Affective lability and difficulties with regulation are differentially associated with amygdala and prefrontal response in women with Borderline Personality Disorder

The present neuroimaging study investigated two aspects of difficulties with emotion associated with Borderline Personality Disorder (BPD()): affective lability and difficulty regulating emotion. While these two characteristics have been previously linked to BPD symptomology, it remains unknown whether individual differences in affective lability and emotion regulation difficulties are subserved by distinct neural substrates within a BPD sample. To address this issue, sixty women diagnosed with BPD were scanned while completing a task that assessed baseline emotional reactivity as well as top-down emotion regulation. More affective instability, as measured by the Affective Lability Scale (ALS()), positively correlated with greater amygdala responses on trials assessing emotional reactivity. Greater difficulties with regulating emotion, as measured by the Difficulties with Emotion Regulation Scale (DERS()), was negatively correlated with left inferior frontal gyrus (IFG()) recruitment on trials assessing regulatory ability. These findings suggest that, within a sample of individuals with BPD, greater bottom-up amygdala activity is associated with heightened affective lability. By contrast, difficulties with emotion regulation are related to reduced IFG recruitment during emotion regulation. These results point to distinct neural mechanisms for different aspects of BPD symptomology

Pathways to high-lethality suicide attempts

The purpose of this study was to develop a model of the trajectory to high-lethality suicidal behavior for individuals with Major Depressive Disorder (MDD) and Borderline Personality Disorder (BPD). An increased number of previous suicide attempts, substance use immediately prior to the attempt, and objective planning were proposed to lead directly to an attempt of higher lethality. Meanwhile, aggression and impulsivity were hypothesized to lead indirectly, through their association with past suicidal behavior, to a higher lethality attempt. Path analysis revealed a revised model that applied only to individuals with BPD. In this final model, impulsivity was found to be significantly associated with higher-lethality suicide attempts and the frequency of an individual's past suicidal behavior. Additionally, the traits of impulsivity and aggression were found to be significantly correlated in the multivariate model. Pathways linking alcohol use at the time of the attempt to the lethality of suicidal behavior and aggression to the frequency of an individual's past suicidal behavior were not found to be significant, and no model using the variables of interest in this study could be determined for individuals with MDD. These results are discussed in light of current theories of suicidal behavior and in terms of their implications for clinical practice

The Relationship between Social Maladjustment, Childhood Abuse and Suicidal Behavior in College Students

There are over 1,000 suicides on college campuses annually. Childhood abuse and social maladjustment are risk factors for suicidal behavior in the college student population. Few studies have investigated how these variables combine to instantiate risk for suicidal behavior. Thus, the current study examined the role of social maladjustment (i.e. insecure attachment style and inadequate social support) in the relationship between childhood abuse and suicidal behavior among college students. Six hundred fifty-nine undergraduate college students completed online self-report questionnaires measuring childhood sexual and physical abuse, suicidal behavior, social support, and attachment style. Structural equation modeling was used to explore hypothesized relationships between childhood abuse, social maladjustment, and suicidal behavior. Social maladjustment mediated the relationship between childhood physical and sexual abuse and suicidal behavior. These findings reveal social maladjustment is a pathway by which childhood abuse is associated with suicidal behavior. Implications are discussed as they pertain to improving suicide prevention interventions for college students. How to cite: Restrepo DM, Chesin D, & Jeglic EL (2016). The Relationship between Social Maladjustment, Childhood Abuse and Suicidal Behavior in College Students. International Journal of Psychology and Psychological Therapy, 16, 235-248

Affective lability and difficulties with regulation are differentially associated with amygdala and prefrontal response in women with Borderline Personality Disorder

The present neuroimaging study investigated two aspects of difficulties with emotion associated with Borderline Personality Disorder (BPD): affective lability and difficulty regulating emotion. While these two characteristics have been previously linked to BPD symptomology, it remains unknown whether individual differences in affective lability and emotion regulation difficulties are subserved by distinct neural substrates within a BPD sample. To address this issue, sixty women diagnosed with BPD were scanned while completing a task that assessed baseline emotional reactivity as well as top-down emotion regulation. More affective instability, as measured by the Affective Lability Scale (ALS), positively correlated with greater amygdala responses on trials assessing emotional reactivity. Greater difficulties with regulating emotion, as measured by the Difficulties with Emotion Regulation Scale (DERS), was negatively correlated with left Inferior Frontal Gyrus (IFG) recruitment on trials assessing regulatory ability. These findings suggest that, within a sample of individuals with BPD, greater bottom-up amygdala activity is associated with heightened affective lability. By contrast, difficulties with emotion regulation are related to reduced IFG recruitment during emotion regulation. These results point to distinct neural mechanisms for different aspects of BPD symptomology

Suicide attempters with Borderline Personality Disorder show differential orbitofrontal and parietal recruitment when reflecting on aversive memories.

Suicidal behavior and difficulty regulating emotions are hallmarks of Borderline Personality Disorder (BPD). This study examined neural links between emotion regulation and suicide risk in BPD. 60 individuals with BPD (all female, mean age = 28.9 years), 46 of whom had attempted suicide, completed a fMRI task involving recalling aversive personal memories. Distance trials assessed the ability to regulate emotion by recalling memories from a third-person, objective viewpoint. Immerse trials assessed emotional reactivity and involved recalling memories from a first-person perspective. Behaviorally, both groups reported less negative affect on Distance as compared to Immerse trials. Neurally, two sets of findings were obtained. The first reflected differences between attempters and non-attempters. When immersing and distancing, attempters showed elevated recruitment of lateral orbitofrontal cortex, a brain region implicated in using negative cues to guide behavior. When distancing, attempters showed diminished recruitment of the precuneus, a region implicated in memory recall and perspective taking. The second set of findings related to individual differences in regulation success - the degree to which individuals used distancing to reduce negative affect. Here, we observed that attempters who successfully regulated exhibited precuneus recruitment that was more similar to non-attempters. These data provide insight into mechanisms underlying suicide attempts in BPD. Future work may examine if these findings generalize to other diagnoses and also whether prior findings in BPD differ across attempters and non-attempters