Nonacceptance of negative emotions in women with borderline personality disorder: association with neuroactivity of the dorsal striatum
Nonacceptance of negative emotions in women with borderline personality disorder: association with neuroactivity of the dorsal striatum
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DOI：
10.1503/jpn.180077
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发表时间：
2019-09-01
影响因子：
4.3
通讯作者：
Beblo, Thomas
中科院分区：
文献类型：
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作者：
Lamers, Agnes;Toepper, Max;Beblo, Thomas
背景：情绪障碍是边缘型人格障碍（BPD）患者的关键症状，被认为是情绪调节功能障碍（如情绪接受度降低）的结果。在目前的功能性磁共振成像（fMRI）研究中，我们研究了BPD患者习惯性情绪接受的神经相关因素。方法：女性BPD患者和女性健康对照者在fMRI中被动观看消极和中性的面部电影片段。我们使用情绪接受问卷（EAQ）来评估情绪接受度。为了研究大脑激活与习惯性情绪接受消极刺激的关系，我们将EAQ分数作为兴趣回归因子纳入消极电影与中性电影期间大脑激活强度的数据分析中。结果：我们在分析中纳入了20名BPD女性和20名健康对照。与健康对照相比，BPD患者在面对负刺激（或中性刺激）时，大脑额纹状体区域（即左侧额上回、右侧尾状回）以及左侧楔前叶、左侧中央前回、左侧后扣带皮层和左侧海马的激活明显增加。与健康对照组相比，BPD患者的情绪接受度下降，并且BPD患者的习惯性情绪接受与纹状体区域（即左壳核，左尾状核）的激活呈负相关。局限性：不可能得出因果结论。未排除合并症诊断，且仅调查女性参与者。刺激并没有立即被评估，也可能不能推广到所有的负面情绪。我们不能对这里可能应用的其他情绪调节策略做出任何陈述。结论：数据表明，BPD女性在处理负性刺激时纹状体过度激活与她们对不愉快情绪状态的接受倾向降低有关。因此，BPD患者可能会受益于专注于情感接受的治疗方法，以使情绪反应正常化。
Background: Emotion dysfunction is a key symptom in patients with borderline personality disorder (BPD) and is considered a consequence of dysfunctional emotion regulation (e.g., reduced emotion acceptance). In the present functional MRI (fMRI) study, we investigated the neural correlates of habitual emotion acceptance in individuals with BPD. Methods: Female patients with BPD and female healthy controls passively viewed negative and neutral movie clips of faces during fMRI. We assessed emotion acceptance using the Emotion Acceptance Questionnaire (EAQ). To examine brain activation associated with habitual emotional acceptance of negative stimuli, the EAQ score was included as a regressor of interest in brain data analyses of activation intensity during negative compared with neutral movies. Results: We included 20 women with BPD and 20 heatlhy controls in our analysis. Compared with healthy controls, patients with BPD showed significantly more activation in frontostriatal brain regions (i.e., left superior frontal gyrus, right caudate) as well as in the left precuneus, left precentral gyrus, left posterior cingulate cortex and left hippocampus when confronted with negative (v. neutral) stimuli. Patients with BPD reported decreased emotion acceptance compared with healthy controls, and habitual emotion acceptance was inversely associated with activation of striatal areas (i.e., left putamen, left caudate) in patients with BPD. Limitations: Causal conclusions are not possible. Comorbid diagnoses were not excluded, and only female participants were investigated. Stimuli were not rated immediately and may not be generalizable to all negative emotions. We cannot make any statements about other emotion-regulation strategies that may have been applied here. Conclusion: Data indicate that striatal hyperactivation during the processing of negative stimuli in women with BPD is related to their decreased disposition to accept unpleasant emotional states. Thus, individuals with BPD may benefit from therapy approaches that focus on emotion acceptance in order to normalize emotional reactions.