title: Neural correlates of attachment trauma in borderline personality disorder: a functional magnetic resonance imaging study.
abstract: Functional imaging studies have shown that individuals with borderline personality disorder (BPD) display prefrontal and amygdala dysfunction while viewing or listening to emotional or traumatic stimuli. The study examined for the first time the functional neuroanatomy of attachment trauma in BPD patients using functional magnetic resonance imaging (fMRI) during the telling of individual stories. A group of 11 female BPD patients and 17 healthy female controls, matched for age and education, told stories in response to a validated set of seven attachment pictures while being scanned. Group differences in narrative and neural responses to "monadic" pictures (characters facing attachment threats alone) and "dyadic" pictures (interaction between characters in an attachment context) were analyzed. Behavioral narrative data showed that monadic pictures were significantly more traumatic for BPD patients than for controls. As hypothesized BPD patients showed significantly more anterior midcingulate cortex activation in response to monadic pictures than controls. In response to dyadic pictures patients showed more activation of the right superior temporal sulcus and less activation of the right parahippocampal gyrus compared to controls. Our results suggest evidence for potential neural mechanisms of attachment trauma underlying interpersonal symptoms of BPD, i.e. fearful and painful intolerance of aloneness, hypersensitivity to social environment, and reduced positive memories of dyadic interactions.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Ulm, Am Hochstraess 8, 89081 Ulm, Germany. anna.buchheim@uni-ulm.de
authors.forename: Anna
authors.initials: A
authors.lastname: Buchheim
authors.forename: Susanne
authors.initials: S
authors.lastname: Erk
authors.forename: Carol
authors.initials: C
authors.lastname: George
authors.forename: Horst
authors.initials: H
authors.lastname: Kächele
authors.forename: Tilo
authors.initials: T
authors.lastname: Kircher
authors.forename: Philipp
authors.initials: P
authors.lastname: Martius
authors.forename: Dan
authors.initials: D
authors.lastname: Pokorny
authors.forename: Martin
authors.initials: M
authors.lastname: Ruchsow
authors.forename: Manfred
authors.initials: M
authors.lastname: Spitzer
authors.forename: Henrik
authors.initials: H
authors.lastname: Walter
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D009769:Object Attachment; D020534:Parahippocampal Gyrus / Q000503:physiopathology; D013702:Temporal Lobe / Q000503:physiopathology