An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder

Peña-Arteaga, Víctor De la; Berruga-Sánchez, Mercedes; Steward, Trevor; Martínez‐Zalacaín, Ignacio; Goldberg, Ximena; Wainsztein, Agustina; Abulafia, Carolina; Cardoner, Narcı́s; Castro, Mariana N.; Villarreal, Mirta F.; Menchón, José M.; Guinjoan, Salvador M.; Soriano‐Mas, Carles

doi:10.1192/j.eurpsy.2021.2231

Cited by 16 publications

(7 citation statements)

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“…Depression, as one of the common negative emotions, may cause intense emotional stress to patients, and NSSI can be an effective way to relieve the emotional stress ( Tilton-Weaver et al, 2019 ). The rate of comorbidity between depression and borderline personality disorder is very high, and previous studies have found that the two disorders have many commonalities in phenomenological and pathological mechanisms ( Galione and Oltmanns, 2013 ; Nenov-Matt et al, 2020 ; De la Pena-Arteaga et al, 2021 ; Villarreal et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Peng

Liao

et al. 2023

Front. Psychol.

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BackgroundNon-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations.MethodsThe current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants.ResultsPatients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression.ConclusionThis study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.

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Section: Discussionmentioning

confidence: 99%

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Peng

Liao

et al. 2023

Front. Psychol.

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“…Decreases in dmPFC activity during emotional regulation have been described in other psychiatric disorders that are often highly comorbid with obesity [33], including mood and anxiety disorders, [34], depression [35], and generalized anxiety disorder [36].…”

Section: Discussionmentioning

confidence: 99%

“…Alterations in both pathways have been found to contribute to deficits in mentalizing (i.e., formulating thoughts surrounding internal mental states and intentions) [ 31 ], although the dmPFC is understood to be specifically involved in volitional emotional regulation as neurofeedback training has been shown to lead to an increase in top‐down connectivity from the dmPFC onto the amygdala [ 32 ]. Decreases in dmPFC activity during emotional regulation have been described in other psychiatric disorders that are often highly comorbid with obesity [ 33 ], including mood and anxiety disorders, [ 34 ], depression [ 35 ], and generalized anxiety disorder [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Dynamic fronto‐amygdalar interactions underlying emotion‐regulation deficits in women at higher weight

Maturana‐Quijada,

Steward,

Vilarrasa

et al. 2023

Obesity

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ObjectiveThe regulation of negative emotions entails the modulation of subcortical regions, such as the amygdala, by prefrontal regions. There is preliminary evidence suggesting that individuals at higher weight may present with hypoactivity in prefrontal regulatory systems during emotional regulation, although the directionality of these pathways has not been tested. In this study, we compared fronto‐amygdalar effective connectivity during cognitive reappraisal as a function of BMI in 48 adult women with obesity and 54 control participants.MethodsDynamic causal modeling and parametric empirical Bayes were used to map effective connectivity between the dorsomedial prefrontal cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, and the amygdala.ResultsDifficulty in Emotion Regulation Scale scores were higher in the obesity group compared with control participants (p < 0.001). A top‐down cortical model best explained our functional magnetic resonance imaging data (posterior probability = 86%). Participants at higher BMI were less effective at inhibiting activity in the amygdala via the orbitofrontal cortex and dorsomedial prefrontal cortex during reappraisal compared with those at lower BMI. In contrast, increased excitatory modulation of dorsolateral prefrontal cortex‐to‐amygdalar connectivity was found in participants at lower BMI.ConclusionsThese findings support a framework involving alterations in fronto‐amygdalar connectivity contributing to difficulties in regulating negative affect in individuals at higher weight.

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“…Connectivity analyses could test assumptions of reduced prefrontal top-down regulation on limbic areas such as the amygdala. However, only very few studies have investigated connectivity during emotion regulation tasks in BPD 149 . A considerable number of studies have investigated resting-state connectivity in BPD, yielding conflicting results with respect to the fronto-limbic imbalance hypothesis [150][151][152] .…”

Section: Neurobiologymentioning

confidence: 99%

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Leichsenring,

Fonagy,

Heim

et al. 2024

World Psychiatry

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Borderline personality disorder (BPD) was introduced in the DSM‐III in 1980. From the DSM‐III to the DSM‐5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self‐image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self‐mutilation behavior, and transient stress‐related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi‐structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self‐mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in outpatient and 22% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post‐traumatic stress disorder, attention‐deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various approaches have been empirically supported in randomized controlled trials, including dialectical behavior therapy, mentalization‐based therapy, transference‐focused therapy, and schema therapy. No approach has proved to be superior to others. Compared to treatment as usual, psychotherapy has proved to be more efficacious, with effect sizes between 0.50 and 0.65 with regard to core BPD symptom severity. However, almost half of the patients do not respond sufficiently to psychotherapy, and further research in this area is warranted. It is not clear whether some patients may benefit more from one psychotherapeutic approach than from others. No evidence is available consistently showing that any psychoactive medication is efficacious for the core features of BPD. For discrete and severe comorbid anxiety or depressive symptoms or psychotic‐like features, pharmacotherapy may be useful. Early diagnosis and treatment of BPD can reduce individual suffering and societal costs. However, more high‐quality studies are required, in both adolescents and adults. This review provides a comprehensive update of the BPD diagnosis and clinical characterization, risk factors, neurobiology, cognition, and management. It also discusses the current controversies concerning the disorder, and highlights the areas in which further research is needed.

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An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder

Cited by 16 publications

References 58 publications

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Dynamic fronto‐amygdalar interactions underlying emotion‐regulation deficits in women at higher weight

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

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