Emotion regulation in Borderline Personality Disorder: functional neuronal correlates of habitual and instructed acceptance and suppression of positive and negative emotions

边缘型人格障碍（BPD）患者的特点是情感不稳定，包括经历快速变化，强烈的情绪状态。人们一直认为，情感不稳定是通过使用适应不良的情绪调节策略（即情绪抑制）来加强和保持的。行为研究表明，情绪抑制会导致反弹效应，其中包括情绪唤醒的矛盾增加。这似乎同样适用于BPD患者。相反，在BPD的辩证行为疗法中，假设情绪的接受对情绪健康有积极的影响。然而，在BPD患者的神经元水平上，对情绪的抑制和接受的短期和长期影响的研究尚缺乏。通过功能性磁共振断层扫描（fMRT），我们解决了情绪抑制是否有助于增强BPS的情感强度的问题。一方面，我们将情绪抑制和接受的习惯性使用与神经元对情绪（消极和积极）视觉刺激的反应联系起来。另一方面，我们研究了在完成短暂的情绪调节训练后，在对情绪视觉刺激的反应中指导使用情绪抑制和接受的效果。我们预计，与接受相比，情绪抑制会导致（准）边缘脑区情绪唤醒的反弹效应，与抑郁症和健康对照组相比，BPD患者的情绪唤起尤其明显。我们的研究结果也为BPS的治疗提供了重要的启示。

Patients with borderline personality disorder (BPD) are characterized by affective instability which comprises the experience of rapidly changing, intensive emotional states. It has been argued that affective instability is reinforced and preserved by the use of maladaptive emotion regulation strategies, i. e. suppression of emotions. Behavioral research indicates that emotional suppression consecutively leads to a rebound-effect which includes a paradoxical increase of emotional arousal. It seems likely that the same applies for patients with BPD. In contrast, it is assumed, e.g. in Dialectical Behavior Therapy of BPD, that acceptance of emotions has positive effects on emotional well-being. However, research is missing on the short- and long-term effects of suppression and acceptance of emotions on a neuronal level in patients with BPD. With functional magnetic resonance tomography (fMRT) we address the question of whether emotional suppression contributes to enhanced affect intensity in BPS. On the one hand, we correlate the habitual use of emotional suppression and acceptance as assessed with questionnaires with the neuronal activity in reaction to emotional (negative and positive) visual stimuli. On the other hand, we examine the effects of instructed use of suppression and acceptance of emotions in reaction to emotional visual stimuli after completion of a short emotion regulation training. We expect that emotional suppression in contrast to acceptance causes a rebound-effect of emotional arousal in (para-) limbic brain regions, which is particularly pronounced in patients with BPD compared to a depressive and a healthy control group. Our research findings also provide important implications for the therapy of BPS.