Using real-time brain imaging, a team of researchers have discovered that patients with Borderline Personality Disorder (BPD) are physically unable to regulate emotion.

The findings, by Harold W. Koenigsberg, MD, professor of psychiatry at Mount Sinai School of Medicine suggest individuals with BPD are unable activate neurological networks that would help to control feelings.

Using functional magnetic resonance imaging (fMRI), researchers viewed how the brains of people with BPD reacted to social and emotional stimuli.

Koenigsberg found that when people with BPD attempted to control and reduce their reactions to disturbing emotional scenes, the anterior cingulate cortex and intraparetical sulci areas of the brain that are active in healthy people under the same conditions remained inactive in the BPD patients.

“This research shows that BPD patients are not able to use those parts of the brain that healthy people use to help regulate their emotions,” said Dr. Koenigsberg.

“This may explain why their emotional reactions are so extreme. The biological underpinnings of the disordered emotional control systems are central to borderline pathology. Studying which areas of the brain function differently in patients with borderline personality disorder can lead to more targeted uses of psychotherapy and medications, and also provide a link to connect the genetic basis of the disorder.”

According to background information in the article, borderline personality disorder is a common condition, affecting up to two percent of all adults in the United States, mostly women.

Characteristics of borderline personality disorder include being so emotionally overreactive that they suffer alternating bouts of depression, anxiety and anger, are interpersonally hypersensitive, and are impelled to self-destructive and even suicidal behavior.

Patients with BPD often exhibit other types of impulsive behaviors, including excessive spending, binge eating and risky sex. BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.

Like most personality disorders, treatment focuses on helping a person understand how their behaviors impact others, and to change their perception and way of thinking about others’ reactions. This a lengthy process usually conducted in psychotherapy sessions with an experienced clinician, such as a psychologist, who specializes in the treatment of personality disorders.

The disorder is found in about 10-15 percent of people in psychiatric care. Sadly, nearly 10 percent of people with this condition ultimately die of suicide. Only in the past decade have researchers begun to identify underlying biological factors associated with the condition.

This was a small, observational and correlational study. Further studies on fMRI need to be conducted to understand exactly how people diagnosed with borderline personality disorder may differ from others. Additional research may find markers or patterns of changes in the brain that are consistent in identifying people with this condition, versus other conditions and people without the diagnosis.

The research is published in the journal Biological Psychiatry.

Source: The Mount Sinai Medical Center