Atypical processing of social anticipation and feedback in borderline personality disorder
Open accessAbstract
BACKGROUND-: Borderline personality disorder (BPD) is characterized by maladaptive social functioning, and widespread negativity biases. The neural underpinnings of these impairments remain elusive. We thus tested whether BPD patients show atypical neural activity when processing social (compared to non-social) anticipation, feedback, and particularly, how they relate to each other. METHODS-: We acquired functional MRI data from 21 BPD women and 24 matched healthy controls (HCs) while they performed a task in which cues and feedbacks were either social (neutral faces for cues; happy or angry faces for positive and negative feedbacks, respectively) or non-social (dollar sign; winning or losing money for positive and negative feedbacks, respectively). This task allowed for the analysis of social anticipatory cues, performance-based feedback, and their interaction. RESULTS-: Compared to HCs, BPD patients expressed increased activation in the superior temporal sulcus during the processing of social cues, consistent with elevated salience associated with an upcoming social event. BPD patients also showed reduced activation in the amygdala while processing evaluative social feedback. Importantly, perigenual anterior cingulate cortex (pgACC) activity during the presentation of the social cue correlated with reduced amygdala activity during the presentation of the negative social feedback in the BPD patients. CONCLUSIONS-: These neuroimaging results clarify how BPD patients express altered responses to different types of social stimuli (i.e. social anticipatory cues and evaluative feedback) and uncover an atypical relationship between frontolimbic regions (pgACC-amygdala) over the time span of a social interaction. These findings may help to explain why BPD patients suffer from pervasive difficulties adapting their behavior in the context of interpersonal relationships and should be considered while designing better-targeted interventions.
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BPD is characterized by impulsive, intrusive, and angry enmeshment in, rather than only detachment from, primary relationships in reaction to a combination of a terror of abandonment and a fragmented and unstable sense of self, which is acted out as hostile and impulsive demands in relationships.
“BPD, by contrast, is characterized by impulsive, intrusive, and angry enmeshment in, rather than only detachment from, primary relationships in reaction to a combination of a terror of abandonment and a fragmented and unstable sense of self, which is acted out as hostile and impulsive demands in relationships [30, 108, 127, 144].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [30]
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Experimental — accuracy not yet measuredBPD involves emotion dysregulation associated with deficits in social cognition related to dichotomous thinking, paranoia, aggressive attributions, and increased attention to, but impaired recognition, understanding, and empathy for, the emotions, thoughts, and intentions of others.
“BPD also involves emotion dysregulation associated with deficits in social cognition related to dichotomous thinking, paranoia, aggressive attributions, and increased attention to, but impaired recognition, understanding, and empathy for, the emotions, thoughts, and intentions of others [30, 108, 127, 144].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [30]
The Introduction describes emotional dysregulation, an attentional bias toward negative emotional information, and difficulties in social interactions. The Discussion reports altered processing of social signals. Neither passage establishes dichotomous thinking, paranoia, aggressive attributions, or impaired recognition, understanding, and empathy for others’ emotions, thoughts, and intentions. (LLM, conf=0.88)
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- Authors
- Doell, K. C., Olié, E., Courtet, P., Corradi-Dell'Acqua, C., Perroud, N., & Schwartz, S.
- Affiliations
- University of Geneva (CH)
- Inserm (FR)
- Corresponding author
- Doell, Kimberly C.
- Venue
- NeuroImage: Clinical
- Publisher
- Elsevier BV
- Published
- 2020
- Volume
- 25
- Pages
- 102126
- ISSN
- 2213-1582 (ISSN-L)
- PMC
- PMC6938803
- OpenAlex
- W2996022779
- Cited by
- 21
- References
- 74
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2018: 1
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- NeuroImage Clinical (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- Iris (University of Trento) (submittedVersion, cc-by-nc-nd)
- HAL (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- OSF Preprints (OSF Preprints) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by-nc-nd)
- Funders
- National Center of Competence in Research Quantum Science and Technology
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (51NF40-104897)
- Université de Genève (SFETD-IUD 2012)
- 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, social feedback, negativity bias, superior temporal sulcus, amygdala, pregenual anterior cingulate cortex, social salience, emotional face processing
- MeSH terms
- Adult, Borderline Personality Disorder, Brain, Cues, Feedback, Female, Humans, Magnetic Resonance Imaging, Social Behavior, Young Adult, Anticipation, Psychological
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 ›
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