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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…
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“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
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Mayeli, M., Abolmaali, K., Nokani, M., & Talepasand, S. (2020) · Complementary Medicine Journal · doi:10.32598/cmja.10.3.1005.1 · Cited by 1
McLachlan, J. (2019) · doi:10.17638/03056231 · Cited by 2
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Neurowissenschaftliche Forschung und Psychotherapie bei der Borderline-Persönlichkeitsstörung
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Self-citationCortical-Limbic and Default-Mode Networks in Borderline Personality Disorder
Krause-Utz, A., & Schmahl, C. G. (2021) · Springer eBooks · doi:10.1007/978-3-030-59797-9_17 · Cited by 2
Self-citationZutphen, C. P. V. (2017) · doi:10.26481/dis.20170323lvz · Cited by 2
“During up-regulation participants were instructed to imagine that they, or a close relative, were involved in the situation (Schulze et al., 2011) or imagine themselves as the central figure of the story and heighten their feelings of closeness (Lang et al.”
BackgroundMethodInfluentialAffective Instability: Bipolar Disorder Versus Borderline Personality Disorder
Reich, D. B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1314-5_5 · Cited by 2
Fusina, F., Marino, M., & Angrilli, A. (2025) · Frontiers in Neuroscience · doi:10.3389/fnins.2025.1599349 · Cited by 1
“Other research indicated that the dorsal anterior cingulate cortex (dACC) is deactivated during reappraisal tasks in BPD patients (Koenigsberg et al., 2009; Schulze et al., 2011; Lang et al., 2012; van Zutphen et al., 2018).”
Oxazepam and cognitive reappraisal: A randomised experiment
Nilsonne, G., Tamm, S., Golkar, A., Olsson, A., Sörman, K., Howner, K., Kristiansson, M., Ingvar, M., & Petrović, P. (2021) · PLoS ONE · doi:10.1371/journal.pone.0249065 · Cited by 3
“Cognitive reappraisal is important in psychiatric conditions involving anxiety [8–10], which may be associated with insufficient top-down control [9, 11].”
BackgroundStressresilienz: Neue Perspektiven aus der neuropsychologischen Forschung
Wessa, M. (2018) · Gehirne unter Spannung · doi:10.1007/978-3-662-57463-8_10 · Cited by 1
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Pizarro‐Campagna, E. (2019) · Research Bank (Australian Catholic University) · doi:10.26199/5de04a21b8d75
“emotions, as evidenced by attenuated activation of the left orbitofrontal cortex, and increased activation of the bilateral insula (Schulze et al., 2011).”
BackgroundUsing Functional Neuroimaging to Refine the Diagnostic Construct of Borderline Personality Disorder
Silverman, M. H., Schulz, S. C., & Cullen, K. R. (2016) · Journal of Neuroimaging in Psychiatry and Neurology · doi:10.17756/jnpn.2016-005 · Cited by 1
“Three studies found decreased activation in regions hypothesized to be involved in emotion regulation and cognitive control, including the ventrolateral prefrontal cortex (vlPFC), dorsolateral prefontal cortex (dlPFC), ACC, and dorsomedial prefrontal cortex (dmPFC) [109, 110, 113].”
BackgroundResultWie beeinflussen neurobiologische Erkenntnisse die Psychotherapie?
Herpertz, S. C. (2012) · Springer eBooks · doi:10.1007/978-3-642-22470-6_4 · Cited by 6
Self-citationAdolescent emotional dysregulation and suicide
Xu, F., & Xu, S. (2026) · Medicine · doi:10.1097/md.0000000000043127
“[21,22] [23–26] Research has uncovered a strong correlation between emotional dysregulation and child and adolescent suicide.”
Afshani, M., & Mohammadi, A. (2026) · Basic and Clinical Neuroscience Journal · doi:10.32598/bcn.17.2.2572.2
“…it can impair functioning across life domains, including work, education, and relationships, contributing to difficulties in maintaining employment, social connections, and effective stress coping (Reichenberger et al., 2017; Salsman & Linehan, 2012; Scheiderer et al., 2016; Schulze et al., 2011).”
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“Deficient emotion regulation represents a risk factor across the major mental disorders (Johnstone and Walter, 2014; Erk et al., 2010; Schulze et al., 2010; Zimmerman et al., 2017; Jiang et al.,2025).”
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Prins, E. (2020) · Zorg + Welzijn · doi:10.32388/dvmi9r
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“Using a previously validated procedure of cognitive reappraisal (40), Schmitt and colleagues (2016) confirmed parts of these results on a sample of patients with BPD (N = 32 patients) undergoing DBT and showed an enhanced neural connectivity between ventro-lateral pre-frontal cortex areas and the amygdala (32), consis…”
ResultRôle des mécanismes d'autorégulation dans la soumission à l'autorité
Lepage, J. (2017) · theses.fr (ABES) · doi:10.70675/ed9d576cz7d61z4542z857ez41704b109a94
“Un certain nombre d’études s’est intéressé aux stratégies de réévaluation cognitive appliquées aux stimuli aversifs (e.g., Banks et al., 2007 ; Kalisch et al., 2005 ; Kanske et al., 2011 ; Lamm, Batson, & Decety, 2007 ; Ochsner et al., 2002, 2004 ; Schulze et al., 2011).”
BackgroundThe Functional Domain of Self-Other Regulation
Lorenzini, N., Fonagy, P., & Luyten, P. (2021) · Depression and personality · doi:10.1007/978-3-030-70699-9_4
Oakley, M. (2021) · Scholarworks (University of Massachusetts Amherst) · doi:10.7275/15908338 · Cited by 3
“(Aldao, 2013, Schulze et al., 2011).”
BackgroundInfluentialNeuropsychotherapie – Psychotherapieverfahren und ihre Wirkung
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Anger and Interpersonal Aggression
Alia-Klein, N., Falkner, A. L., Miczek, K., & de Almeida, R. D. (2020) · Frontiers Research Topics · doi:10.3389/978-2-88963-904-5
Neuronale Korrelate emotionaler Dysregulation bei Patienten mit Borderline-Persönlichkeitsstörung
Schauer, J., Viviani, R., & Sosic-Vasic, Z. (2016) · Nervenheilkunde · doi:10.1055/s-0037-1616425
“Die meisten Studien zum Überbegriff Emotionsregulation bei BPS untersuchen mittels Stimuluspräsentation (z. B. emotionale Gesichter oder Bilder) den Bereich der emotionalen Sensitivität im Sinne einer verringerten Detektionsund Antwortschwelle für emotionale Stimuli sowie einer erhöhten Wahrscheinlichkeit, dass Stimul…”
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Journal of Management, Spirituality & Religion: Editorial Board
Adler, J. M., Allemand, M., Borkenau, P., Colvin, R. W., Hermann, A. D., & McLarnon, W. (2010) · doi:10.1080/14766086.2010.529647
van Zutphen, L., Siep, N., Jacob, G. A., Domes, G., Sprenger, A., Willenborg, B., Goebel, R., & Arntz, A. (n.d.) · doi:10.4018/978-1-5225-3704-5.ch003
“We used an emotion sensitivity and regulation paradigm 12–14 with different categories of emotional social stimuli.”
BackgroundMethodResultInfluentialSelf-citation
Metadata
- 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
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