Differential valuation and learning from social and non-social cues in Borderline Personality Disorder

AbstractBackgroundVolatile interpersonal relationships are a core feature of Borderline Personality Disorder (BPD), and lead to devastating disruption of patients’ personal and professional lives. Quantitative models of social decision making and learning hold promise for defining the underlying mechanisms of this problem. In this study, we tested BPD and control subject weighting of social versus non-social information, and their learning about choices under stable and volatile conditions. We compared behavior using quantitative models.MethodsSubjects (n=20 BPD, n=23 control) played an extended reward learning task with a partner (confederate) that requires learning about non-social and social cue reward probability (The Social Valuation Task). Task experience was measured using language metrics: explicit emotions/beliefs, talk about the confederate, and implicit distress (using the previously established marker self-referentiality). Subjects’ weighting of social and non-social cues was tested in mixed-effects regression models. Subjects’ learning rates under stable and volatile conditions were modelled (Rescorla-Wagner approach) and group x condition interactions tested.ResultsCompared to controls, BPD subject debriefings included more mentions of the confederate and less distress language. BPD subjects also weighted social cues more heavily, but had blunted learning responses to (non-social and social) volatility.ConclusionsThis is the first report of patient behavior in the Social Valuation Task. The results suggest that BPD subjects expect higher volatility than do controls. These findings lay the groundwork for a neuro-computational dissection of social and non-social belief updating in BPD, which holds promise for the development of novel clinical interventions that more directly target pathophysiology.

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THE BORDERLINE PERSONALITY DISORDER OF ANTONY IN THE DRAMA ANTONY AND CLEOPATRABY WILLIAM SHAKESPEARE

Journal of English Language and Literature (JELL) ◽

10.37110/jell.v3i01.34 ◽

2018 ◽

Vol 3 (01) ◽

pp. 27-44

Author(s):

Eny Suprihandani ◽

Thea Jacinda

Keyword(s):

Borderline Personality Disorder ◽

William Shakespeare ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Sigmund Freud ◽

Mental Disease ◽

Borderline Personality ◽

Antony And Cleopatra ◽

Self Image ◽

Psychoanalytic Approach

Literature can be analyzed from many perspectives and point of views. By using psychoanalytic approach, this paper attempts to analyze one of the Shakespearean’s characters, Antony in the drama Antony and Cleopatra. The objective is to prove whether Antony truly suffers from Borderline Personality Disorder. Borderline Personality Disorder (BPD) is a personality disorder whose essential features are a pattern of marked impulsivity and instability of affects, interpersonal relationships, and self-image. Psychoanalysis theory is a theory developed by Sigmund Freud that enables to analyze whether a person suffers from a certain mental disease. Using those approaches, the characterization of Antony can be analyzed from his words, thoughts and other character’s opinion about him and then compared to the symptoms of Borderline Personality Disorder (BPD) and then found if they are matched. That Antony suffers from Borderline Personality Disorder can be finally proved.

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Experiences of women living with borderline personality disorder

Health SA Gesondheid ◽

10.4102/hsag.v21i0.1017 ◽

2016 ◽

Vol 21 ◽

pp. 110-119 ◽

Cited By ~ 1

Author(s):

N. Ntshingila ◽

M. Poggenpoel ◽

C. P.H. Myburgh ◽

A. Temane

Keyword(s):

Mental Health ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Life Story ◽

Borderline Personality ◽

Childhood Experiences ◽

Educational Challenges ◽

Contextual Study ◽

Experiences Of Women

There is limited understanding of the experiences of women living with borderline personality disorder. It was therefore decided to discover how women living with this disorder would tell their life story. For the researcher, who worked in a psychotherapy ward where most women were living with borderline personality disorder, the care of these women was of vital importance, as they were less understood by mental health care providers.The research aimed to explore and describe the experiences of women living with borderline personality disorder. A qualitative, explorative, descriptive and contextual study design was used. Data was collected through in-depth phenomenological interviews that focused on the central question, “Tell me your life story”. Eight participants living with borderline personality disorder were interviewed. Tesch's method for data analysis was used (Creswell, 2009:186), along with an independent coder. Measures to ensure trustworthiness and ethical principles were applied throughout the research. From the findings obtained by means of the interviews of women living with borderline personality disorder, it was evident that there were childhood experiences of living in an unsafe space, related to unhealthy family dynamics, boundary violations and educational challenges. They experienced chronic feelings of emptiness in their relationships with theself. They also presented with a pattern of unstable interpersonal relationships and compromised mental health, which was apparent through the early on set of mental problems, emotional upheaval, looking for emotional escape and having different triggerfactors. Lastly, all these women yearned for facilitated mental health.

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Facilitation of self-empowerment of women living with borderline personality disorder: A concept analysis

Health SA Gesondheid ◽

10.4102/hsag.v21i0.1006 ◽

2016 ◽

Vol 21 ◽

pp. 437-443

Author(s):

N. Ntshingila ◽

A. Temane ◽

M. Poggenpoel ◽

C. P.H. Myburgh

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Nurse Practitioners ◽

Borderline Personality ◽

Central Concept ◽

Self Image ◽

Analysis And Synthesis ◽

Definition Of ◽

Synthesis Reasoning

Background: Borderline personality disorder is characterised by a pattern of instability in interpersonal relationships, self-image, affects and marked impulsivity.Objective: : The objective is to define the central concept of “facilitation of self empowerment”.Method: Analysis and synthesis reasoning methods as indicated by Walker and Avant (2011) were used to define the central concept.Results: A definition of the concept “facilitation of self-empowerment” was formulated from the dictionary and subject definitions.Conclusion: The central concept is important for developing a model as a frame of reference to assist psychiatric nurse practitioners in facilitating the mental health of women living with borderline personality disorder.

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Diagnosis of Borderline Personality Disorder

10.1093/med/9780199997510.003.0002 ◽

2017 ◽

Author(s):

Barbara Stanley ◽

Tanya Singh

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Affect Regulation ◽

Borderline Personality ◽

Affect Dysregulation ◽

Affective Dysregulation ◽

Mood Changes ◽

Self Image ◽

Persistent Pattern

The diagnosis of borderline personality disorder (BPD) can be devastating. BPD is characterized by instability on several domains: affect regulation, impulse control, interpersonal relationships, and self-image, and it affects about 1–2% of the general population—up to 10% of psychiatric outpatients, and 20% of inpatients. In addition to meeting the criteria set forth in DSM-5, BPD, like all personality disorders, is characterized by a pervasive and persistent pattern of behavior that begins in early childhood and is stable across contexts. Affective dysregulation (inappropriate, intense anger or difficulty controlling anger; affective instability due to a marked reactivity of mood), is one of the core domains associated with BPD and is characterized by erratic, easily aroused mood changes and disproportionate emotional responses. Affect dysregulation differs in BPD and mood disorders because in BPD it can shift rapidly and is affected by environmental triggers.

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Clinical Features, Neuropsychology and Neuroimaging in Bipolar and Borderline Personality Disorder: A Systematic Review of Cross-Diagnostic Studies

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.681876 ◽

2021 ◽

Vol 12 ◽

Author(s):

Anna Massó Rodriguez ◽

Bridget Hogg ◽

Itxaso Gardoki-Souto ◽

Alicia Valiente-Gómez ◽

Amira Trabsa ◽

...

Keyword(s):

Systematic Review ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Clinical Features ◽

Explanatory Power ◽

Borderline Personality ◽

Neuropsychological Performance ◽

Diagnostic Studies ◽

Co Morbidity

Background: Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) have clinically been evolving as separate disorders, though there is still debate on the nosological valence of both conditions, their interaction in terms of co-morbidity or disorder spectrum and their distinct pathophysiology.Objective: The objective of this review is to summarize evidence regarding clinical features, neuropsychological performance and neuroimaging findings from cross-diagnostic studies comparing BD and BPD, to further caracterize their complex interplay.Methods: Using PubMed, PsycINFO and TripDataBase, we conducted a systematic literature search based on PRISMA guidelines of studies published from January 1980 to September 2019 which directly compared BD and BPD.Results: A total of 28 studies comparing BD and BPD were included: 19 compared clinical features, 6 neuropsychological performance and three neuroimaging abnormalities. Depressive symptoms have an earlier onset in BPD than BD. BD patients present more mixed or manic symptoms, with BD-I differing from BPD in manic phases. BPD patients show more negative attitudes toward others and self, more conflictive interpersonal relationships, and more maladaptive regulation strategies in affective instability with separate pathways. Impulsivity seems more a trait in BPD rather than a state as in BD. Otherwise, BD and BPD overlap in depressive and anxious symptoms, dysphoria, various abnormal temperamental traits, suicidal ideation, and childhood trauma. Both disorders differ and share deficits in neuropsychological and neuroimaging findings.Conclusion: Clinical data provide evidence of overlapping features in both disorders, with most of those shared symptoms being more persistent and intense in BPD. Thus, categorical classifications should be compared to dimensional approaches in transdiagnostic studies investigating BPD features in BD regarding their respective explanatory power for individual trajectories.Systematic Review Registration: The search strategy was pre-registered in PROSPERO: CRD42018100268.

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Effects of childhood maltreatment on social cognition and brain functional connectivity in borderline personality disorder patients

10.1101/461087 ◽

2018 ◽

Author(s):

Xochitl Duque ◽

Ruth Alcalá-Lozano ◽

Jorge J. González-Olvera ◽

Eduardo A. Garza-Villarreal ◽

Francisco Pellicer

Keyword(s):

Child Abuse ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Childhood Maltreatment ◽

Social Cognitive ◽

Borderline Personality ◽

Cognitive Test ◽

Cognitive Responses ◽

Cognitive Paradigms

AbstractBorderline personality disorder (BPD) is a chronic condition characterized by high levels of impulsivity, affective instability, and difficulty to establish and manage interpersonal relationships. This paper assessed differences in performance on social cognitive paradigms (MASC, RMTE) and how it related to child abuse. Specifically, it evaluated the relationship between performance on cognitive paradigms and baseline brain connectivity in patients with BPD, compared to healthy controls.BPD patients had higher levels of childhood maltreatment, increased impulsivity and aggression, and more dissociative symptoms than control subjects. For the sexual abuse subdimension, there were no differences between the BPD and the control groups, but there was a negative correlation between MASC scores and total childhood maltreatment levels, as well as between physical abuse, physical negligence, and MASC. Both groups showed that the higher the level of childhood maltreatment, the lower the performance on the MASC social cognitive test. Further, in the BPD group, there was hypoconnectivity between the structures responsible for emotion regulation and social cognitive responses that have been described as part of the frontolimbic circuitry. The more serious the child abuse, the lower the connectivity.

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A negative bias in decoding positive social cues characterizes emotion processing in patients with symptom-remitted Borderline Personality Disorder

Borderline Personality Disorder and Emotion Dysregulation ◽

10.1186/s40479-019-0114-3 ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 3

Author(s):

Nikolaus Kleindienst ◽

Sophie Hauschild ◽

Lisa Liebke ◽

Janine Thome ◽

Katja Bertsch ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Emotion Recognition ◽

Cognitive Processing ◽

Social Cognitive ◽

Borderline Personality ◽

Social Cues ◽

Negative Bias ◽

Social Signals ◽

Emotional Facial Expressions

Abstract Background Impairments in the domain of interpersonal functioning such as the feeling of loneliness and fear of abandonment have been associated with a negative bias during processing of social cues in Borderline Personality Disorder (BPD). Since these symptoms show low rates of remission, high rates of recurrence and are relatively resistant to treatment, in the present study we investigated whether a negative bias during social cognitive processing exists in BPD even after symptomatic remission. We focused on facial emotion recognition since it is one of the basal social-cognitive processes required for successful social interactions and building relationships. Methods Ninety-eight female participants (46 symptom-remitted BPD [r-BPD]), 52 healthy controls [HC]) rated the intensity of anger and happiness in ambiguous (anger/happiness blends) and unambiguous (emotion/neutral blends) emotional facial expressions. Additionally, participants assessed the confidence they experienced in their own judgments. Results R-BPD participants assessed ambiguous expressions as less happy and as more angry when the faces displayed predominantly happiness. Confidence in these judgments did not differ between groups, but confidence in judging happiness in predominantly happy faces was lower in BPD patients with a higher level of BPD psychopathology. Conclusions Evaluating social cues that signal the willingness to affiliate is characterized by a negative bias that seems to be a trait-like feature of social cognition in BPD. In contrast, confidence in judging positive social signals seems to be a state-like feature of emotion recognition in BPD that improves with attenuation in the level of acute BPD symptoms.

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Low Compliance to Pharmacological Treatment of Severe Chronic Illness: Passive Suicide Ideation in Borderline Personality Disorder?

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1270 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S711-S711

Author(s):

M. Bonea ◽

I. Miclutia

Keyword(s):

Liver Cirrhosis ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Treatment Plan ◽

Primary Hypothyroidism ◽

Borderline Personality ◽

Affective Instability

IntroductionThe core features of Borderline Personality Disorder (BPD), such as deliberate self-harm, suicide attempts and demandingness in interpersonal relationships persist with age, even though impulsivity decreases. Impairing progressive disease combined with affective instability and chronic feelings of emptiness can lead to a desire for death.ObjectivesTo present a case of BPD with severe chronic endocrine pathology and liver cirrhosis who refused to take his treatment as prescribed.MethodsA case report is presented and discussed.ResultsWe report the case of a 61-year-old man with BPD and liver cirrhosis, complex endocrine pathology (pituitary adenoma, diabetes insipidus and primary hypothyroidism), type 2 diabetes mellitus with insulin therapy, essential hypertension and alcohol use disorder. He had a history of 5 suicide attempts caused by marked feelings of rejection and emptiness and a pattern of unstable relationships and lack of commitment, thus his marriage lasted only 2 years. He idealized and was extremely familiar with his clinician and displayed marked affective instability (dysphoria, periods of anger and despair, affective ambivalence towards his parents and recurrent depressive symptoms). Because of his liver disease, the psychotropic medication was ceased by his physician. The patient refused to follow the rest of his treatment plan and diet as prescribed, resulting in the deterioration of his somatic status. The patient denied an active suicidal ideation, but did not explain his non-compliance.ConclusionThe impairment from BPD and the risk of suicide persist even in older age affecting the outcome of co-morbid somatic conditions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Life-World of Persons with Borderline Personality Disorder

The Oxford Handbook of Phenomenological Psychopathology ◽

10.1093/oxfordhb/9780198803157.013.67 ◽

2018 ◽

pp. 664-681 ◽

Cited By ~ 1

Author(s):

Giovanni Stanghellini ◽

Milena Mancini

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Sense Of Self ◽

Borderline Personality ◽

The Self ◽

The Other ◽

Emotional Intensity ◽

Life World ◽

The Social ◽

Shame And Guilt

Persons with borderline personality disorder are often described as affected by extreme emotional fluctuations. This article analyses their fundamental emotions: dysphoria and anger, despair, boredom, shame, and guilt. Our focus will be mainly on the two distinct life-world configurations that originate from dysphoria and anger: the dysphoric life-world and the life-world of anger. The first is characterized by a quasi-ineffable constellation of feelings in which Self and Others are irritatingly indefinite. In the second, the vague sense of Self and Others disappear: the Self is the victim, the Other the Offender. This emotional intensity does not allow borderline persons to distance themselves from what they feel here-and-now, thus feelings and values overlap. We call this “frustrated normativity.” Borderline persons are guided by the value of authenticity thus entering into collision with the social norms/conventions which they consider inauthentic and therefore an unwarranted challenge to their truly natural being: spontaneity.

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Transcranial Magnetic Stimulation for Borderline Personality Disorder: Rationale, Stimulation Site and Methods

European Psychiatry ◽

10.1016/s0924-9338(09)71001-6 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

L. Cailhol ◽

E. Bui ◽

B. Roussignol ◽

A.-H. Moncany ◽

R. Klein ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Transcranial Magnetic Stimulation ◽

Personality Disorder ◽

Interpersonal Relationships ◽

Magnetic Stimulation ◽

Suicide Attempts ◽

Repetitive Transcranial Magnetic Stimulation ◽

Controlled Trial ◽

Borderline Personality ◽

Post Traumatic Stress

Borderline personality disorder (BPD) is characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This disorder is associated with a significant rate of suicide attempts and completed suicides (4 to 10%), a major impairment in social functioning and an increased healthcare utilization cost. Treatments available include psychotherapy and pharmacotherapy. Research has shown some efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) on post-traumatic stress disorder and mood disorder which both share common biological or clinical features with BPD. It is then likely that rTMS might prove efficient on BPD symptoms.A review of the literature on neuroimaging and neuropsychology of BPD shows a hypoactivity of the dorsolateral prefrontal cortex which may be a potential target site for rTMS.We will conduct a pilot randomized sham-controlled trial on 30 BPD patients assessing the efficacy of a 10-day course of daily rTMS on neuropsychological tasks, BPD symptoms severity, risk taking behaviour, depression and general psychopathology.

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