Cerebral processing of social rejection in patients with borderline personality disorder
Cerebral processing of social rejection in patients with borderline personality disorder
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DOI：
10.1093/scan/nst176
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发表时间：
2014-11-01
影响因子：
4.2
通讯作者：
Lis, Stefanie
中科院分区：
文献类型：
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作者：
Domsalla, Melanie;Koppe, Georgia;Lis, Stefanie
对被抛弃或拒绝的强烈恐惧是边缘型人格障碍（BPD）患者社会关系的核心特征。共有20名未经药物治疗的BPD患者和20名健康参与者（HC，年龄和教育程度匹配）玩了一个虚拟的投球游戏，包括三个条件：排除，纳入和控制条件与预定义的游戏规则，而大脑活动使用功能磁共振成像进行评估。在每个封闭条件后评估排除的主观经验。在排除条件下，两组受试者的排除感相似;然而，在入选和对照条件下，BPD受试者比HC受试者更感到被排除。在这三种情况下，BPD患者表现出更强的参与背侧前扣带回和内侧前额叶皮层。对于HC，激活在几个大脑区域，如小脑和楔前叶不同的相互作用的情况下，而BPD受试者在这些地区的激活不调制的实验条件。BPD的受试者在他们的主观反应和他们的社会互动情况的神经处理方面都不同于HC。我们的数据表明，患有BPD的人很难区分社交场合，并且在不受他人意图影响的社交场合中倾向于过度心理化。
An intense fear of abandonment or rejection is a central feature of social relationships for individuals with borderline personality disorder (BPD). A total of 20 unmedicated BPD patients and 20 healthy participants (HC, matched for age and education) played a virtual ball-tossing game including the three conditions: exclusion, inclusion and a control condition with predefined game rules, whereas cerebral activity was assessed using functional magnetic resonance imaging. Subjective experiences of exclusion were assessed after each blocked condition. Both groups felt similarly excluded during the exclusion condition; however, BPD subjects felt more excluded than HC during the inclusion and control conditions. In all three conditions, BPD patients showed a stronger engagement of the dorsal anterior cingulate and medial prefrontal cortex. For HC, activation in several cerebral regions such as the insula and the precuneus differed depending on the interaction situation, whereas for BPD subjects activation in these regions was not modulated by experimental conditions. Subjects with BPD differed from HC in both their subjective reactions to and their neural processing of social interaction situations. Our data suggest that individuals with BPD have difficulty in discriminating between social situations, and tend to hypermentalize during social encounters that are not determined by the intentions of others.