Rejection Distress Suppresses Medial Prefrontal Cortex in Borderline Personality Disorder.

Autor: Fertuck EA; Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, New York; Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York. Electronic address: efertuck@ccny.cuny.edu., Stanley B; Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York., Kleshchova O; Department of Psychology, University of Nevada Reno, Reno, Nevada., Mann JJ; Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York., Hirsch J; Departments of Psychiatry, Neuroscience and Comparative Medicine, Yale School of Medicine, New Haven, Connecticut., Ochsner K; Department of Psychology, Columbia University, New York, New York., Pilkonis P; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania., Erbe J; Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York., Grinband J; Department of Psychiatry, Columbia University, New York, New York.
Jazyk: angličtina
Zdroj: Biological psychiatry. Cognitive neuroscience and neuroimaging [Biol Psychiatry Cogn Neurosci Neuroimaging] 2023 Jun; Vol. 8 (6), pp. 651-659. Date of Electronic Publication: 2022 Dec 05.
DOI: 10.1016/j.bpsc.2022.11.006
Abstrakt: Background: Borderline personality disorder (BPD) is characterized by an elevated distress response to social exclusion (i.e., rejection distress), the neural mechanisms of which remain unclear. Functional magnetic resonance imaging studies of social exclusion have relied on the classic version of the Cyberball task, which is not optimized for functional magnetic resonance imaging. Our goal was to clarify the neural substrates of rejection distress in BPD using a modified version of Cyberball, which allowed us to dissociate the neural response to exclusion events from its modulation by exclusionary context.
Methods: Twenty-three women with BPD and 22 healthy control participants completed a novel functional magnetic resonance imaging modification of Cyberball with 5 runs of varying exclusion probability and rated their rejection distress after each run. We tested group differences in the whole-brain response to exclusion events and in the parametric modulation of that response by rejection distress using mass univariate analysis.
Results: Although rejection distress was higher in participants with BPD (F 1,40  = 5.25, p = .027, η 2  = 0.12), both groups showed similar neural responses to exclusion events. However, as rejection distress increased, the rostromedial prefrontal cortex response to exclusion events decreased in the BPD group but not in control participants. Stronger modulation of the rostromedial prefrontal cortex response by rejection distress was associated with higher trait rejection expectation, r = -0.30, p = .050.
Conclusions: Heightened rejection distress in BPD might stem from a failure to maintain or upregulate the activity of the rostromedial prefrontal cortex, a key node of the mentalization network. Inverse coupling between rejection distress and mentalization-related brain activity might contribute to heightened rejection expectation in BPD.
(Copyright © 2022 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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