Background: This study aimed to investigate whether people with borderline personality disorder (BPD) can benefit from reliving positive autobiographical memories in terms of mood and state self... Show moreBackground: This study aimed to investigate whether people with borderline personality disorder (BPD) can benefit from reliving positive autobiographical memories in terms of mood and state self-esteem and elucidate the neural processes supporting optimal memory reliving. Particularly the role of vividness and brain areas involved in autonoetic consciousness were studied, as key factors involved in improving mood and state self-esteem by positive memory reliving. Methods: Women with BPD (N = 25), Healthy Controls (HC, N = 33) and controls with Low Self-Esteem (LSE, N = 22) relived four neutral and four positive autobiographical memories in an MRI scanner. After reliving each memory mood and vividness was rated. State self-esteem was assessed before and after the Reliving Autobio-graphical Memories (RAM) task. Results: Overall, mood and state self-esteem were lower in participants with BPD compared to HC and LSE, but both the BPD and LSE group improved significantly after positive memory reliving. Moreover, participants with BPD indicated that they relived their memories with less vividness than HC but not LSE, regardless of valence. When reliving (vs reading) memories, participants with BPD showed increased precuneus and lingual gyrus activation compared to HC but not LSE, which was inversely related to vividness. Discussion: Women with BPD seem to experience more challenges in reliving neutral and positive autobio-graphical memories with lower vividness and less deactivated precuneus potentially indicating altered autono-etic consciousness. Nevertheless, participants with BPD do benefit in mood and self-esteem from reliving positive memories. These findings underline the potential of positive autobiographical memory reliving and suggest that interventions may be further shaped to improve mood and strengthen self-views in people with BPD. Show less
Background: Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma... Show moreBackground: Borderline Personality Disorder (BPD) is frequently complicated by the presence of dissociative symptoms. Pathological dissociation is linked with earlier and more severe trauma exposure, emotional dysregulation and worse treatment outcomes in Posttraumatic Stress Disorder and Dissociative Disorders, with implications for BPD. Objective: A systematic scoping review was conducted to assess the extent of current literature regarding the impact of dissociation on BPD and to identify knowledge gaps. Methods: Four electronic databases (MEDLINE, APA PsycINFO, EMBASE, CINAHL Plus) were searched, and English peer-reviewed studies with adults with BPD were included, following Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension for scoping reviews (PRISMA-ScR) 2018 guidelines. Results: Most of the 70 included studies were observational (98%) with first authors from Germany (59%). Overall, dissociation was associated with increased BPD symptom severity, self-harm and reduced psychotherapy treatment response; findings regarding suicide risk were mixed. Dissociation was associated with working memory and cognitive deficits, decreased pain perception, altered body ownership, no substance abuse or the abuse of sedative substances, increased fantasy proneness, personality fragmentation, fearful attachment, dream anxiety, perceived stress and altered stress responses, increased cumulative body mass index, decreased water consumption, several neurological correlates and changes in gene expression. Conclusion: BPD with significant dissociative symptoms may constitute a more severe and at-risk subgroup of BPD patients. However, there are significant research gaps and methodological issues in the area, including the possibility of unrecognized Dissociative Disorders in BPD study populations confounding results. Further studies are needed to better understand the impact of dissociation on BPD course and treatment, and to clarify the most appropriate assessment tools for clinical practice. In addition, interventional studies are needed to develop dissociation-specific BPD treatments to determine whether targeting dissociation in BPD can improve treatment outcomes. Show less
BackgroundInterpersonal difficulties in borderline personality disorder (BPD) could be related to the disturbed self-views of BPD patients. This study investigates affective and neural responses to... Show moreBackgroundInterpersonal difficulties in borderline personality disorder (BPD) could be related to the disturbed self-views of BPD patients. This study investigates affective and neural responses to positive and negative social feedback (SF) of BPD patients compared with healthy (HC) and low self-esteem (LSE) controls and how this relates to individual self-views.MethodsBPD (N = 26), HC (N = 32), and LSE (N = 22) performed a SF task in a magnetic resonance imaging scanner. Participants received 15 negative, intermediate and positive evaluative feedback words putatively given by another participant and rated their mood and applicability of the words to the self.ResultsBPD had more negative self-views than HC and felt worse after negative feedback. Applicability of feedback was a less strong determinant of mood in BPD than HC. Increased precuneus activation was observed in HC to negative compared with positive feedback, whereas in BPD, this was similarly low for both valences. HC showed increased temporoparietal junction (TPJ) activation to positive v. negative feedback, while BPD showed more TPJ activation to negative feedback. The LSE group showed a different pattern of results suggesting that LSE cannot explain these findings in BPD.ConclusionsThe negative self-views that BPD have, may obstruct critically examining negative feedback, resulting in lower mood. Moreover, where HC focus on the positive feedback (based on TPJ activation), BPD seem to focus more on negative feedback, potentially maintaining negative self-views. Better balanced self-views may make BPD better equipped to deal with potential negative feedback and more open to positive interactions. Show less
People diagnosed with Borderline Personality Disorder (BPD) continuously struggle with knowing who they are and maintaining relationships. Fortunately, psychotherapies for BPD have proven effective... Show morePeople diagnosed with Borderline Personality Disorder (BPD) continuously struggle with knowing who they are and maintaining relationships. Fortunately, psychotherapies for BPD have proven effective. However, not everyone benefits from treatment with particular challenges remaining in social relations and finding meaning in life. Therefore, it is important to understand how we can better support people with BPD.We know that identity disturbances relate to interpersonal difficulties but we do not really understand how. Therefore, we investigated how interactions with others are influenced by how people see themselves, in the general population and in people diagnosed with BPD. To this end, we studied brain activation and the role of childhood trauma and low self-esteem. In addition, we investigated whether self-views can be strengthened using positive memories.We found that the way people respond to critiques and compliments relates to how positive or negative they see themselves. Moreover, vivid positive memories can benefit mood and self-esteem. However, people with BPD seem to not sufficiently distance themselves from critiques nor engage in positive memories and compliments. Finding the right balance between distance from critiques and engagement with a positive self-image may break the cycle of negative self-knowledge and contribute to better social interactions. Show less
Dissociation, emotion dysregulation, and cognitive disturbances are key features of Borderline Personality Disorder (BPD). The aim of this thesis was to investigate associations between... 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
