Self-other disturbance in borderline personality disorder: Neural, self-report, and performance-based evidence.
Self-other disturbance in borderline personality disorder: Neural, self-report, and performance-based evidence.
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DOI：
10.1037/per0000127
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
Levy KN
中科院分区：
文献类型：
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作者：
Beeney JE;Hallquist MN;Ellison WD;Levy KN
患有边缘型人格障碍 (BPD) 的人表现出贫乏的自我意识以及在积极和消极两极之间转换的自我和他人表征。然而，很少有研究调查 BPD 表征障碍的本质。本研究采用多模式方法。采用卡片分类任务来研究 BPD 中自我表征的复杂性、整合性和效价。使用人格表征维护任务来评估自我表征和其他表征维护的损害。最后，功能性磁共振成像（fMRI）被用来评估边缘性人格障碍患者是否表现出与自我相关的神经异常，以及哪些大脑区域可能与表征维持不良有关。患有 BPD 的个体对自我方面进行了排序，这表明自我表征更加复杂，但总体上整合程度较低，负面效价更高。在表征维持任务中，边缘性人格障碍患者在 3 小时内对自我和他人的表征表现出较低的一致性，但仅限于抽象的、基于个性的表征。这项测量的表现介导了支持社会认知的几个区域的组间大脑激活。我们没有发现特定于自我的社会认知障碍的证据。此外，BPD 组表现出对条件不敏感的主要影响，即内侧前额叶皮层、颞顶叶交界处、额极的几个区域、楔前叶和颞中回的过度激活，所有这些区域都对社会认知至关重要。相比之下，对照组的视觉、感觉、运动和镜像神经元区域的激活程度更高。这些发现的讨论与关于精神过度化以及自我干扰和其他干扰之间的重叠的研究有关。
Individuals with borderline personality disorder (BPD) display an impoverished sense of self and representations of self and others that shift between positive and negative poles. However, little research has investigated the nature of representational disturbance in BPD. The present study takes a multi-modal approach. A card sort task was employed to investigate complexity, integration and valence of self-representation in BPD. Impairment in maintenance of self and other representations was assessed using a personality representational maintenance task. Finally, functional magnetic resonance imaging (fMRI) was used to assess whether individuals with BPD show neural abnormalities related specifically to the self and what brain areas may be related to poor representational maintenance. Individuals with BPD sorted self-aspects suggesting more complexity of self-representation, but also less integration and more negative valence overall. On the representational maintenance task, individuals with BPD showed less consistency in their representations of self and others over the 3-hour period, but only for abstract, personality-based representations. Performance on this measure mediated between-group brain activation in several areas supporting social cognition. We found no evidence for social cognitive disturbance specific to the self. Additionally, the BPD group showed main effects, insensitive to condition, of hyperactivation in the medial prefrontal cortex, temporal parietal junction, several regions of the frontal pole, the precuneus and middle temporal gyrus, all areas crucial social cognition. In contrast, controls evidenced greater activation in visual, sensory, motor and mirror neuron regions. These findings are discussed in relation to research regarding hypermentalization and the overlap between self- and other-disturbance.