Neurobiology of borderline personality disorderE l trastorno de personalidad límite (TPL) es una condición psiquiátrica seria y compleja, caracterizada por alteraciones en distintos aspectos psicológicos: desregulación crónica de los afectos, inestabilidad de la auto-imagen y de la identidad, inestabilidad en las relaciones interpersonales y pobre control de los impulsos 1 . Un estudio realizado en población general en Estados Unidos de Norteamérica estimó que la prevalencia en vida del TPL es de 6%, siendo en hombres 5,6% y en mujeres 6,2%. Esta condición se asocia a considerable discapacidad y co-morbilidades psiquiátricas, siendo las más frecuentes: los trastornos del ánimo (17,2%), los trastornos de ansiedad (14,8%) y los trastornos por consumo de sustancias (9,5%) 2 . En relación a la etiopatogenia del TPL, estudios longitudinales han permitido determinar la importante influencia de los factores psicosociales, como: diversas formas de disfunción familiar 3 y violencia intra-familiar 4 , alteraciones particulares en la comunicación madre-hijo 5 y el abuso sexual 6 . En este artículo presentamos una revisión no sistemática de la literatura sobre la neurobiología del TPL, utilizando la base de datos PubMed, se realizaron búsquedas en inglés utilizando los siguientes términos: neurobioloy, borderline personality disorder, affect dysregulation. Buscando integrar coherentemente investigaciones que han caracterizado este trastorno a partir de los determinantes genéticos, alteraciones neuroquími-cas, disfunciones neuropsicológicas y correlatos neuro-anatómicos y neuro-funcionales. Estos hallazgos permitirían concebir de forma inicial una fisiopatología particular para este trastorno. Hallazgos neurobiológicosLos estudios genéticos en TPL han estimado la heredabilidad de este trastorno, mostrando una concordancia de 35% en gemelos monocigóticos y de 7% en dizigóticos 7 . Debido a la multiplicidad de aspectos psicopatológicos y funciones cognitivas involucradas, los estudios genéticos han investigado la asociación entre ciertos genes y rasgos dimensionales de este trastorno (por ej. impulsividad) como forma de entender el impacto de las variantes genéticas en la conducta humana. Individuos portadores de polimorfismos genéticos de la enzima MAO-A (monoamino oxidasa A, enzima metabolizadora de neurotransmisores como norepinefrina, dopamina, serotonina) que
Individuels de Relation (CAMIR); IPOIn the 1970s the work of Ainsworth helped to refine the attachment concept. With her colleagues, Ainsworth developed a laboratory procedure called the Strange Situation, which was designed to assess the quality and organization of infant attachment and exploratory behavior in the context of incrementally increasing environmental stress [3]. The Strange Situation consists of a series of infant-caregiver Abstract Introduction: Several studies have shown that insecure attachment representations play a central role in the psychopathology of personality disorders, however, it is unclear how the adult attachment disorders relate to the personality organization.Objective: To evaluate the correlation between secure, dismissing and preoccuppied attachment styles and personality structure, in two samples: a clinic and a control group.Methods: A descriptive, cross-sectional study with a sample of 27 women hospitalized in a psychiatric unit and a non-clinical sample of 24 women in regular health check. Inventory of Personality Organization (IPO) and the Cartes: Modèles Individuels de Relation (CAMIR) were applied. Results:The percentage of secure prototype is lower in the clinical group (14.8% vs. 37.5%). The clinical group showed on average 22 points higher on the IPO. No significant association between attachment style and the three primary scales of the IPO was observed, although the score on these three scales was lower among those with a secure attachment style. People with secure attachment had on average 42 points lower on the OQ-45.2 than the other two groups, a difference that was statistically significant. Conclusion:Small sample size would not permit the association to be statistically significant. Further research is needed.
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