memory
Functional magnetic resonance imaging
Interpersonal trauma
Resting-state functional connectivity
Script-driven imagery
All authors
Krause, A.D.
Supervisor
Elzinga, B.M.; Spinhoven, Ph.; Schmahl, Ch.
Committee
Does, A.J.W. van der; Crone, E.A.M.; Roelofs, K.; Veltman, D.
Qualification
Doctor (dr.)
Awarding Institution
Clinical Psychology, Social and Behavioural Science, Leiden University
Date
2017-11-16