Emerging studies have focused on the heightened emotional reactivity observed in people with borderline personality disorder, whose lives are often marked by chaotic relationships, turbulent emotions and impulsive actions.
People with borderline personality disorder also seem to be more likely to meet diagnostic criteria for posttraumatic stress disorder and mood disorders.
New research published in the journal Biological Psychiatry paints perhaps the sharpest picture we have so far of the patterns of brain activity which may underlie the intense and unstable emotional experiences associated with this diagnosis.
Neuropsychologist Dr. Anthony Ruocco at the University of Toronto and his colleagues describe two critical brain underpinnings of emotion dysregulation in borderline personality disorder: heightened activity in brain circuits involved in the experience of negative emotions and reduced activation of brain circuits that normally suppress negative emotion once it is generated.
In their study, researchers performed a meta-analysis of previously published neuroimaging studies to examine dysfunctions underlying negative emotion processing in borderline personality disorder.
A literature review identified 11 relevant studies from which they pooled the results to further analyze, providing data on 154 patients with borderline personality disorder and 150 healthy control subjects.
Ruocco commented, “We found compelling evidence pointing to two interconnected neural systems which may subserve symptoms of emotion dysregulation in this disorder.
“The first, centered on specific limbic structures, which may reflect a heightened subjective perception of the intensity of negative emotions, and the second, comprised primarily of frontal brain regions, which may be inadequately recruited to appropriately regulate emotions.”
Experts believe it is important to note that reduced activity in a frontal area of the brain, called the subgenual anterior cingulate, may be unique to borderline personality disorder and could serve to differentiate it from other related conditions, such as recurrent major depression.
“This new report adds to the impression that people with borderline personality disorder are ‘set-up’ by their brains to have stormy emotional lives, although not necessarily unhappy or unproductive lives,” commented Dr. John Krystal, Editor of Biological Psychiatry.
“Given that many of the most effective psychotherapies for borderline personality disorder work to improve emotion regulation skills, these findings could suggest that dysfunctions in critical frontal ‘control’ centers might be normalized after successful treatment,” concluded Ruocco.