Classical conditioning in borderline personality disorder: an fMRI study
Abstract
Previous research suggests disturbed emotional learning and memory in borderline personality disorder (BPD). Studies investigating the neural correlates of aversive differential delay conditioning in BPD are currently lacking. We aimed to investigate acquisition, within-session extinction, between-session extinction recall, and reacquisition. We expected increased activation in the insula, amygdala, and anterior cingulate, and decreased prefrontal activation in BPD patients. During functional magnetic resonance imaging, 27 medication-free female BPD patients and 26 female healthy controls (HC) performed a differential delay aversive conditioning paradigm. An electric shock served as unconditioned stimulus, two neutral pictures as conditioned stimuli (CS+/CS-). Dependent variables were blood-oxygen-level-dependent response, skin conductance response (SCR), and subjective ratings (valence, arousal). No significant between-group differences in brain activation were found [all p(FDR) > 0.05]. Within-group comparisons for CS+unpaired > CS- revealed increased insula activity in BPD patients but not in HC during early acquisition; during late acquisition, both groups recruited fronto-parietal areas [p(FDR) < 0.05]. During extinction, BPD patients rated both CS+ and CS- as significantly more arousing and aversive than HC and activated the amygdala in response to CS+. In contrast, HC showed increased prefrontal activity in response to CS+ > CS during extinction. During extinction recall, there was a trend for stronger SCR to CS+ > CS in BPD patients. Amygdala habituation to CS+paired (CS+ in temporal contingency with the aversive event) during acquisition was found in HC but not in patients. Our findings suggest altered temporal response patterns in terms of increased vigilance already during early acquisition and delayed extinction processes in individuals with BPD.
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Naturally occurring dissociative states (DSS4 ratings) were relatively low in some studies compared to script-driven imagery studies inducing dissociation.
“Naturally occurring dissociative states (DSS4 ratings: mean ± standard deviation (M ± SD)) were relatively low ([137]: BPD 1.16 ± 0.28; [138] 2.14 ± 1.67) as compared to script-driven imagery studies inducing dissociation (e.g., [55]: BPDd 6.85 ± 2.03; 9-point Likert scale, 9 indicating extreme symptoms).”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [138]
Krause-Utz, Mauchnik, et al. (2014) found that controls but not BPD patients showed amygdala habituation during acquisition of CS+, and no significant effect of trait or state dissociation (DSS) was observed on skin conductance response or brain activity.
“Controls but not BPD patients showed amygdala habituation during acquisition of CS+paired (CS+ in temporal contingency with the aversive event). No significant effect of trait or state dissociation (DSS) was observed, neither on skin conductance response (SCR) nor on brain activity.”
From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [138]
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- Authors
- Krause-Utz, A., Keibel-Mauchnik, J., Ebner-Priemer, U., Bohus, M., & Schmahl, C.
- Affiliations
- Leiden University (NL)
- Heidelberg University (DE)
- Corresponding author
- Schmahl, Christian
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2015-03-27
- Volume
- 266
- Issue
- 4
- Pages
- 291-305
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W2002527784
- Cited by
- 24
- References
- 56
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 2 · 2016: 3
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Studienstiftung des Deutschen Volkes
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- borderline personality disorder, classical conditioning, aversive conditioning, extinction, extinction recall, reacquisition, insula, amygdala, anterior cingulate cortex, prefrontal cortex, emotional learning, emotional memory, skin conductance response, temporal contingency
- MeSH terms
- Adult, Analysis of Variance, Animals, Borderline Personality Disorder, Brain, Conditioning, Classical, Female, Galvanic Skin Response, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Oxygen, Psychiatric Status Rating Scales, Young Adult
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