English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Borderline personality disorder, a debilitating personality disorder characterized by a range of features associated with emotional dysregulation, including affective lability and hyperactivity in response to emotional stimuli, impulsivity, dissociation, suicidal ideation, and difficulties with interpersonal relationships, affects up to 2.7% of the U.S. adult population (1).Psychotherapy treatments for thedisordercan be helpful in promoting symptomatic remission and good psychosocial functioning when targeted appropriately, although this is difficult to attain in a sizeable proportion of patients (2, 3). Identifying functional abnormalities in neural activity underlying cognitive processes that are known to be aberrant in individuals with borderline personality disorder is an important next step to provide objective neural markers to enhance the effectiveness of treatments for individuals with the disorder. For example, a more nuanced understanding of the neural mechanisms of the disorder could help identify specific underlying neural processes for treatments to target. In addition, the degree of normalization of neural abnormalities during treatment could help determine in the future whether a particular treatment is effective for a given individual with the disorder. One theory proposes that borderline personality disorder is characterized by delayed—or deficient—habituation of behavioral, and underlying neural, responses to salient negative emotional stimuli and events (4). A related theory proposes abnormal sensitization to such stimuli and events, whereby these stimuli continue to be perceived as aversive for longer periods of time after desensitization procedures, such as extinction, in individuals with borderline personality disorder compared with healthy individuals. Yet, although there is some evidence in favor of the deficient habituation theory based on a study of individuals with borderline personality disorder (5), no study examined neural and behavioral responses to repeated presentation of salient emotional stimuli over time in this psychiatric population. In this issue of the Journal, Denny and colleagues (6) sought to distinguish between these two related theories of borderline personality disorder in a well-designed neuroimaging study, in which repeated negative emotional and neutral images were shown to adults with borderline personality disorder, healthy control adults, and a psychiatric control group of adults with avoidant personality disorder. The authors developed a specific task in which images depicting scenes of negative emotional and neutral social interactions between two or more people were shown five times each during two sessions 3 days apart. The authors examined behavioral responses, as measured by self-reports of negative affect, as well as activity in three key neural regions in the salience network, comprising the amygdala, anterior insula, and dorsal anterior cingulate cortex, regions subserving emotional, interoceptive processing (7, 8) and directed attentional processes. Salience network activity and self-reports were measured over both sessions in each participant group. The key finding of the study was that while all participants showed habituation of salience network neural activity within each session in response to negative emotional images, only the borderline personality disorder group showed an increase in activity in this neural network between sessions, and less habituation of self-reported negative affect from the first to the second session in this group compared with the two other groups nearly reached statistical significance. Furthermore, abnormal sensitization of salience network activity in response to negative social scenes was positively associated with the degree of abnormal behavioral sensitization to these images (i.e., negative affective ratings) from thefirst to the second session. Abnormal sensitization of neural activity was also evident for neutral images in the borderline personality disorder group, suggesting that individuals with the disorder may perceive negativity in, and sensitize to, otherwise neutral social situations. Individuals with borderline personality disorder also had greater negative self-reports for neutral images from the first to the second session compared with the other groups, indicating A more nuanced understanding of the neural mechanisms of the disorder could help identify specific underlying neural processes for treatments to target.

the american journal of psychiatry

Abnormal Sensitization of Neural and Behavioral Responses to Socially Relevant Images in Individuals With Borderline Personality Disorder: Implications for Guiding More Effective Targeting of Treatments