Single-dose effects of Citalopram on neural responses to affective stimuli in borderline personality disorder: A randomized clinical trial

AbstractBorderline personality disorder (BPD) is characterized by severe interpersonal dysfunction with problems in social cognition, empathy and social approach. Although the neuropeptide oxytocin is known to regulate complex social cognition and behavior in healthy individuals and clinical populations, there is still a lack of evidence for a potential beneficial effect of oxytocin administration on social cognition and social approach in BPD. Fifty-one women with BPD and 51 matched healthy controls were randomized to a double-blind, placebo-controlled, between-subject experimental trial. We administered a single dose of 24 IU oxytocin or placebo intranasally prior to a standardized task measuring affective and cognitive empathy and approach motivation. All participants were free of hormonal contraception and tested in the mid-luteal phase of their menstrual cycle. In the placebo condition, patients with BPD showed reduced cognitive and affective empathy, and less approach behavior motivation than healthy controls. Intranasal oxytocin significantly increased affective empathy and approach motivation in both BPD patients and healthy controls compared to placebo. More importantly, oxytocin administration led to similar scores between BPD and healthy controls. These findings provide the first evidence for a beneficial effect of oxytocin on deficits in affective empathy and approach motivation of BPD. Our results indicate a beneficial effect of a single dose of oxytocin on affective empathy and approach motivation in women with BPD adapting their level of social functioning to healthy controls. Future clinical trials will need to investigate the long-term effects and effectiveness of oxytocin as an add-on treatment for social impairments in BPD.

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Generalizability of pharmacological and psychotherapy clinical trial results for borderline personality disorder to community samples.

Personality Disorders Theory Research and Treatment ◽

10.1037/per0000091 ◽

2015 ◽

Vol 6 (1) ◽

pp. 81-87 ◽

Cited By ~ 13

Author(s):

Nicolas Hoertel ◽

Saioa López ◽

Shuai Wang ◽

Ana González-Pinto ◽

Frédéric Limosin ◽

...

Keyword(s):

Clinical Trial ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Clinical Trial Results

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Stimulus valence, episodic memory, and the priming of brain activation profiles in borderline personality disorder

Psychological Medicine ◽

10.1017/s0033291721001136 ◽

2021 ◽

pp. 1-11

Author(s):

Morgan Szczepaniak ◽

Asadur Chowdury ◽

Paul H. Soloff ◽

Vaibhav A. Diwadkar

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Episodic Memory ◽

Memory Task ◽

Processing System ◽

Borderline Personality ◽

Affective Valence ◽

Repeated Presentation ◽

Affective Stimuli ◽

Specific Effects

Abstract Background Borderline personality disorder (BPD) is characterized by instability in affective regulation that can result in a loss of cognitive control. Triggers may be neuronal responses to emotionally valenced context and/or stimuli. ‘Neuronal priming’ indexes the familiarity of stimuli, and may capture the obligatory effects of affective valence on the brain's processing system, and how such valence mediates responses to the repeated presentation of stimuli. We investigated the effects of affective valence of stimuli on neuronal priming (i.e. changes in activation to repeated presentation of stimuli), and if these effects distinguished BPD patients from controls. Methods Forty BPD subjects and 25 control subjects (age range: 18–44) participated in an episodic memory task during fMRI. Stimuli were presented in alternating epochs of encoding (six images of positive, negative, and neutral valence) and recognition (six images for ‘old’ v. ‘new’ recognition). Analyses focused on inter-group differences in the change in activation to repeated stimuli (presented during Encoding and Recognition). Results Relative to controls, BPD showed greater priming (generally greater decrease from encoding to recognition) for negatively valenced stimuli. Conversely, BPD showed less priming for positively valenced stimuli (generally greater increase from encoding to recognition). Conclusion Plausibly, the relative familiarity of negative valence to patients with BPD exerts an influence on obligatory responses to repeated stimuli leading to repetition priming of neuronal profiles. The specific effects of valence on memory and/or attention, and consequently on priming can inform the understanding of mechanisms of altered salience for affective stimuli in BPD.

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