The Neural Correlates of Anomalous Habituation to Negative Emotional Pictures in Borderline and Avoidant Personality Disorder Patients

Abstract

Objective Extreme emotional reactivity is a defining feature of borderline personality disorder, yet the neural-behavioral mechanisms underlying this affective instability are poorly understood. One possible contributor would be diminished ability to engage the mechanism of emotional habituation. We tested this hypothesis by examining behavioral and neural correlates of habituation in borderline patients, healthy controls, and a psychopathological control group of avoidant personality disorder patients. Method During fMRI scan acquisition, borderline patients, healthy controls and avoidant personality disorder patients viewed novel and repeated pictures, providing valence ratings at each presentation. Statistical parametric maps of the contrasts of activation during repeat versus novel negative picture viewing were compared between groups. Psychophysiological interaction analysis was employed to examine functional connectivity differences between groups. Results Unlike healthy controls, neither borderline nor avoidant personality disorder participants showed increased activity in dorsal anterior cingulate cortex when viewing repeat versus novel pictures. This failure to increase dorsal anterior cingulate activity was associated with greater affective instability in borderline participants. In addition, borderline and avoidant participants showed smaller insula-amygdala connectivity increases than healthy participants and did not show habituation in ratings of the emotional intensity of the images as did healthy participants. Borderline patients differed from avoidant patients in insula-ventral anterior cingulate connectivity during habituation. Conclusions Borderline patients fail to habituate to negative pictures as do healthy participants and differ from both healthy controls and avoidant patients in neural activity during habituation. A failure to effectively engage emotional habituation processes may contribute to affective instability in borderline patients.

Time course of facial emotion processing in women with borderline personality disorder: an ERP study

“…This model may explain seemingly inconsistent results from various emotion recognition tasks. It is also congruent with neuroimaging studies that have revealed enhanced and prolonged amygdala activations, 14,15 a decreased prefrontal inhibition of the amygdala and altered insular and anterior cingulate activations [16][17][18] for emotional stimuli in patients with BPD. In combining eye tracking with functional MRI (fMRI), we recently found more and faster initial eye movements toward the eyes, and thus the most threatening part of angry faces, associated with increased amygdala activation in patients with BPD.…”

The functional profile of the human amygdala in affective processing: Insights from intracranial recordings

“…Recent neuroimaging data delineated an important relation between deficient behavioral habituation to emotional stimuli and abnormal amygdala-insula functional connectivity amongst BPD individuals (Koenigsberg et al, 2014). As reduced amygdala functioning and volume is consistently reported to contribute to BPD symptomatology (Hazlett et al, 2012;Ruocco, Amirthavasagam, & Zakzanis, 2012), future iEEG research delineating novelty and familiarity detection amongst affectively relevant stimuli would be instrumental to better understand amygdala's role in such processing in healthy and BPD individuals.…”

Aberrant link between empathy and social attribution style in borderline personality disorder

“…Regarding the STG, previous work has shown that patients with BPD exhibited reduced activity in the superior temporal gyrus compared to healthy controls in a cognitive empathy task, while affective empathy was associated with greater insula activity compared to controls (Dziobek et al, 2011). Recent work has also shown a weakened responsiveness of the dACC that may reflect a failure to habituate to negative stimuli and add to the affective instability found in BPD patients (Koenigsberg et al, 2014). With respect to the precuneus, reappraisal strategies correlated with increased activation of the posterior cingulate and precuneus regions in both patients in controls (Koenigsberg et al, 2009).…”