Borderline personality disorder (BPD) is a complex psychiatric disorder that involves the core feature of affect dysregulation. Prior neuroimaging studies have indicated that BPD patients have (1) excessive amygdala activation to negative emotion and (2) diminished frontal regulation. This study examined amygdala functional connectivity in 12 women with BPD and 12 matched healthy comparison volunteers. We explored how connectivity patterns would change in the context of processing neutral, overt fear, or masked fear face expressions. Each participant underwent three 5-min fMRI scans in which they primarily viewed: (1) neutral, (2) overt fear, and (3) masked fear faces. In comparison to their healthy counterparts, young women with BPD showed (1) lower connectivity between bilateral amygdala and mid-cingulate cortex during the neutral scan; (2) higher connectivity between bilateral amygdala and rostral anterior cingulate cortex during the overt fear scan; and (3) higher right amygdala connectivity with bilateral thalamus and right caudate during the masked fear scan. Exploratory analyses revealed interesting correlations between amygdala connectivity in these conditions with multiple clinical measures. Results from the neutral scan add to the few prior connectivity studies in BPD that have been suggestive of lower fronto-limbic connectivity in BPD. However, the connectivity findings during fear processing are novel, and map onto basic research models for amygdala connectivity, that is, connections to frontal areas for overt fear processing versus connections to thalamus for automatic fear processing. Further, results suggest that BPD subjects tap into both pathways more strongly than healthy comparisons.

Objective: The purpose of this study was to assess the relative accuracies of the Conners' Brief Rating Scale, Parent Version, the Conners' Continuous Performance Test II (CPT II), and a novel interactive game called ''Groundskeeper'' to discriminate child psychiatric patients with and without attention-deficit/hyperactivity disorder (ADHD). Methods: We administered the three assessments to 113 clinically referred ADHD and non-ADHD patients who had been diagnosed with the Kiddie-Schedule of Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL), Version 19. Results: As measured by the area under the curve (AUC) statistic from receiver operating characteristic (ROC) analysis, the diagnostic accuracy of Groundskeeper (0.79) was as high as the accuracy of the Conners' parent rating of inattention (0.76) and better than the CPT II percent correct (0.62). Combining the three tests produced an AUC of 0.87. Correlations among the three measures were small and, mostly, not significant. Conclusions: Our finding of similar diagnostic accuracies between Groundskeeper and the Conners' inattention scale is especially remarkable given that the Conners' inattention scale shares method variance with the diagnostic process. Although our work is preliminary, it suggests that computer games may be useful in the diagnostic process. This provides an important direction for research, given the objectivity of such measures and the fact that computer games are well tolerated by youth.

This represents a promising new approach to screening tools for ADHD.

No abstract

Offspring of mothers with mood disorders are known to be at risk for a range of adverse outcomes, but the prevalence of personality disorders (PDs) in this group is unknown. The goal of this study was to assess risk of PD diagnoses and symptoms in offspring of mothers with and without mood disorders, and to explore contributing factors to this risk. This longitudinal study assessed PDs and symptoms of PDs in offspring of mothers with bipolar disorder (O-BD), major depression (O-MDD), and no psychiatric diagnosis (O-WELL) in mid-adolescence and in early adulthood. O-BD were more likely to develop a Cluster B PD than O-MDD or O-WELL in adolescence, and more likely to develop a Cluster B PD then O-WELL in early adulthood. Dimensional analyses revealed that O-BD had elevated symptoms in PDs across all PD clusters at mid-adolescence and young adulthood. O-MDD showed elevated symptoms of antisocial PD at both time points, and of obsessive-compulsive PD at young adulthood. Offspring of mothers with mood disorders, especially O-BD, are at increased risk for PD diagnoses and symptoms in mid-adolescence and early adulthood. Contributing factors to risk of PD symptoms in at-risk offspring are discussed.