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Emotional learning during dissociative states in borderline personality disorder

Ebner-Priemer, Ulrich W., Mauchnik, Jana, Kleindienst, Nikolaus, Schmahl, Christian, Peper, Martin, Rosenthal, M. Zachary, Flor, Herta, Bohus, Martin·2009·Journal of Psychiatry and Neuroscience
DOI 10.1139/jpn.0929
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Abstract

Background: Neurobiological findings and clinical data suggest that dissociative experience inhibits conditioning processes, but experimental studies are lacking. The aim of our study was to determine whether high states of dissociative experience would specifically alter emotional learning, but not declarative knowledge. Methods: We used an aversive differential delay conditioning procedure in 33 unmedicated patients with borderline personality disorder (BPD) and 35 healthy controls. Results: Patients with BPD who had high state dissociative experiences (BPD D+) showed diminished acquisition of differential aversive delay conditioning with respect to emotional learning compared with those who did not experience dissociative symptoms (BPD D−) and healthy controls (skin conductance response; interaction dissociation × quadratic time × type, p = 0.009). Specifically, the control group and the BPD D− subgroup showed an increase in valence and arousal to the conditioned stimulus (CS+) during the conditioning procedure (all p < 0.012) and demonstrated differential skin conductance responses in the acquisition and extinction phases. In contrast, the BPD D+ subgroup showed no increase in valence and arousal to CS+ or differential response regarding skin conductance. We examined general psychopathology, trauma history, perceptual differences and posttraumatic stress disorder as confounding factors, but we found no evidence of bias. Limitations: Subdividing the BPD group reduced power. In addition, because our sample included only women, the generalizability of our results is constrained. Furthermore, we performed no separate analysis of the influence of different aspects of dissociation on the learning process. Conclusion: Emotional, amygdala-based learning processes seem to be inhibited during state dissociative experience. State dissociative experience may alter acquisition and extinction processes and should be closely monitored in exposure-based psychotherapy.

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  • In BPD, dissociation is primarily stress-related and appears to have substantial impact on affective-cognitive functioning.

    “In BPD, dissociation is primarily stress-related and appears to have substantial impact on affective–cognitive functioning [6–8].”

    From Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder (2017) · cites this paper as [7]

    The Limitations section says stress is known to trigger dissociative symptoms, but does not establish that dissociation in BPD is primarily stress-related. The study reports diminished emotional learning during high dissociative states in patients with BPD. Its Discussion describes findings on cognitive/declarative knowledge as inconsistent, so the broader claim about affective–cognitive functioning exceeds what this study clearly shows. (LLM, conf=0.84)

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Authors
Ebner-Priemer, U. W., Mauchnik, J., Kleindienst, N., Schmahl, C., Peper, M., Rosenthal, M. Z., Flor, H., & Bohus, M.
Affiliations
  • Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, University of Heidelberg
  • Institute of Psychology, University of Marburg, Germany
  • Department of Psychiatry and Behavioral Science, Duke University Medical Center, USA
  • Department of Neuropsychology and Clinical Psychology, Central Institute of Mental Health, University of Heidelberg, Germany
Venue
Journal of Psychiatry and Neuroscience
Publisher
Canadian Science Publishing
Published
2009-05
Volume
34
Issue
3
Pages
214-222
ISSN
  • 1180-4882
  • 1488-2434
DOI
10.1139/jpn.0929
Cited by
27
References
10
Language
en
Licence
www.nrcresearchpress.com/page/about/CorporateTextAndDataMining (tdm)

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