title: Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder.
abstract: Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.
authors.affiliation: Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands. a.d.krause@fsw.leidenuniv.nl.|Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands. a.d.krause@fsw.leidenuniv.nl.|Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany. a.d.krause@fsw.leidenuniv.nl.|Medical Faculty, University of Heidelberg, Mannheim, Germany. a.d.krause@fsw.leidenuniv.nl.
authors.forename: Annegret
authors.initials: A
authors.lastname: Krause-Utz
authors.affiliation: Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands.
authors.forename: Rachel
authors.initials: R
authors.lastname: Frost
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Mannheim, Germany.|Medical Faculty, University of Heidelberg, Mannheim, Germany.
authors.forename: Dorina
authors.initials: D
authors.lastname: Winter
authors.affiliation: Institute of Clinical Psychology, Leiden University, Leiden, The Netherlands.|Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands.
authors.forename: Bernet M
authors.initials: BM
authors.lastname: Elzinga
mesh_terms: D001883:Borderline Personality Disorder / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D003861:Depersonalization / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D004213:Dissociative Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008032:Limbic System / Q000000981:diagnostic imaging / Q000503:physiopathology; D059906:Neuroimaging; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000523:psychology
keywords: Borderline personality disorder; Brain structure and function; Depersonalization disorder; Dissociation; Dissociative identity disorder; Neuroimaging; Posttraumatic stress disorder (PTSD); Trauma