Are the Interpersonal and Identity Disturbances in the Borderline Personality Disorder Criteria Linked to the Traits of Affective Instability and Impulsivity?

Koenigsberg, Harold W.; Harvey, Philip D.; Mitropoulou, Vivian; New, Antonia S.; Goodman, Marianne; Silverman, Jeremy M.; Serby, Michael; Schopick, Frances; Siever, Larry J.

doi:10.1521/pedi.15.4.358.19181

Cited by 146 publications

(99 citation statements)

References 19 publications

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“…It was argued that, contrasted to patients with schizophrenia, individuals with schizotypal personality disorder might have an attenuated risk for psychosis and functional impairments because of a more efficient fronto-cortical buffering of subcortical dopaminergic tone (Koenigsberg et al, 2001;Kirrane et al, 2000; for a similar view with respect to healthy participantsʼ MI and paranormal belief, see Mohr et al, 2004).…”

Section: Further Issuesmentioning

confidence: 99%

Dopamine, Paranormal Belief, and the Detection of Meaningful Stimuli

Kempler

Möhr

Haker³

et al. 2010

Journal of Cognitive Neuroscience

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Dopamine, paranormal belief, and the detection of meaningful stimuliKrummenacher, P; Mohr, C; Haker, H; Brugger, P Krummenacher, P; Haker, H; Brugger, P (2010 Abstract ■ Dopamine (DA) is suggested to improve perceptual and cognitive decisions by increasing the signal-to-noise ratio. Somewhat paradoxically, a hyperdopaminergia (arguably more accentuated in the right hemisphere) has also been implied in the genesis of unusual experiences such as hallucinations and paranormal thought. To test these opposing assumptions, we used two lateralized decision tasks, one with lexical (tapping left-hemisphere functions), the other with facial stimuli (tapping right-hemisphere functions). Participants were 40 healthy righthanded men, of whom 20 reported unusual, "paranormal" experiences and beliefs ("believers"), whereas the remaining participants were unexperienced and critical ("skeptics"). In a between-subject design, levodopa (200 mg) or placebo administration was balanced between belief groups (double-blind procedure). For each task and visual field, we calculated sensitivity in the placebo group. Criterion analyses revealed that believers favored false alarms over misses, whereas skeptics displayed the opposite preference. Unexpectedly, under levodopa, these decision preferences were lower in both groups. We thus infer that levodopa (1) decreases sensitivity in perceptual-cognitive decisions, but only in skeptics, and (2) makes skeptics less and believers slightly more conservative. These results stand at odd to the common view that DA generally improves signal-to-noise ratios. Paranormal ideation seems an important personality dimension and should be assessed in investigations on the detection of signals in noise. ■

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Section: Further Issuesmentioning

confidence: 99%

Dopamine, Paranormal Belief, and the Detection of Meaningful Stimuli

Kempler

Möhr

Haker³

et al. 2010

Journal of Cognitive Neuroscience

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“…There is evidence that disturbed relationships in BPD result from the social impairments caused by the other behavioral dimensions of the disorder (Koenigsberg et al, 2001). Effect sizes are clinically significant in all the three behavioral dimensions.…”

Section: Pharmacological Evidencementioning

confidence: 99%

Dopamine Dysfunction in Borderline Personality Disorder: A Hypothesis

Friedel

2004

Neuropsychopharmacol

124

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Research on the biological basis of borderline personality disorder (BPD) has focused primarily on the serotonin model of impulsive aggression. However, there is evidence that dopamine (DA) dysfunction may also be associated with BPD. Pertinent research and review articles, identified by Medline searches of relevant topics, books, references from bibliographies, and conference proceedings from 1975 to 2003, were reviewed. Evidence of DA dysfunction in BPD derives from the efficacy of traditional and atypical antipsychotic agents in BPD, and from provocative challenges with amphetamine and methylphenidate of subjects with the disorder. In addition, human and animal studies indicate that DA activity plays an important role in emotion information processing, impulse control, and cognition. The results of this review suggest that DA dysfunction is associated with three dimensions of BPD, that is, emotional dysregulation, impulsivity, and cognitive-perceptual impairment. The main limitation of this hypothesis is that the evidence reviewed is circumstantial. There is no study that directly demonstrates DA dysfunction in BPD. In addition, the therapeutic effects of antipsychotic agents observed in BPD may be mediated by non-DA mechanisms of action. If the stated hypothesis is correct, DA dysfunction in BPD may result from genetic, developmental, or environmental factors directly affecting specific DA pathways. Alternatively, DA dysfunction in BPD may be a compensatory response to alterations in the primary neural systems that control emotion, impulse control, and cognition, and that are mediated by the brain's main neurotransmitters, glutamate, and GABA, or in one or more other neuromodulatory pathways such as serotonin, acetylcholine, and norepinephrine.

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“…The principal dimensions that have been the focus of biological research in borderline pathology include impulsive aggression and affective dysregulation (Koenigsberg et al, 2001). Impulsive-aggression includes behaviors directed toward the self or others, such as self-injury, domestic violence, assault, suicide, and property destruction.…”

Section: Psychopathology In Bpdmentioning

confidence: 99%

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

Oquendo

Krunic

Parsey

et al. 2005

Neuropsychopharmacol

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Previous neuroimaging studies of major depression have not controlled for the presence of personality disorders characterized by impulsive aggressive behavior, such as borderline personality disorder (BPD). Using positron emission tomography (PET), we studied regional glucose uptake in response to fenfluramine (FEN) in depressed subjects with BPD (n ¼ 11) and depressed patients without Cluster B Axis II disorders (n ¼ 8). Subjects were scanned while medication-free after a single blind placebo administration and after FEN on a second day. Brain responses were measured by PET imaging of [ 18 F]fluorodeoxyglucose (FDG) and serial prolactin levels. Scans were compared at a voxel level using statistical parametric mapping. Correlations of changes in relative regional cerebral uptake (rCMRglu) with clinical measures were assessed. Depressed borderline patients had greater relative activity in parietotemporal cortical regions (BA 40, BA 22, and BA 42) before and after FEN activation compared to those without BPD. They also had less relative uptake in the anterior cingulate cortex (BA 32) at baseline compared to depressed patients without BPD and FEN abolished this difference. Impulsivity was positively correlated with rCMRglu in superior and middle frontal cortex (BA 6 and 44). Hostility was positively correlated with rCMRglu in temporal cortical regions (BA 21 and 22). In conclusions, borderline pathology in the context of a Major Depressive Disorder is associated with altered activity in parietotemporal and anterior cingulate cortical regions. Controlling for the presence of BPD in future imaging studies of mood disorders may elucidate similarities and differences in regional serotonergic function in these two often comorbid disorders.

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Are the Interpersonal and Identity Disturbances in the Borderline Personality Disorder Criteria Linked to the Traits of Affective Instability and Impulsivity?

Cited by 146 publications

References 19 publications

Dopamine, Paranormal Belief, and the Detection of Meaningful Stimuli

Dopamine, Paranormal Belief, and the Detection of Meaningful Stimuli

Dopamine Dysfunction in Borderline Personality Disorder: A Hypothesis

Positron Emission Tomography of Regional Brain Metabolic Responses to a Serotonergic Challenge in Major Depressive Disorder with and without Borderline Personality Disorder

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