Stuck in a negative me: fMRI study on the role of disturbed self-views in social feedback processing in borderline personality disorder

AbstractBackgroundInterpersonal difficulties in borderline personality disorder (BPD) could be related to the disturbed self-views of BPD patients. This study investigates affective and neural responses to positive and negative social feedback (SF) of BPD patients compared with healthy (HC) and low self-esteem (LSE) controls and how this relates to individual self-views.MethodsBPD (N = 26), HC (N = 32), and LSE (N = 22) performed a SF task in a magnetic resonance imaging scanner. Participants received 15 negative, intermediate and positive evaluative feedback words putatively given by another participant and rated their mood and applicability of the words to the self.ResultsBPD had more negative self-views than HC and felt worse after negative feedback. Applicability of feedback was a less strong determinant of mood in BPD than HC. Increased precuneus activation was observed in HC to negative compared with positive feedback, whereas in BPD, this was similarly low for both valences. HC showed increased temporoparietal junction (TPJ) activation to positive v. negative feedback, while BPD showed more TPJ activation to negative feedback. The LSE group showed a different pattern of results suggesting that LSE cannot explain these findings in BPD.ConclusionsThe negative self-views that BPD have, may obstruct critically examining negative feedback, resulting in lower mood. Moreover, where HC focus on the positive feedback (based on TPJ activation), BPD seem to focus more on negative feedback, potentially maintaining negative self-views. Better balanced self-views may make BPD better equipped to deal with potential negative feedback and more open to positive interactions.

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Social feedback processing in borderline personality disorder

Psychological Medicine ◽

10.1017/s003329171500207x ◽

2015 ◽

Vol 46 (3) ◽

pp. 575-587 ◽

Cited By ~ 13

Author(s):

C. W. Korn ◽

L. La Rosée ◽

H. R. Heekeren ◽

S. Roepke

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Character Traits ◽

Healthy Controls ◽

Healthy Individuals ◽

Social Feedback ◽

Feedback Processing ◽

Relevant Feedback ◽

Self And Other

BackgroundPatients with borderline personality disorder (BPD) show negative and unstable self- and other-evaluations compared to healthy individuals. It is unclear, however, how they process self- and other-relevant social feedback. We have previously demonstrated a positive updating bias in healthy individuals: When receiving social feedback on character traits, healthy individuals integrate desirable more than undesirable feedback. Here, our aim was to test whether BPD patients exhibit a more negative pattern of social feedback processing.MethodWe employed a character trait task in which BPD patients interacted with four healthy participants in a real-life social interaction. Afterwards, all participants rated themselves and one other participant on 80 character traits before and after receiving feedback from their interaction partners. We compared how participants updated their ratings after receiving desirable and undesirable feedback. Our analyses included 22 BPD patients and 81 healthy controls.ResultsHealthy controls showed a positivity bias for self- and other-relevant feedback as previously demonstrated. Importantly, this pattern was altered in BPD patients: They integrated undesirable feedback for themselves to a greater degree than healthy controls did. Other-relevant feedback processing was unaltered in BPD patients.ConclusionsOur study demonstrates an alteration in self-relevant feedback processing in BPD patients that might contribute to unstable and negative self-evaluations.

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Faculty Opinions recommendation of Social feedback processing in borderline personality disorder.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725852182.793513800 ◽

2016 ◽

Author(s):

Christian Schmahl ◽

Dorina Winter

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Social Feedback ◽

Feedback Processing

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Faculty Opinions recommendation of Social feedback processing in borderline personality disorder.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725852182.793510847 ◽

2015 ◽

Author(s):

Sabine Herpertz ◽

Haang Jeung

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Borderline Personality ◽

Social Feedback ◽

Feedback Processing

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Impaired decision making and feedback evaluation in borderline personality disorder

Psychological Medicine ◽

10.1017/s003329171000262x ◽

2011 ◽

Vol 41 (9) ◽

pp. 1917-1927 ◽

Cited By ~ 58

Author(s):

B. Schuermann ◽

N. Kathmann ◽

C. Stiglmayr ◽

B. Renneberg ◽

T. Endrass

Keyword(s):

Decision Making ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Executive Functions ◽

Negative Feedback ◽

Borderline Personality ◽

Negative Consequences ◽

Feedback Processing ◽

Feedback Information ◽

Feedback Evaluation

BackgroundIncreased impulsivity is considered to be a core characteristic of borderline personality disorder (BPD) and has been shown to play a significant role in decision making and planning. Neuropsychological studies in BPD revealed impairments of executive functions, and it is assumed that these deficits are related to altered feedback processing. However, research on executive functions in BPD is still limited and the underlying deficits remain an open question. The present study, therefore, explored whether decision-making deficits are related to altered feedback evaluation in BPD.MethodA total of 18 BPD patients and 18 matched healthy controls underwent a modified version of the Iowa Gambling Task while an electroencephalogram was recorded. Feedback processing was examined by measuring the feedback-related negativity (FRN) and the P300 as electrophysiological correlates of feedback evaluation.ResultsBehavioural results revealed that BPD patients, relative to controls, made more risky choices and did not improve their performance. With regard to the FRN, amplitudes in BPD patients did not discriminate between positive and negative feedback information. Further, BPD patients showed reduced FRN amplitudes, which were associated with enhanced impulsivity and enhanced risk taking. In contrast, the P300 amplitudes following negative feedback were increased in BPD patients, relative to controls.ConclusionsThis study indicates that BPD patients are impaired in decision making, which might be related to a dysfunctional use of feedback information. Specifically, BPD patients did not learn to avoid disadvantageous selections, even though they attended to negative consequences.

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