title: Dissociation in borderline personality disorder: Disturbed cognitive and emotional inhibition and its neural correlates.
abstract: Evidence is heterogeneous regarding whether patients with borderline personality disorder (BPD) display disturbed emotional inhibition in the emotional Stroop task. Previous findings suggest that state dissociation may influence cognitive inhibition of task-irrelevant material, particularly with negative content. Our aim was to examine performance in an emotional Stroop task including negative, neutral, and positive words in BPD patients and healthy controls during functional magnetic resonance imaging. In advance, half of the BPD patients underwent a dissociation induction using script-driven imagery. BPD patients without dissociation induction showed behavioural performance comparable to that of healthy controls but displayed stronger neural responses, especially to positive stimuli, in the superior temporal gyrus, dorsomedial prefrontal cortex, and anterior cingulate cortex. BPD patients with dissociation induction showed overall slower and less accurate responses as well as increased reaction times for negative versus neutral words compared with BPD patients without dissociation induction. Moreover, they showed comparatively decreased neuronal activity in the fusiform gyrus and parietal cortices independent of valence, but elevated activity in the left inferior frontal gyrus in response to negative versus neutral words. In conclusion, experimentally induced dissociation in BPD was associated with inefficient cognitive inhibition, particularly of negative stimuli, in the emotional Stroop task.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany. Electronic address: Dorina.Winter@zi-mannheim.de.
authors.forename: Dorina
authors.initials: D
authors.lastname: Winter
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Institute of Psychology, Leiden University; Institute of Brain and Cognition, Leiden, the Netherlands.
authors.forename: Annegret
authors.initials: A
authors.lastname: Krause-Utz
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lis
authors.affiliation: Department of Psychology, Clinical and Health Psychology Centre, and Centre for Cognition and Brain Studies, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Chui-De
authors.initials: CD
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lanius
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany.
authors.forename: Friederike
authors.initials: F
authors.lastname: Schriner
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Faculty of Health, University of Antwerp, Belgium.
authors.forename: Martin
authors.initials: M
authors.lastname: Bohus
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmahl
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D004213:Dissociative Disorders / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism* / Q000473:pathology; D006179:Gyrus Cinguli / Q000378:metabolism / Q000473:pathology; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000378:metabolism / Q000473:pathology; D011930:Reaction Time / Q000502:physiology; D055815:Young Adult
keywords: cognitive functioning; emotion; emotional Stroop task; executive functioning; memory; script-driven imagery; state dissociation