Suicide attempters with Borderline Personality Disorder show differential orbitofrontal and parietal recruitment when reflecting on aversive memories
Open accessAbstract
Suicidal behavior and difficulty regulating emotions are hallmarks of Borderline Personality Disorder (BPD). This study examined neural links between emotion regulation and suicide risk in BPD. 60 individuals with BPD (all female, mean age = 28.9 years), 46 of whom had attempted suicide, completed a fMRI task involving recalling aversive personal memories. Distance trials assessed the ability to regulate emotion by recalling memories from a third-person, objective viewpoint. Immerse trials assessed emotional reactivity and involved recalling memories from a first-person perspective. Behaviorally, both groups reported less negative affect on Distance as compared to Immerse trials. Neurally, two sets of findings were obtained. The first reflected differences between attempters and non-attempters. When immersing and distancing, attempters showed elevated recruitment of lateral orbitofrontal cortex, a brain region implicated in using negative cues to guide behavior. When distancing, attempters showed diminished recruitment of the precuneus, a region implicated in memory recall and perspective taking. The second set of findings related to individual differences in regulation success - the degree to which individuals used distancing to reduce negative affect. Here, we observed that attempters who successfully regulated exhibited precuneus recruitment that was more similar to non-attempters. These data provide insight into mechanisms underlying suicide attempts in BPD. Future work may examine if these findings generalize to other diagnoses and also whether prior findings in BPD differ across attempters and non-attempters.
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Several studies did not find statistically significant associations or evidence of emotional dysregulation between patients with and without suicide attempts.
“Several studies did not find statistically significant associations [30,32,35,45] or evidence of emotional dysregulation between patients with and without suicide attempts [44,54,62,63,67].”
From The Role of Emotion Dysregulation in Understanding Suicide Risk: A Systematic Review of the Literature (2024) · cites this paper as [62]
The Results (Behavioral results; page unavailable) report no significant difference between suicide attempters and non-attempters with BPD in self-reported regulation success. The Discussion (Emotion regulation and suicide in BPD; page unavailable) also describes comparable emotion-regulation difficulty scores, but reports different neural activation during regulation. Thus, the source supports no measured behavioral difference, not a general absence of differences in emotion regulation. (LLM, conf=0.86)
Experimental — accuracy not yet measuredImmersion and reappraisal of negative autobiographical memories are associated with greater OFC activity in suicide attempters.
“Immersion and reappraisal of negative autobiographical memories are associated with greater OFC activity in suicide attempters (102).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [102]
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- Authors
- Silvers, J. A., Hubbard, A. D., Chaudhury, S., Biggs, E., Shu, J., Grunebaum, M. F., Fertuck, E., Weber, J., Kober, H., Carson-Wong, A., Brodsky, B. S., Chesin, M., Ochsner, K. N., & Stanley, B.
- Affiliations
- University of California, Los Angeles (US)
- New York University (US)
- Columbia University (US)
- City University of New York (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Silvers, Jennifer A.
- ORCID
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2016-10
- Volume
- 81
- Pages
- 71-78
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC5021587
- OpenAlex
- W2467894947
- Cited by
- 30
- References
- 62
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 2
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institutes of Health (5r01ag043463-05, UL1TR001863)
- National Institute on Aging (R01-AG043463)
- National Institute of Mental Health (P50MH090964, F31MH094056, R01MH061017)
- National Center for Advancing Translational Sciences
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD069178)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- borderline personality disorder, suicide attempts, emotion regulation, perspective taking, lateral orbitofrontal cortex, precuneus, parietal cortex, negative affect, suicide risk
- MeSH terms
- Adult, Analysis of Variance, Avoidance Learning, Borderline Personality Disorder, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Memory, Oxygen, Parietal Lobe, Suicide, Attempted, Prefrontal Cortex, Young Adult
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