Neural correlates of the use of psychological distancing to regulate responses to negative social cues: a study of patients with borderline personality disorder.
BACKGROUND
Emotional instability is a defining feature of borderline personality disorder (BPD); yet, little is understood about its underlying neural correlates. One possible contributing factor to emotional instability is a failure to adequately employ adaptive cognitive regulatory strategies such as psychological distancing.


METHODS
To determine whether there are differences in neural dynamics underlying this control strategy between BPD patients and healthy control (HC) subjects, blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging signals were acquired as 18 BPD and 16 HC subjects distanced from or simply looked at pictures depicting social interactions. Contrasts in signal between distance and look conditions were compared between groups.


RESULTS
Borderline personality disorder patients showed a different pattern of activation compared with HC subjects when looking at negative versus neutral pictures. When distancing versus looking at negative pictures, both groups showed decreased negative affect ratings and increased activation of the dorsolateral prefrontal cortex, areas near/along the intraparietal sulcus (IPS), ventrolateral prefrontal cortex, and posterior cingulate/precuneus regions. However, the BPD group showed less BOLD signal change in dorsal anterior cingulate cortex and IPS, less deactivation in the amygdala, and greater activation in the superior temporal sulcus and superior frontal gyrus.


CONCLUSIONS
Borderline personality disorder and HC subjects display different neural dynamics while passively viewing social emotional stimuli. In addition, BPD patients do not engage the cognitive control regions to the extent that HCs do when employing a distancing strategy to regulate emotional reactions, which may be a factor contributing to the affective instability of BPD.
Koenigsberg
Harold W
HW
Department of Psychiatry, Mount Sinai School of Medicine, New York, New York 10468, USA. HWarrenK@nyc.rr.com
Fan
Jin
J
Ochsner
Kevin N
KN
Liu
Xun
X
Guise
Kevin G
KG
Pizzarello
Scott
S
Dorantes
Christine
C
Guerreri
Stephanie
S
Tecuta
Lucia
L
Goodman
Marianne
M
New
Antonia
A
Siever
Larry J
LJ
D000328:Adult; D000339:Affect / Q000502:physiology; D001883:Borderline Personality Disorder / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012929:Psychological Distance; D012938:Social Perception