Reduced amygdala reactivity and impaired working memory during dissociation in borderline personality disorder
Open accessAbstract
Affective hyper-reactivity and impaired cognitive control of emotional material are core features of borderline personality disorder (BPD). A high percentage of individuals with BPD experience stress-related dissociation, including emotional numbing and memory disruptions. So far little is known about how dissociation influences the neural processing of emotional material in the context of a working memory task in BPD. We aimed to investigate whole-brain activity and amygdala functional connectivity (FC) during an Emotional Working Memory Task (EWMT) after dissociation induction in un-medicated BPD patients compared to healthy controls (HC). Using script-driven imagery, dissociation was induced in 17 patients ('BPD_D'), while 12 patients ('BPD_N') and 18 HC were exposed to neutral scripts during fMRI. Afterwards, participants performed the EWMT with neutral vs. negative IAPS pictures vs. no distractors. Main outcome measures were behavioral performance (reaction times, errors) and whole-brain activity during the EWMT. Psychophysiological interaction analysis was used to examine amygdala connectivity during emotional distraction. BPD patients after dissociation induction showed overall WM impairments, a deactivation in bilateral amygdala, and lower activity in left cuneus, lingual gyrus, and posterior cingulate than BPD_N, along with stronger left inferior frontal gyrus activity than HC. Furthermore, reduced amygdala FC with fusiform gyrus and stronger amygdala FC with right middle/superior temporal gyrus and left inferior parietal lobule was observed in BPD_D. Findings suggest that dissociation affects reactivity to emotionally salient material and WM. Altered activity in areas associated with emotion processing, memory, and self-referential processes may contribute to dissociative states in BPD.
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Adults with BPD and adolescents with BPD features also are at increased risk for abuse or re-victimization as adults and for cumulative polyvictimization across the lifespan.
“Adults with BPD [14, 96, 98, 118, 121] and adolescents with BPD features [89, 154, 182] also are at increased risk for abuse or re-victimization as adults and for cumulative polyvictimization across the lifespan.”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [98]
The Materials and methods > Sample passage reports severe childhood abuse or neglect among the adult BPD participants. It does not address their risk of abuse or re-victimization in adulthood, cumulative polyvictimization across the lifespan, or adolescents with BPD features; searches for those outcomes found no supporting passage. (LLM, conf=0.76)
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“Furthermore, it is likely that present findings may not be specific to BPD but also observable in other clinical populations with dissociative features, being a trans-diagnostic phenomenon [15, 75].”
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Complex PTSD and borderline personality disorder
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- Authors
- Krause-Utz, A., Winter, D., Schriner, F., Chiu, C.-D., Lis, S., Spinhoven, P., Bohus, M., Schmahl, C., & Elzinga, B. M.
- Affiliations
- Leiden University (NL)
- Heidelberg University (DE)
- Chinese University of Hong Kong (HK)
- Central Institute of Mental Health (DE)
- Corresponding author
- Krause-Utz, Annegret
- ORCID
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2017-05-19
- Volume
- 268
- Issue
- 4
- Pages
- 401-415
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- PMC
- PMC5956011
- OpenAlex
- W2615326810
- Cited by
- 57
- References
- 86
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 2 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 7 · 2019: 8 · 2018: 5 · 2017: 1
- FWCI
- 7.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Funders
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016·085·353)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- borderline personality disorder, dissociation, amygdala, working memory, emotional working memory, amygdala functional connectivity, emotional numbing, emotional distraction, script-driven imagery, fusiform gyrus, inferior frontal gyrus, posterior cingulate cortex, emotional processing
- MeSH terms
- Adolescent, Adult, Amygdala, Analysis of Variance, Borderline Personality Disorder, Dissociative Disorders, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Memory Disorders, Memory, Short-Term, Middle Aged, Oxygen, Young Adult
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