Neuronal correlates of cognitive reappraisal in borderline patients with affective instability
Abstract
Background Borderline personality disorder has been characterized by enhanced emotional reactivity and deficient emotion regulation in behavioral and functional imaging studies. We aimed to validate patients' difficulties in the cognitive regulation of negative emotions and investigated if emotion regulation deficits are restricted to the decrease of negative emotions. A cognitive reappraisal paradigm was used and hence a regulation strategy that is typically applied in cognitive-behavioral therapy. Methods Fifteen unmedicated female borderline patients with affective instability and 15 healthy female control subjects underwent functional magnetic resonance imaging during a delayed reappraisal paradigm. Hemodynamic responses were measured in response to aversive pictures in an initial viewing phase and a subsequent reappraisal phase with three different conditions: decreasing, increasing, and maintaining the initial emotional reaction. Results Patients demonstrated enhanced activation of left amygdala and right insula during the initial viewing of aversive stimuli. During attempting to decrease the initial emotional reaction, patients showed attenuated activation of the left orbitofrontal cortex and increased activation of the bilateral insula. The attempt to increase negative emotions resulted in enhanced activity in amygdala and insula, whereas no group differences were found. Conclusions The results point to the role of two distinguishable processes of emotional difficulti…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
BPD patients activate lOFC to a lesser extent than controls while they activated amygdala and insula more during cognitive reappraisal.
“Testing more complex emotional regulation targeting the OFC with cognitive reappraisal of emotional pictures, BPD patients have been found to activate lOFC to a lesser extent than controls while they activated amygdala and insula more (Schulze et al., 2011; Figure 8D).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Schulze et al., 2011
Cites
Emotion regulation: affective, cognitive, and social consequences.
Gross, J. J. (2002) · Psychophysiology · doi:10.1017/s0048577201393198 · Cited by 4,890 · cited 2× · see citing works
“The mean percent signal hange was calculated using anatomical regions of interest for the mygdala and a 3 mm sphere centered on the coordinate (38, 10, 8) erived from the whole-brain analysis.”
BackgroundMethodHiding feelings: The acute effects of inhibiting negative and positive emotion
Gross, J. J., & Levenson, R. W. (1997) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.106.1.95 · Cited by 1,834 · see citing works
Amygdala–frontal connectivity during emotion regulation
Banks, S. J., Eddy, K. T., Angstadt, M., Nathan, P. J., & Phan, K. L. (2007) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsm029 · Cited by 1,187 · see citing works
The Neural Bases of Distraction and Reappraisal
McRae, K., Hughes, B., Chopra, S., Gabrieli, J. D. E., Gross, J. J., & Ochsner, K. N. (2010) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2009.21243 · Cited by 642 · see citing works
Trull, T. J., Solhan, M. B., Tragesser, S. L., Jahng, S., Wood, P. K., Piasecki, T. M., & Watson, D. (2008) · Journal of Abnormal Psychology · doi:10.1037/a0012532 · Cited by 503 · see citing works
Suppression and enhancement of emotional responses to unpleasant pictures
Jackson, D. C., Malmstadt, J. R., Larson, C. L., & Davidson, R. J. (2000) · Psychophysiology · doi:10.1111/1469-8986.3740515 · Cited by 459 · see citing works
Silbersweig, D., Clarkin, J. F., Goldstein, M., Kernberg, O. F., Tuescher, O., Levy, K. N., Brendel, G., Pan, H., Beutel, M., Pavony, M. T., et al. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.06010126 · Cited by 411 · see citing works
Brennan, K. A., & Shaver, P. R. (1998) · Journal of Personality · doi:10.1111/1467-6494.00034 · Cited by 353 · see citing works
Emotion Dysregulation as a Core Feature of Borderline Personality Disorder
Glenn, C. R., & Klonsky, E. D. (2009) · Journal of Personality Disorders · doi:10.1521/pedi.2009.23.1.20 · Cited by 336 · see citing works
Koenigsberg, H. W., Fan, J., Ochsner, K. N., Liu, X., Guise, K. G., Pizzarello, S., Dorantes, C., Guerreri, S., Tecuta, L., Goodman, M., et al. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.06.010 · Cited by 250 · see citing works
Affective instability and impulsivity in personality disorder
Herpertz, S., Gretzer, A., Steinmeyer, E. M., Muehlbauer, V., Schuerkens, A., & Sass, H. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)01444-4 · Cited by 110 · see citing works
Self-citationMinzenberg, M. J., Poole, J. H., & Vinogradov, S. (2008) · Development and Psychopathology · doi:10.1017/s0954579408000163 · Cited by 91 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Ochsner, K. N., Silvers, J. A., & Buhle, J. T. (2012) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2012.06751.x · Cited by 1,879 · see citing works
Cognitive Reappraisal of Emotion: A Meta-Analysis of Human Neuroimaging Studies
Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., Weber, J., & Ochsner, K. N. (2014) · Cerebral Cortex · doi:10.1093/cercor/bht154 · Cited by 1,896 · see citing works
Neural network of cognitive emotion regulation—an ALE meta-analysis and MACM analysis
Kohn, N., Eickhoff, S. B., Scheller, M., Laird, A. R., Fox, P. T., & Habel, U. (2014) · NeuroImage · doi:10.1016/j.neuroimage.2013.11.001 · Cited by 956 · see citing works
“…the results of various studies on cognitive emotion regulation in fMRI and PET and found significant convergent activations in several areas previously proposed to play an important role in the regulation of emotional states (McRae et al., 2010; Ochsner and Gross, 2005; Schulze et al., 2011).”
BackgroundResultThe Future of Emotion Regulation Research: Capturing Context
Aldao, A. (2013) · Perspectives on Psychological Science · doi:10.1177/1745691612459518 · Cited by 948 · see citing works
“…Johnstone, van Reekum, Urry, Kalin, & Davidson, 2007), anxiety (e.g., Campbell-Sills et al., 2011), and borderline personality disorder (e.g., Schulze et al., 2011); suppression in depression (e.g., Dalgleish & Yiend, 2006) and anxiety (e.g., Kingsep & Page, 2010); suppression and…”
BackgroundEmotion regulation and mental health: recent findings, current challenges, and future directions
Berking, M., & Wupperman, P. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e3283503669 · Cited by 836 · see citing works
The Neural Bases of Distraction and Reappraisal
McRae, K., Hughes, B., Chopra, S., Gabrieli, J. D. E., Gross, J. J., & Ochsner, K. N. (2010) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2009.21243 · Cited by 642 · see citing works
Morawetz, C., Bode, S., Derntl, B., & Heekeren, H. R. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.11.014 · Cited by 458 · see citing works
Components of Emotion Dysregulation in Borderline Personality Disorder: A Review
Carpenter, R. W., & Trull, T. J. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0335-2 · Cited by 446 · see citing works
Emotion recognition in borderline personality disorder-a review of the literature.
Domes, G., Schulze, L., & Herpertz, S. (2009) · Journal of Personality Disorders · doi:10.1521/pedi.2009.23.1.6 · Cited by 373 · see citing works
Self-citationSakiris, N., & Berle, D. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.101751 · Cited by 369 · see citing works
“These include major depressive disorder (Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008), generalised anxiety disorder (Mennin, Holoway, Fresco, Moore, & Heimberg, 2007), social anxiety disorder (Kashdan & Breen, 2008), somatoform disorders (Waller & Scheidt, 2006), borderline personality disorder (Schulze et al., 2011),…”
BackgroundZilverstand, A., Parvaz, M. A., & Goldstein, R. Z. (2017) · NeuroImage · doi:10.1016/j.neuroimage.2016.06.009 · Cited by 360 · see citing works
Emotion Dysregulation as a Core Feature of Borderline Personality Disorder
Glenn, C. R., & Klonsky, E. D. (2009) · Journal of Personality Disorders · doi:10.1521/pedi.2009.23.1.20 · Cited by 336 · see citing works
Dörfel, D., Lamke, J.-P., Hummel, F., Wagner, U., Erk, S., & Walter, H. (2014) · NeuroImage · doi:10.1016/j.neuroimage.2014.06.051 · Cited by 322 · see citing works
“Moreover, dysfunction of emotion regulation is a well-known feature of psychiatric conditions (Davidson et al., 2000, 2002; Erk et al., 2010a; Johnstone and Walter, 2014; Kanske et al., 2012; Koenigsberg et al., 2009; Schulze et al., 2010).”
BackgroundRuocco, A. C., Amirthavasagam, S., Choi-Kain, L. W., & McMain, S. (2012) · Biological Psychiatry · doi:10.1016/j.biopsych.2012.07.014 · Cited by 233 · see citing works
The Latest Neuroimaging Findings in Borderline Personality Disorder
Krause-Utz, A., Winter, D., Niedtfeld, I., & Schmahl, C. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0438-z · Cited by 235 · see citing works
Self-citationThe role of emotion regulation in the characterization, development and treatment of psychopathology
Lincoln, T. M., Schulze, L., & Renneberg, B. (2022) · Nature Reviews Psychology · doi:10.1038/s44159-022-00040-4 · Cited by 234 · see citing works
Self-citationNeural circuitry of impaired emotion regulation in substance use disorders
Wilcox, C. E., Pommy, J. M., & Adinoff, B. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15060710 · Cited by 213 · see citing works
“Anxiety and borderline personality disorders are associated with insula/amygdala hyperactivation during tasks of affect intensity/reactivity, andamygdala/insula activation is positively associated with self-reported negative valence of task stimuli (18, 21, 44, 53, 55, 56).”
Goodman, M., Carpenter, D., Tang, C. Y., Goldstein, K. E., Avedon, J., Fernandez, N., Mascitelli, K. A., Blair, N. J., New, A. S., Triebwasser, J., et al. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.06.020 · Cited by 198 · see citing works
“For example, the studies reporting amygdala hyperactivity (e.g., Koenigsberg et al., 2009; Minzenberg et al., 2007; Schulze et al., 2011) involved unmedicated BPD patients, while the studies demonstrating diminished amygdala responsivity included participants currently taking psychotropic medications (Smoski et al.”
Reduced plasma oxytocin levels in female patients with borderline personality disorder
Bertsch, K., Schmidinger, I., Neumann, I. D., & Herpertz, S. C. (2013) · Hormones and Behavior · doi:10.1016/j.yhbeh.2012.11.013 · Cited by 189 · see citing works
“The intranasal administration of oxytocin in healthy male volunteers has been found to reduce stress and enhance the correct recognition of facial emotions, theory of mind, and trust (e.g., Domes et al., 2007; Heinrichs et al., 2003; Kosfeld et al., 2005; Schulze et al., 2011a).”
BackgroundSelf-citationPotentiated amygdala response to repeated emotional pictures in borderline personality disorder
Hazlett, E. A., Zhang, J., New, A. S., Zelmanova, Y., Goldstein, K. E., Haznedar, M. M., Meyerson, D., Goodman, M., Siever, L. J., & Chu, K.-W. (2012) · Biological Psychiatry · doi:10.1016/j.biopsych.2012.03.027 · Cited by 186 · see citing works
Borderline personality disorder
Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S. O., & Zanarini, M. C. (2018) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2018.29 · Cited by 480 · see citing works
Self-citationTop-Down Dysregulation—From ADHD to Emotional Instability
Petrovic, P., & Castellanos, F. X. (2016) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2016.00070 · Cited by 179 · see citing works
“Testing more complex emotional regulation targeting the OFC with cognitive reappraisal of emotional pictures, BPD patients have been found to activate lOFC to a lesser extent than controls while they activated amygdala and insula more (Schulze et al., 2011; Figure 8D).”
BackgroundKanske, P., Heissler, J., Schönfelder, S., & Wessa, M. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.03.089 · Cited by 175 · see citing works
“A number of questionnaire studies showed altered emotion regulation across different diagnoses (Berking et al., 2008) and there is also some indication that these deficits can be observed on the neural level in different diagnoses (Modinos et al., 2010; Schulze et al., 2011).”
BackgroundPowers, J. P., & LaBar, K. S. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.04.023 · Cited by 173 · see citing works
“…taking including mentalizing (Frith and Frith, 2006; Saxe and Kanwisher, 2003), representing alternative visual perspectives (Aichhorn et al., 2006; Schurz et al., 2013), egocentric spatial representation (Schindler and Bartels, 2013), and representing the position of the body in space (Blanke et…”
Daros, A. R., & Williams, G. E. (2019) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000212 · Cited by 169 · see citing works
“Supporting this assertion, individuals with BPD perceived themselves as being less successful at using cognitive reappraisal tactics even when no behavioral differences in performance were evident.(169,170) People with BPD may also overvalue ineffective ER strategies that favor short-term benefits over long-term goals…”
BackgroundSchmahl, C., Herpertz, S. C., Bertsch, K., Ende, G., Flor, H., Kirsch, P., Lis, S., Meyer-Lindenberg, A., Rietschel, M., Schneider, M., et al. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-12 · Cited by 168 · see citing works
Self-citationvan Zutphen, L., Siep, N., Jacob, G., Goebel, R., & Arntz, A. (2015) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.01.001 · Cited by 166 · see citing works
“Schulze et al. (2011) instructed their participants slightly different: participants had to imagine that the situation was not real or that they were a detached observer.”
BackgroundMethodResultInfluentialEmotion regulation by cognitive reappraisal - The role of frontal theta oscillations
Ertl, M., Hildebrandt, M., Ourina, K., Leicht, G., & Mulert, C. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.05.044 · Cited by 159 · see citing works
“The left middle/inferior frontal gyrus as estimated by the sLORETA analysis, is a very consistent finding in fMRI based emotion regulation research (Johnstone et al., 2007; Ochsner et al., 2002; Schulze et al., 2011; Winecoff et al., 2011).”
InfluentialGlutamatergic transmission in schizophrenia
Kantrowitz, J. T., & Javitt, D. C. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32835035b2 · Cited by 155 · see citing works
Emotion regulation, attention to emotion, and the ventral attentional network
Viviani, R. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00746 · Cited by 146 · see citing works
Müller, L. E., Schulz, A., Andermann, M., Gäbel, A., Gescher, D. M., Spohn, A., Herpertz, S. C., & Bertsch, K. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.1252 · Cited by 141 · see citing works
Self-citationReconsidering Emotion Dysregulation
D’Agostino, A., Covanti, S., Monti, M. R., & Starčević, V. (2017) · Psychiatric Quarterly · doi:10.1007/s11126-017-9499-6 · Cited by 151 · see citing works
“A recent research [112] provides evidence for difficulties in cognitive reappraisal of aversive stimuli and negative emotions in female borderline patients.”
Alterations of amygdala-prefrontal connectivity with real-time fMRI neurofeedback in BPD patients.
Paret, C., Kluetsch, R., Zaehringer, J., Ruf, M., Demirakca, T., Bohus, M., Ende, G., & Schmahl, C. (2016) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsw016 · Cited by 114 · see citing works
“Those with BPD also show reduced lateral prefrontal cortex (PFC) activation in the processing of emotions (Schulze et al., 2011, 2016; Krause-Utz et al., 2012; Lang et al., 2012).”
BackgroundSelf-citationImpairments of Interpersonal Functioning: Empathy and Intimacy in Borderline Personality Disorder
Jeung, H., & Herpertz, S. C. (2014) · Psychopathology · doi:10.1159/000357191 · Cited by 118 · see citing works
Self-citationAffective Disturbance and Psychopathology: An Emotion Regulation Perspective
Jazaieri, H., Urry, H., & Gross, J. (2013) · Journal of Experimental Psychopathology · doi:10.5127/jep.030312 · Cited by 110 · see citing works
Cognitive reappraisal in trauma-exposed women with borderline personality disorder
Lang, S., Kotchoubey, B., Frick, C., Spitzer, C., Grabe, H. J., & Barnow, S. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2011.08.061 · Cited by 108 · see citing works
“However, in contrast to Koenigsberg et al. (2009) and Schulze et al. (2011), we did not find enhanced activity in the amygdala or insula in BPD patients relative to HC subjects.”
InfluentialHerpertz, S. C., & Bertsch, K. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15020216 · Cited by 139 · see citing works
“neuronal activity in the anterior insula (25, 26).”
BackgroundSelf-citationSchulze, L., Schulze, A., Renneberg, B., Schmahl, C., & Niedtfeld, I. (2019) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2018.11.004 · Cited by 102 · see citing works
Self-citationGray matter abnormalities in patients with narcissistic personality disorder
Schulze, L., Dziobek, I., Vater, A., Heekeren, H. R., Bajbouj, M., Renneberg, B., Heuser, I., & Roepke, S. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.05.017 · Cited by 102 · see citing works
“Several studies in non-clinical (Domes et al., 2010; Kanske et al., 2011; Ochsner et al., 2004) and clinical populations (Erk et al., 2011; Johnstone et al., 2007; Schulze et al., 2011) have emphasized the importance of prefrontal structures in this regard.”
BackgroundSelf-citationBrain volumes differ between diagnostic groups of violent criminal offenders
Bertsch, K., Grothe, M., Prehn, K., Vohs, K., Berger, C., Hauenstein, K., Keiper, P., Domes, G., Teipel, S., & Herpertz, S. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0391-6 · Cited by 96 · see citing works
“(female) BPD patients suggest an association of the patients’ emotional hyperreactivity, impulsivity, and reactive aggression with disturbed fronto-limbic inhibition [9, 10], only little is known about structural and functional alterations in (male) offenders with BPD.”
BackgroundSelf-citationDown-regulation of amygdala activation with real-time fMRI neurofeedback in a healthy female sample
Paret, C., Kluetsch, R., Ruf, M., Demirakca, T., Hoesterey, S., Ende, G., & Schmahl, C. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00299 · Cited by 95 · see citing works
“ORIGINAL RESEARCH ARTICLE published: 18 September 2014 doi: 10.3389/fnbeh.2014.00299 Down-regulation of amygdala activation with real-time fMRI neurofeedback in a healthy female sample”
BackgroundInfluentialSelf-citationFunctional Connectivity of Pain-Mediated Affect Regulation in Borderline Personality Disorder
Niedtfeld, I., Kirsch, P., Schulze, L., Herpertz, S., Bohus, M., & Schmahl, C. (2012) · PLoS ONE · doi:10.1371/journal.pone.0033293 · Cited by 91 · see citing works
“Although earlier studies proposed an altered connectivity between limbic and prefrontal regions in BPD [15,52], this is to our knowledge the first study directly addressing functional connectivity during an emotion regulation task in BPD.”
ResultSelf-citationBorderline personality disorder and bipolar affective disorder. Spectra or spectre? A review
Bassett, D. L. (2012) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1177/0004867411435289 · Cited by 91 · see citing works
“Schulze et al. (2011) used fMRI to examine differences in metabolic activity associated with emotional reactivity in female patients with borderline personality disorder and healthy controls during a delayed reappraisal paradigm using aversive pictures and cognitive reappraisal strategies.”
MethodKoenigsberg, H., Denny, B. T., Fan, J., Liu, X., Guerreri, S., Mayson, S., Rimsky, L., New, A., Goodman, M., & Siever, L. (2014) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.13070852 · Cited by 87 · see citing works
“Anomalous neural activity has been identified in borderline patients during cognitive reappraisal (7, 8).”
BackgroundResultA Neurobiological Model of Borderline Personality Disorder: Systematic and Integrative Review
Ruocco, A. C., & Carcone, D. (2016) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000123 · Cited by 111 · see citing works
“, scenes of loss, grief, abuse, or physical threat) by imagining either that the situation was not real or that they were detached observers.(138,144) A third study incorporated three standardized negative and neutral scripts and instructed participants to distance themselves from the contents of the scripts by percei…”
BackgroundAmygdala hyperactivation to angry faces in intermittent explosive disorder
McCloskey, M. S., Phan, K. L., Angstadt, M., Fettich, K. C., Keedy, S., & Coccaro, E. F. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.04.006 · Cited by 93 · see citing works
Picó‐Pérez, M., Alemany-Navarro, M., Dunsmoor, J. E., Raduà, J., Albajes‐Eizagirre, A., Vervliet, B., Cardoner, N., Benet, O., Harrison, B. J., Soriano‐Mas, C., et al. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.06.029 · Cited by 98 · see citing works
Perez, D. L., Vago, D. R., Pan, H., Root, J., Tuescher, O., Fuchs, B. H., Leung, L., Epstein, J., Cain, N., Clarkin, J., et al. (2015) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12357 · Cited by 83 · see citing works
Krause-Utz, A., Veer, I., Rombouts, S. A., Bohus, M., Schmahl, C., & Elzinga, B. (2014) · Psychological Medicine · doi:10.1017/s0033291714000324 · Cited by 83 · see citing works
“Several studies in BPD patients have reported hyperactivity of the amygdala and insula during emotional challenge (Niedtfeld et al. 2010; Schulze et al. 2011; Leichsenring et al. 2011; Krause-Utz et al. 2012; O‘Neill & Frodl, 2012).”
BackgroundInfluentialSelf-citationKamphausen, S., Schröder, P., Maier, S., Bader, K., Feige, B., Kaller, C., Glauche, V., Ohlendorf, S., van Elst, L. T., Klöppel, S., et al. (2013) · World Journal of Biological Psychiatry · doi:10.3109/15622975.2012.665174 · Cited by 80 · see citing works
“Similarly, Schulze et al. (2011) found reduced activity of the left orbitofrontal cortex and increased activity of the bilateral insula in BPD patients versus controls during the attempt to decrease their initial emotional reaction to emotional scenes.”
BackgroundfMRI feedback enhances emotion regulation as evidenced by a reduced amygdala response
Sarkheil, P., Zilverstand, A., Kilian-Hütten, N., Schneider, F., Goebel, R., & Mathiak, K. (2015) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.11.027 · Cited by 77 · see citing works
Rausch, J., Gäbel, A., Nagy, K., Kleindienst, N., Herpertz, S. C., & Bertsch, K. (2015) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2015.02.002 · Cited by 75 · see citing works
Self-citationSchmitt, R., Winter, D., Niedtfeld, I., Herpertz, S., & Schmahl, C. (2016) · Biological Psychiatry: Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2016.07.003 · Cited by 73 · see citing works
Self-citationKuo, J. R., Fitzpatrick, S., Metcalfe, R. K., & McMain, S. F. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.05.002 · Cited by 73 · see citing works
“…scripts (Lang et al., 2012) as well as reduced deactivation of the amygdala (Koenigsberg et al., 2009) and increased activation of the insula (Schulze et al., 2011) during reappraisal of negative images compared with HCs. Ruocco, Medaglia, Ayaz, and Chute (2010) examined the effects of…”
BackgroundHidalgo, N. A. I., Oelkers-Ax, R., Nagy, K., Mancke, F., Bohus, M., Herpertz, S., & Bertsch, K. (2016) · Journal of Psychiatry & Neuroscience · doi:10.1503/jpn.140215 · Cited by 73 · see citing works
Self-citationFrederickson, J., Messina, I., & Grecucci, A. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02054 · Cited by 70 · see citing works
Review on Neural Correlates of Emotion Regulation and Music: Implications for Emotion Dysregulation
Hou, J.-C., Song, B., Chen, A. C., Sun, C.-G., Zhou, J.-X., Zhu, H.-D., & Beauchaine, T. P. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00501 · Cited by 69 · see citing works
“…al., 2006) are all implicated in emotional reactivity, whereas the OFC (Ito, 2004; Rempel-Clower, 2007), vlPFC, dlPFC (Elliott, 2003; Chan et al., 2008; Levy and Wagner, 2011), and anterior insula (Sitaram et al., 2014) are implicated in effortful regulation of emotion (see Schulze et al., 2011).”
BackgroundBaczkowski, B. M., van Zutphen, L., Siep, N., Jacob, G., Domes, G., Maier, S., Sprenger, A., Senft, A., Willenborg, B., Tüscher, O., et al. (2016) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0760-z · Cited by 68 · see citing works
Self-citationDistinct brain structure and behavior related to ADHD and conduct disorder traits
Bayard, F., Nymberg Thunell, C., Abé, C., Almeida, R., Banaschewski, T., Barker, G., Bokde, A. L. W., Bromberg, U., Büchel, C., Quinlan, E. B., et al. (2020) · Molecular Psychiatry · doi:10.1038/s41380-018-0202-6 · Cited by 67 · see citing works
Soloff, P. H., White, R. T., Omari, A. A., Ramaseshan, K. S., & Diwadkar, V. A. (2015) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2015.04.006 · Cited by 68 · see citing works
Holtmann, J., Herbort, M. C., Wüstenberg, T., Soch, J., Richter, S., Walter, H., Roepke, S., & Schott, B. H. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00054 · Cited by 63 · see citing works
“Compatibly, a direct investigation of voluntary emotion regulation in BPD has indeed yielded both increased amygdala activation and decreased recruitment of the OFC in BPD patients relative to healthy controls (Schulze et al., 2011).”
BackgroundRegional brain responses in nulliparous women to emotional infant stimuli
Montoya, J. L., Landi, N., Kober, H., Worhunsky, P. D., Rutherford, H. J. V., Mencl, W. E., Mayes, L. C., & Potenza, M. N. (2012) · PLoS ONE · doi:10.1371/journal.pone.0036270 · Cited by 61 · see citing works
“For example, healthy subjects as compared to individuals with borderline personality disorder, a condition characterized by emotional dysregulation, showed greater recruitment of the precentral gyrus during responses to aversive as compared to neutral stimuli [68].”
BackgroundEmotion Regulation by Psychological Distance and Level of Abstraction: Two Meta-Analyses
Moran, T., & Eyal, T. (2022) · Personality and Social Psychology Review · doi:10.1177/10888683211069025 · Cited by 72 · see citing works
Vega, D., Ripollés, P., Soto, Á., Torrubia, R., Ribas, J., Monreal, J., Pascual, J., Salvador, R., Pomarol-Clotet, E., Rodríguez-Fornells, A., et al. (2017) · Brain Imaging and Behavior · doi:10.1007/s11682-017-9687-x · Cited by 61 · see citing works
Neurocognitive profiles of people with borderline personality disorder
Mak, A. D. P., & Lam, L. C. W. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32835b57a9 · Cited by 63 · see citing works
Prehn, K., Schulze, L., Rossmann, S., Berger, C., Vohs, K., Fleischer, M., Hauenstein, K., Keiper, P., Domes, G., & Herpertz, S. C. (2012) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.584906 · Cited by 56 · see citing works
“…were randomly presented and preceeded by an instruction BPD (for a review see, Domes et al. 2009) as well as a pronounced defi cit regarding the cognitive control of emotions (reappraisal of affective stimuli) associated with decreased activity in the orbitofrontal cortex (Schulze et al. 2011).”
MethodSelf-citationSauer, C., Sheppes, G., Lackner, H., Arens, E., Tarrasch, R., & Barnow, S. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.04.113 · Cited by 58 · see citing works
(2016) · doi:10.1093/scan/nsw183 · Cited by 58 · see citing works
“In previous studies using similar picture sets, it was found that BPD patients rated IAPS pictures as more arous- ing than HCs (Schulze et al., 2011) and tended to show less habituation over the course of the experiment (Koenigsberg et al., 2014).”
BackgroundSelf-citationKrause-Utz, A., Winter, D., Schriner, F., Chiu, C.-D., Lis, S., Spinhoven, P., Bohus, M., Schmahl, C., & Elzinga, B. M. (2018) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-017-0806-x · Cited by 57 · see citing works
Self-citationBrand, B. L., & Lanius, R. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-13 · Cited by 58 · see citing works
“Heightened limbic reactivity particularly affecting the amygdala and insula has been a well replicated finding in response to exposure to negative emotional stimuli in BPD [90-96].”
BackgroundEnhanced emotional interference on working memory performance in adults with ADHD
Marx, I., Domes, G., Havenstein, C., Berger, C., Schulze, L., & Herpertz, S. (2011) · World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.599213 · Cited by 55 · see citing works
“Particularly the anterior cingulate (with dopaminergic and serotoninergic neurotransmission involvement), but also the orbitofrontal and dorsolateral prefrontal cortex most likely integrate emotion and cognitive control processes (Holroyd and Coles 2002; Ochsner et al. 2004; Schulze et al. 2011).”
BackgroundSelf-citationWolf, R. C., Thomann, P. A., Sambataro, F., Vasic, N., Schmid, M., & Wolf, N. D. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0303-1 · Cited by 54 · see citing works
“roimaging studies in BPD have revealed abnormalities of OFC volume [13, 14], metabolism [15, 16] and activation [2, 4, 5, 17].”
BackgroundResultMeaney, R., Hasking, P., & Reupert, A. (2016) · PLOS ONE · doi:10.1371/journal.pone.0157294 · Cited by 53 · see citing works
“Specifically, compared to those without the disorder, people with BPD employ significantly more expressive suppression (a response-focused strategy involving inhibiting the expression of distressing emotions) [34], and less cognitive reappraisal (an antecedent-focused strategy, whereby a potentially distressing event…”
BackgroundModulation of negative emotions through anodal tDCS over the right ventrolateral prefrontal cortex
Vergallito, A., Riva, P., Pisoni, A., & Lauro, L. J. R. (2018) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2018.07.037 · Cited by 55 · see citing works
Bertsch, K., Hillmann, K., & Herpertz, S. (2018) · Psychopathology · doi:10.1159/000487363 · Cited by 53 · see citing works
Self-citationEmotion dysregulation in borderline personality disorder: A fronto-limbic imbalance?
Sicorello, M., & Schmahl, C. (2020) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2020.12.002 · Cited by 52 · see citing works
Self-citationEnhanced Detection of Emotional Facial Expressions in Borderline Personality Disorder
Schulze, L., Domes, G., Köppen, D., & Herpertz, S. C. (2012) · Psychopathology · doi:10.1159/000341730 · Cited by 45 · see citing works
Self-citationNeural correlates of effective and ineffective mood induction
Kohn, N., Falkenberg, I., Kellermann, T., Eickhoff, S. B., Gur, R. C., & Habel, U. (2013) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nst055 · Cited by 45 · see citing works
Morandotti, N., Dima, D., Jogia, J., Frangou, S., Sala, M., Vidovich, G. Z. D., Lazzaretti, M., Gambini, F., Marraffini, E., d'Allio, G., et al. (2013) · Psychiatry Research · doi:10.1016/j.pscychresns.2013.02.002 · Cited by 49 · see citing works
“…abnormalities in prefrontal regions in BPD patients are related to impairment in emotional regulation (Johnson et al., 2003), cognitive reappraisal (Schulze et al., 2011) and impulse control (Berlin et al., 2005), potentially contributing to impulsive aggressive and self-destructive behaviors…”
Schulze, L., Schmahl, C., & Niedtfeld, I. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.03.027 · Cited by 48 · see citing works
“Prehn K, Schulze L, Rossmann S, Berger C, Vohs K, Fleischer M, et al. (2013): Effects of emotional stimuli on working memory processes in male criminal offenders with borderline and antisocial personality disorder. responses to emotional stimuli in comorbid borderline personality disorder and bipolar depression.”
InfluentialHow Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?
Bourvis, N., Aouidad, A., Cabelguen, C., Cohen, D., & Xavier, J. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02054 · Cited by 48 · see citing works
“…and hippocampus to stressful stimuli in medication-free BPD patients and decreased activity in the bilateral dlPFC and ACC (Minzenberg et al., 2007; Koenigsberg et al., 2009; Schulze et al., 2011, 2016; Hazlett et al., 2012; Bertsch et al., 2013b; Nicol et al., 2015; van Zutphen et al., 2015).”
BackgroundScherpiet, S., Brühl, A. B., Opialla, S., Roth, L., Jäncke, L., & Herwig, U. (2014) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0444-x · Cited by 46 · see citing works
“[8–11], faces [12, 13], or scripts [14], a hyperreactivity of”
BackgroundThe distinctive neural circuitry of complex posttraumatic stress disorder during threat processing
Bryant, R. A., Felmingham, K. L., Malhi, G., Andrew, E., & Korgaonkar, M. S. (2021) · Psychological Medicine · doi:10.1017/s0033291719003921 · Cited by 46 · see citing works
“, 2016), potentially reflecting the enhanced emotional reactivity commonly observed in BPD, however, these studies have used negative stimuli not involving facial expressions (Schulze et al., 2011).”
BackgroundHerpertz, S., Schneider, I., Schmahl, C., & Bertsch, K. (2018) · Psychopathology · doi:10.1159/000488357 · Cited by 46 · see citing works
Self-citationvan der Velde, J., Opmeer, E. M., Liemburg, E. J., Bruggeman, R., Nieboer, R. M., Wunderink, L., & Aleman, A. (2015) · Schizophrenia · doi:10.1038/npjschz.2015.26 · Cited by 39 · see citing works
Winter, D., Niedtfeld, I., Schmitt, R., Bohus, M., Schmahl, C., & Herpertz, S. (2017) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0689-2 · Cited by 45 · see citing works
Self-citationHigh prevalence of brain pathology in violent prisoners: a qualitative CT and MRI scan study
Schiltz, K., Witzel, J. G., Bausch-Hölterhoff, J., & Bogerts, B. (2013) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-013-0403-6 · Cited by 43 · see citing works
Lischke, A., Herpertz, S. C., Berger, C., Domes, G., & Gamer, M. (2017) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsx107 · Cited by 46 · see citing works
“Whereas BPD participants in these studies performed complex tasks that required the regulation of their emotional responses (e.g. Koenigsberg et al., 2009; Niedtfeld et al., 2010; Schulze et al., 2011), BPD participants in this study performed a simple task that did not require regulatory efforts.”
BackgroundResultInfluentialSelf-citationEmotion Regulation: Definition and Relevance for Mental Health
Berking, M., & Whitley, B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1022-9_2 · Cited by 48 · see citing works
Marceau, E., Meuldijk, D., Townsend, M., Solowij, N., & Grenyer, B. (2018) · Neuroscience and Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.09.001 · Cited by 41 · see citing works
“This is particularly relevant in regard to the literature that has investigated neurobiological correlates of specific strategy training in BPD (e.g., Dixon-Gordon et al., 2017; Koenigsberg et al., 2009; Metcalfe et al., 2017; Schulze et al., 2011; Silvers et al., 2016) and further research that may inform the design…”
BackgroundParsing variability in borderline personality disorder: a meta-analysis of neuroimaging studies
Degasperi, G., Cristea, I., Rosa, E. D., Costa, C., & Gentili, C. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01446-z · Cited by 40 · see citing works
Brandl, F., Corbi, Z. L. H., Bratec, S. M., & Sorg, C. (2019) · NeuroImage · doi:10.1016/j.neuroimage.2019.07.008 · Cited by 42 · see citing works
Social Dysfunctioning and Brain in Borderline Personality Disorder
Herpertz, S. C., Jeung, H., Mancke, F., & Bertsch, K. (2014) · Psychopathology · doi:10.1159/000365106 · Cited by 38 · see citing works
Self-citationde la Peña-Arteaga, V., Berruga-Sánchez, M., Steward, T., Martínez-Zalacaín, I., Goldberg, X., Wainsztein, A., Abulafia, C., Cardoner, N., Castro, M., Villarreal, M., et al. (2021) · European psychiatry · doi:10.1192/j.eurpsy.2021.2231 · Cited by 39 · see citing works
“Importantly, this has been suggested to underlie several of the pathological manifestations of this disorder, including affective instability, intense and tumultuous relationships, difficulty controlling anger, impulsivity, suicidal tendencies, and deliberate self-harm (thought to serve an emotion-regulating function)…”
BackgroundAlbein-Urios, N., Verdejo-Román, J., Soriano-Mas, C., Asensio, S., Martínez-González, J. M., & Verdéjo-Garcia, A. (2013) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2013.04.012 · Cited by 39 · see citing works
“Specifically, they exhibit consistent reductions in subgenual anterior cingulate cortex activation during negative emotion experience (Ruocco et al., 2013) and increased insula and decreased orbitofrontal cortex activation during reappraisal (Schulze et al., 2011).”
BackgroundKrause-Utz, A., Walther, J.-C., Lis, S., Schmahl, C., & Bohus, M. (2019) · Psychological Medicine · doi:10.1017/s0033291718002489 · Cited by 38 · see citing works
“, 2016), although BPD patients showed altered neural activity in circuits implicated in ER (Koenigsberg et al., 2009; Schulze et al., 2011; Paret et al., 2016; Schmitt et al., 2016; Zilverstand et al., 2017).”
BackgroundMethodResultInfluentialSelf-citationSilvers, J. A., Hubbard, A. D., Biggs, E. A., Shu, J., Fertuck, E. A., Chaudhury, S. R., Grunebaum, M. F., Weber, J., Hedy Kober, A., Chesin, M. S., et al. (2016) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2016.06.009 · Cited by 44 · see citing works
“With regards to reappraisal specifically, individuals with BPD report comparable reappraisal-related decreases in negative affect to controls, yet show different PFC and amygdala recruitment when reappraising (Koenigsberg et al., 2009a; Lang et al., 2012; Schulze et al., 2011).”
BackgroundResultInfluentialPetrovic, P., Ekman, C. J., Klahr, J., Tigerström, L., Rydén, G., Johansson, A. G. M., Sellgren, C., Golkar, A., Olsson, A., Öhman, A., et al. (2016) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsv072 · Cited by 38 · see citing works
“Apart from lower functional activations in emotional regulation tasks (Wingenfeld et al., 2009; Yang and Raine, 2009; Schulze et al., 2011), volumetric studies have found reduced brain volume in rACC and lObfc (Soloff et al.”
BackgroundInfluentialDaros, A. R., Guevara, M. A., Uliaszek, A. A., McMain, S. F., & Ruocco, A. C. (2018) · Psychopathology · doi:10.1159/000487008 · Cited by 37 · see citing works
Emotion regulation unveiled through the categorical lens of attachment
Domic‐Siede, M., Guzmán‐González, M., Sánchez‐Corzo, A., Álvarez, X., Araya, V., Espinoza, C., Zenis, K., & Marín-Medina, J. (2024) · BMC Psychology · doi:10.1186/s40359-024-01748-z · Cited by 42 · see citing works
- Authors
- Schulze, L., Domes, G., Krüger, A., Berger, C., Fleischer, M., Prehn, K., Schmahl, C., Grossmann, A., Hauenstein, K., & Herpertz, S. C.
- Affiliations
- University of Rostock (DE)
- University of Freiburg (DE)
- Freie Universität Berlin (DE)
- Heidelberg University (DE)
- Corresponding author
- Herpertz, Sabine C.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 69
- Issue
- 6
- Pages
- 564-573
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W1992311480
- Cited by
- 266
- References
- 0
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 12 · 2023: 6 · 2022: 10 · 2021: 28 · 2020: 13 · 2019: 18 · 2018: 25 · 2017: 14 · 2016: 33 · 2015: 20 · 2014: 24 · 2013: 25 · 2012: 23
- FWCI
- 25.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Funders
- German Research Foundation (DFG He 2660/7-1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- borderline personality disorder, cognitive reappraisal, emotion regulation, neuroticism, amygdala, insula, orbitofrontal cortex, emotional reactivity, negative emotions, aversive stimuli, prefrontal cortex dysfunction
- MeSH terms
- Adult, Arousal, Borderline Personality Disorder, Brain, Brain Mapping, Cognition Disorders, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Neuropsychological Tests, Photic Stimulation, Psychometrics, Mood Disorders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
