Self-reported impulsivity in women with borderline personality disorder: the role of childhood maltreatment severity and emotion regulation difficulties

Background: Childhood maltreatment, such as severe emotional, physical, and sexual abuse and neglect, has been linked to impulse control problems and dysfunctional emotional coping. In borderline personality disorder (BPD), a history of childhood maltreatment may worsen difficulties in emotion regulation, which may in turn give rise to impulsive behaviours. The aim of this self-report study was to investigate associations between childhood maltreatment severity, emotion regulation difficulties, and impulsivity in women with BPD compared to healthy and clinical controls. Methods: Sixty-one female patients with BPD, 57 clinical controls (CC, women with Attention Deficit Hyperactivity Disorder and/or Substance Use Disorder, without BPD), and 60 female healthy controls (HC) completed self-report scales on childhood trauma (Childhood Trauma Questionnaire, CTQ), difficulties in emotion regulation (Difficulties in Emotion Regulation Scale, DERS), and impulsivity (UPPS Impulsive Behaviour Scale). A conditional process analysis was performed to investigate whether emotion dysregulation statistically mediated the effect of childhood maltreatment severity on impulsivity depending on group (BPD vs. CC vs. HC). Results: Childhood maltreatment, particularly emotional maltreatment, was positively associated with impulsivity and emotion regulation difficulties across all groups. Difficulties in emotion regulation statistically mediated the effect of childhood maltreatment on impulsivity in BPD, but not in the other groups. Conclusion: In the context of current conceptualizations of BPD and previous research, findings suggest that problems with emotion regulation may be related to a history of childhood maltreatment, which may in turn enhance impulsivity. Targeting emotion dysregulation in psychotherapy and discussing it in relation to childhood maltreatment can help decreasing impulsive behaviors in individuals with BPD. Given the correlational design of our study which does not allow causal conclusions, future studies have to employ prospective, experimental designs and include larger sample sizes to corroborate associations between childhood maltreatment, emotion dysregulation, and impulsivity

Latent classes of DSM-5 acute stress disorder symptoms in children after single-incident trauma: findings from an international data archive

Background: After a potentially traumatic event (PTE), children often show symptoms of acute stress disorder (ASD), which may evolve into posttraumatic stress (PTS) disorder. A growing body of literature has employed latent class analysis (LCA) to disentangle the complex structure underlying PTS symptomatology, distinguishing between homogeneous subgroups based on PTS presentations. So far, little is known about subgroups or classes of ASD reactions in trauma-exposed children. Objective: Our study aimed to identify latent classes of ASD symptoms in children exposed to a single-incident PTE and to identify predictors of class membership (gender, age, cultural background, parental education, trauma type, and trauma history). Method: A sample of 2287 children and adolescents (5–18 years) was derived from the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive, an international archive including studies from the USA, UK, Australia, and Switzerland. LCA was used to determine distinct subgroups based on ASD symptoms. Predictors of class membership were examined using a three-step approach. Results: Our LCA yielded a three-class solution: low (42%), intermediate (43%) and high (15%) ASD symptom severity that differed in terms of impairment and number of endorsed ASD symptoms. Compared to the low symptoms class, children in the intermediate or high severity class were more likely to be of female gender, be younger of age, have parents who had not completed secondary education, and be exposed to a road traffic accident or interpersonal violence (vs. an unintentional injury). Conclusions: These findings provide new information on children at risk for ASD after single-incident trauma,

Exploring the Complex Relationship Between Childhood Trauma and Self-Harm

Previous research has linked self-harm to adverse childhood experiences (i.e. abuse and neglect). Despite the extensive literature on self-harm, it remains of high importance to examine psychological predictors of repetitive self-harming behaviors in those who report childhood trauma. This study explored the role of maladaptive emotion regulation strategies, dissociation proneness, and borderline personality (BP) features. An international sample with n = 374 participants (N = 287, 77%, reporting intentional use of self-harm), was recruited online via relevant mental health platforms and research sites. Within an anonymous survey, participants completed the Self-harm Inventory, Childhood Trauma Questionnaire, Dissociative Experience Scale, Cognitive Emotion Regulation Questionnaire, and Personality Assessment Inventory-Borderline Personality Features Scale. Structural equation modeling (SEM) was used to explore direct and indirect effects. Self-harm was positively correlated to severity of childhood trauma, maladaptive emotion regulation strategies, dissociation, and BP features. In the path-analytical model, independent indirect effects of childhood trauma severity via self-blame, catastrophizing, dissociation, as well as BP features on self-harm were found. Maladaptive emotion regulation, dissociation proneness, and BP features all seem to be important intermediary agents in the close association between childhood trauma and self-harm

Frontal dysfunctions of impulse control : a systematic review in borderline personality disorder and attention-deficit/hyperactivity disorder

Disorders such as borderline personality disorder (BPD) or attention-deficit/hyperactivity disorder (ADHD) are characterized by impulsive behaviors. Impulsivity as used in clinical terms is very broadly defined and entails different categories including personality traits as well as different cognitive functions such as emotion regulation or interference resolution and impulse control. Impulse control as an executive function, however, is neither cognitively nor neurobehaviorally a unitary function. Recent findings from behavioral and cognitive neuroscience studies suggest related but dissociable components of impulse control along functional domains like selective attention, response selection, motivational control, and behavioral inhibition. In addition, behavioral and neural dissociations are seen for proactive vs. reactive inhibitory motor control. The prefrontal cortex with its sub-regions is the central structure in executing these impulse control functions. Based on these concepts of impulse control, neurobehavioral findings of studies in BPD and ADHD were reviewed and systematically compared. Overall, patients with BPD exhibited prefrontal dysfunctions across impulse control components rather in orbitofrontal, dorsomedial, and dorsolateral prefrontal regions, whereas patients with ADHD displayed disturbed activity mainly in ventrolateral and medial prefrontal regions. Prefrontal dysfunctions, however, varied depending on the impulse control component and from disorder to disorder. This suggests a dissociation of impulse control related frontal dysfunctions in BPD and ADHD, although only few studies are hitherto available to assess frontal dysfunctions along different impulse control components in direct comparison of these disorders. Yet, these findings might serve as a hypothesis for the future systematic assessment of impulse control components to understand differences and commonalities of prefrontal cortex dysfunction in impulsive disorders

Voxel-based morphometry in women with borderline personality disorder with and without comorbid posttraumatic stress disorder.

Patients with Borderline Personality Disorder (BPD) showed reduced volume of amygdala and hippocampus, but similar findings are evident in Posttraumatic Stress Disorder (PTSD). Applying voxel-based morphometry (VBM) in a larger cohort of patients with BPD, we sought to extend earlier findings of volume abnormalities in limbic regions and to evaluate the influence of co-occurring PTSD in BPD patients. We used voxel-based morphometry to study gray matter volume (GMV) in 60 healthy controls (HC) and 60 patients with BPD. Subgroup analyses on 53 patients concerning the role of co-occurring PTSD were conducted. Additionally, regression analyses were calculated to assess the relation between borderline symptom severity as well as dissociative experiences and GMV. Differences in local GMV between patients with BPD and HC were observed in the amygdale and hippocampus as well as in the fusiform and cingulate gyrus. Co-occurring PTSD was accompanied by increased GMV in the superior temporal gyrus and dorsolateral prefrontal cortex. Independent of co-occurring PTSD, severity of BPD symptoms predicted smaller GMV in the amygdala and dorsal ACC. Dissociation was positively related to GMV in the middle temporal gyrus. We could replicate earlier findings of diminished limbic GMV in patients with BPD and additionally show that patients with co-morbid PTSD feature increased GMV in prefrontal regions associated with cognitive control

Do I trust you when you smile? Effects of sex and emotional expression on facial trustworthiness appraisal.

BackgroundTrust is a prerequisite for successful social relations. People tend to form a first impression of people's trustworthiness based on their facial appearance. The sex of the judging person and its congruency with the sex of the judged people influence these appraisals. Moreover, trustworthiness and happiness share some facial features, which has led to studies investigating the interplay between both social judgments. Studies revealed high correlation in judging happiness and trustworthiness across different facial identities. However, studies are missing that investigate whether this relationship exists on a within-subject level and whether in-group biases such as the congruency between the sex of the judging and judged individual influence this relationship. In the present study, we addressed these questions.MethodsData were collected in an online-survey in two separate samples (N = 30, German sample, N = 107 Dutch sample). Subjects assessed the intensity of happiness and trustworthiness expressed in neutral and calm facial expression of the same characters (50% males, 50% females). Statistical analyses comprised rm-Anova designs based on rating scores and estimates of within-subject associations between both judgments.ResultsOur findings replicate high correlations between happiness and trustworthiness ratings across facial identities based on average scores across participants. However, the strength of this association was strongly dependent on the methodological approach and inter-subject variability was high. Our data revealed an in-group advantage for trustworthiness in women. Moreover, the faces' sex and emotional expressions differentially influenced the within-subject correlation between both judgments in men and women.ConclusionOur findings replicate previous studies on the association between happiness and trustworthiness judgments. We extend our understanding of the link between both social judgments by uncovering that within-subject variability is high and influenced by sex and the availability and appraisal of positive emotional facial cues

Trustworthiness appraisals of faces wearing a surgical mask during the Covid-19 pandemic in Germany: An experimental study.

BackgroundDuring the Covid-19 pandemic, the negative effects of wearing a mouth-nose cover (MNC) on interpersonal functioning have been discussed in public media but empirical studies on how wearing MNCs affect social judgements are sparse. In the present study, we investigated the effects of MNCs on trustworthiness appraisals, the influence of changes due to MNCs in evaluating joy, and the relationship between a social-cognitive appraisal bias and a participant's characteristics.MethodsAll participants (N = 165) judged the intensity of happiness and trustworthiness in calm facial stimuli presented with and without a surgical mask covering part of the face. We analysed the relationship of changes in judgements evoked by MNCs to participants' evaluations of MNCs as protective tools and explored their associations with the burden experienced by wearing MNCs, compliance to behaviour recommendations, their risk associated with the pandemic, and their levels of psychological distress.ResultsOverall, calm facial stimuli covered with MNCs were evaluated as less trustworthy and, to an even stronger extent, less happy than uncovered facial stimuli. However, participants varied in whether they showed a negative or positive evaluation of faces with MNCs; the negative bias was stronger in those participants who attributed lower protective potential to MNCs, experienced a higher burden while wearing MNCs, wore MNCs less often, and experienced a higher level of psychological distress.ConclusionsA negative bias in trustworthiness appraisals of faces with a positive emotional expression covered by MNCs is linked to a participant's evaluation of MNCs as inefficient and burdening and their experience of high psychological distress

Dissociation in borderline personality disorder : disturbed cognitive and emotional inhibition and its neural correlates

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Whole-brain maps illustrate smaller gray matter volumes in patients with borderline personality disorder (BPD-PTSD) compared to patients with borderline personality disorders and co-occurring PTSD (BPD+PTSD).

<p>For visualization purposes, the statistical maps were thresholded at T>2.5. Size and location of clusters are reported in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065824#pone-0065824-t001" target="_blank">Table 1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065824#pone-0065824-t002" target="_blank">2</a>.</p

Whole-brain maps illustrate smaller gray matter volumes in patients with borderline personality disorders compared to healthy controls (1a) and negative correlations between gray matter volume and the severity of BPD symptoms (1b).

<p>For visualization purposes, the statistical maps were thresholded at T>2.5. Size and location of clusters are reported in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065824#pone-0065824-t001" target="_blank">Table 1</a> and <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065824#pone-0065824-t002" target="_blank">2</a>.</p