Time course of facial emotion processing in women with borderline personality disorder: an ERP study.
BACKGROUND
Borderline personality disorder (BPD) is characterized by a negative perception of others. Previous studies have revealed deficits and biases in facial emotion recognition. This study investigates the behavioural and electrophysiological correlates underlying facial emotion processing in individuals with BPD.


METHODS
The present study was conducted between July 2012 and May 2014. In an emotion classification task, unmedicated female patients with BPD as well as healthy women had to classify faces displaying blends of anger and happiness while the electroencephalogram was recorded. We analyzed visual event-related potentials (ERPs) reflecting early (P100), structural (N170) and categorical (P300) facial processing in addition to behavioural responses.


RESULTS
We included 36 women with BPD and 29 controls in our analysis. Patients with BPD were more likely than controls to classify predominantly happy faces as angry. Independent of facial emotion, women with BPD showed enhanced early occipital P100 amplitudes. Additionally, temporo-occipital N170 amplitudes were reduced at right hemispherical electrode sites. Centroparietal P300 amplitudes were reduced particularly for predominantly happy faces and increased for highly angry faces in women with BPD, whereas in healthy volunteers this component was modulated by both angry and happy facial affect.


CONCLUSIONS
Our sample included only women, and no clinical control group was investigated.


CONCLUSIONS
Our findings suggest reduced thresholds for facial anger and deficits in the discrimination of facial happiness in individuals with BPD. This biased perception is associated with alterations in very early visual as well as deficient structural and categorical processing of faces. The current data could help to explain the negative perception of others that may be related to the patients' impairments in interpersonal functioning.
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Natalie A
NA
Izurieta Hidalgo
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Rieke
R
Oelkers-Ax
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Krisztina
K
Nagy
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Falk
F
Mancke
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Martin
M
Bohus
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Sabine C
SC
Herpertz
From the Department for General Psychiatry, Center of Psychosocial Medicine, University of, Heidelberg, Germany (Izurieta Hidalgo, Nagy, Mancke, Herpertz, Bertsch); the Department for Child and Adolescent Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany (Oelkers-Ax); and the Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany (Bohus).
Katja
K
Bertsch
D000293:Adolescent; D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D015897:Comorbidity; D004192:Discrimination, Psychological / Q000502:physiology; D004569:Electroencephalography; D004644:Emotions / Q000502:physiology; D005071:Evoked Potentials; D000066499:Facial Recognition / Q000502:physiology*; D005260:Female; D006801:Humans; D009483:Neuropsychological Tests; D010775:Photic Stimulation; D011930:Reaction Time; D013997:Time Factors; D055815:Young Adult