Subjective memory complaints and memory performance in patients with borderline personality disorder

Beblo T, Mensebach C, Wingenfeld K, Rullkoetter N, Schlosser N, Driessen M. Subjective memory complaints and memory performance in patients with borderline personality disorder. BMC Psychiatry. 2014;14(1): 255.Background It is still a matter of debate as to whether patients with Borderline Personality Disorder (BPD) suffer from memory deficits. Existing studies indicate no or small impairments in memory test performance. However, it was shown in patients with related disorders, such as depression, that self-reported impairment exceeds test malfunction. In the present study we assessed memory performance of BPD patients through the use of memory tests and a questionnaire for subjective memory complaints (SMC) in everyday life. Methods Thirty-two patients with BPD and 32 healthy control subjects were included in the study. The groups of subjects were comparable with respect to age, education, and gender. Subjects completed verbal and nonverbal memory tests, as well as the everyday memory questionnaire (EMQ). Results BPD patients reported severe SMC but did not show memory test impairment. The results remained stable even when all BPD patients with acute or lifetime depression comorbidity were excluded from analyses. In both groups, SMC and test performances were not related but in BPD patients SMC were related to BPD symptoms. Conclusions Our data indicate memory impairment of BPD patients in everyday life. However, it cannot be ruled out that increased memory complaints result from patients’ negative self-perception. Future research needs to clarify the reasons for memory complaints of BPD patients

Patients With Borderline Personality Disorder and Major Depressive Disorder Are Not Distinguishable by Their Neuropsychological Performance: A Case-Control Study

Beblo T, Mensebach C, Wingenfeld K, Rullkoetter N, Schlosser N, Driessen M. Patients With Borderline Personality Disorder and Major Depressive Disorder Are Not Distinguishable by Their Neuropsychological Performance. A Case-Control Study. The Primary Care Companion For CNS Disorders. 2011.Objective: Patients with borderline personality disorder (BPD) and patients with major depressive disorder (MDD) exhibit a broad range of neuropsychological deficits. Studies in both groups of patients point to differences but also similarities. However, studies that compare both patient groups are missing from the literature. The present study aimed to compare neuropsychological functioning in BPD and MDD patients. Method: Eighteen patients with BPD, 27 patients with MDD, 17 patients with BPD and MDD, and 76 healthy control subjects were included in the case-control study. Patients were treated for their disorders as inpatients of the Clinic of Psychiatry and Psychotherapy Bethel, Ev. Hospital Bielefeld (Bielefeld, Germany). All patients met DSM-IV diagnoses as assessed by trained psychotherapists within the first week of their admission. In addition to a comprehensive neuropsychological test battery, the inhibitory control of emotional stimuli was assessed. Data were collected between June 2004 and June 2007. Results: Patients showed only a few impairments and no increased distractibility toward emotionally negative stimuli. Patients with BPD and patients with MDD were not distinguishable by the neuropsychological test results. Conclusions: These data did not support the notion of specific neuropsychological profiles in BPD and MDD. Future research needs to clarify the overlap of symptoms between both disorders

Autobiographical Memory and Language Use: Linguistic Analyses of Critical Life Event Narratives in a Non-Clinical Population

Rullkoetter N, Bullig R, Driessen M, Beblo T, Mensebach C, Wingenfeld K. Autobiographical Memory and Language Use: Linguistic Analyses of Critical Life Event Narratives in a Non-Clinical Population. APPLIED COGNITIVE PSYCHOLOGY. 2009;23(2):278-287.Previous research indicates a strong association between post-traumatic stress disorder (PTSD), psychopathology. and linguistic indices, but most studies have only compared one traumatic and one neutral life event. Referring, to the Dual Representation Theory for PTSD we investigated the narrative representation of two negative life events, with and without current emotional impact in a non-clinical population. Twenty-five subjects wrote detailed narratives of the two types of life events. Lexical categories were coded and compared between the different scripts. Life events with Current emotional impact were characterised by a greater use of emotional words, especially secondary emotionally words. Proprioceptive words were more often used and there were more errors when present tense was employed. Additionally, a greater number of sentences were found in these scripts. Our data suggest that in healthy subjects a relationship exists between narrative peculiarities and the current emotional impact of autobiographical memory shaped by negative life events. Copyright (C) 2008 John Wiley & Sons, Ltd

Relationship between coping with negative life-events and psychopathology: Major depression and borderline personality disorder

Wingenfeld K, Mensebach C, Rullkoetter N, et al. Relationship between coping with negative life-events and psychopathology: Major depression and borderline personality disorder. PSYCHOLOGY AND PSYCHOTHERAPY-THEORY RESEARCH AND PRACTICE. 2009;82(4):421-425.Ninety psychiatric in-patients and 73 controls have been asked about their coping styles to negative life-events. Patients reported more emotion-oriented coping than controls. Emotion-oriented coping style was positively correlated with psychopathology, while task-oriented coping was negatively correlated with psychopathology in events which the participants had difficulties dealing with

Selective Attention in Depression Influence of Emotionality and Personal Relevance

Schlosser N, Mensebach C, Rullkoetter N, et al. Selective Attention in Depression Influence of Emotionality and Personal Relevance. Journal of Nervous & Mental Disease. 2011;199(9):696-702.Selective attention to negative stimuli has been discussed as being an essential characteristic of depressive disorder. Theories and empirical data, however, are contradictory. The present study addressed the question of whether depressive patients selectively attend to negatively valenced and personally relevant or irrelevant stimuli and whether they habituate to these stimuli. Thirty-one inpatients with major depressive disorder and 37 healthy controls participated in the study. They underwent a modification of the emotional Stroop paradigm. The results indicated that personally relevant stimuli evoked more pronounced Stroop interference than did stimuli without personal relevance in all subjects. Furthermore, habituation to personally relevant negative stimuli was seen in both depressive patients and control subjects. The present findings question a generally negative attentional bias as being a specific characteristic of depressive disorder. Furthermore, as depressed patients habituated to personally relevant negative stimuli, exposure therapy might be suitable for the treatment of depressive disorder

The impact of neutral and emotionally negative distraction on memory performance and its relation to memory complaints in major depression

Beblo T, Mensebach C, Wingenfeld K, et al. The impact of neutral and emotionally negative distraction on memory performance and its relation to memory complaints in major depression. Psychiatry Research. 2010;178(1):106-111.Patients with major depression (MDD) often report relevant cognitive problems in everyday life while performance in standardised neuropsychological tests is not severely disturbed. This discrepancy may partly be due to the differences between the demands of everyday life with the presence of emotionally relevant distractors and standardised neuropsychological settings without those distractors. In the present study, we hypothesise that patients with major depression (MDD) show an increased distractibility towards emotionally negative stimuli and that this distractibility is related to complaints of cognitive functioning in everyday life. Thirty MDD patients and 48 healthy participants performed our recently developed learning paradigm with neutrally and negatively valenced distraction as well as without distraction. Both groups also performed a neuropsychological test battery as well as self- and observer ratings of impairments in memory and attention in every day life. In the MDD sample, cognitive impairments were reported by the patients and their relatives but were not found in the neuropsychological tests. We found a trend towards a poorer memory performance with negatively valenced distraction in the MDD sample when compared to the performance of healthy subjects. However, this impairment was not related to the self- and observer ratings. This result may be due to the fact that the distractors were not personally relevant to the subjects whereas everyday life implies such distractors. Further research is needed to explore everyday cognitive functioning of patients with MDD

Associations of childhood trauma, trauma in adulthood and previous-year stress with psychopathology in patients with major depression and borderline personality disorder

Wingenfeld K, Schaffrath C, Rullkoetter N, et al. Associations of childhood trauma, trauma in adulthood and previous-year stress with psychopathology in patients with major depression and borderline personality disorder. Child Abuse & Neglect. 2011;35(8):647-654

Die deutsche Version des „Early Trauma Inventory” (ETI). Erste psychometrische Charakterisierung eines Interviews zur Erfassung traumatischer Lebensereignisse in der Kindheit und Jugend

Wingenfeld K, Driessen M, Mensebach C, et al. Die deutsche Version des „Early Trauma Inventory” (ETI). Erste psychometrische Charakterisierung eines Interviews zur Erfassung traumatischer Lebensereignisse in der Kindheit und Jugend. Diagnostica. 2011;57(1):27-38.Zusammenfassung. Für den deutschsprachigen Raum stehen derzeit kaum evaluierte Instrumente zur Erfassung traumatischer Ereignisse in der Kindheit und Jugend zur Verfügung. Während das strukturierte klinische Interview für DSM-IV das Vorliegen einer Traumatisierung in der Kindheit und Jugend mittels eines binären Items erfasst, wird mit dem „Early Trauma Inventory” (ETI; Bremner, Vermetten & Mazure, 2000 ) ein breites Spektrum traumatischer Ereignisse erhoben. Beim ETI handelt es sich um ein halbstandardisiertes klinisches Interview mit den Skalen „Emotionale Erfahrungen”, „Erzieherische/Körperliche Bestrafung”, „Sexuelle Erlebnisse” und „Generelle Traumata”. An einer Stichprobe von 230 Probanden wurden die Reliabilität und Validität der deutschen Übersetzung überprüft. Es konnten gute Reliabilitätskoeffizienten gefunden werden sowie hohe bis moderate Korrelationen zwischen dem ETI und einem Fragebogen zur Erfassung traumatischer Erfahrungen in der Kindheit (CTQ). Niedrigere Korrelationskoeffizienten fanden sich zwischen dem ETI und entfernt assoziierten Konstrukten, wie z.B. Depressivität. Insgesamt sprechen die Ergebnisse für eine zufriedenstellende psychometrische Qualität des ETI

Attentional Bias to Personally Relevant Words in Borderline Personality Disorder is Strongly Related to Comorbid Posttraumatic Stress Disorder

Wingenfeld K, Mensebach C, Rullkoetter N, et al. Attentional Bias to Personally Relevant Words in Borderline Personality Disorder is Strongly Related to Comorbid Posttraumatic Stress Disorder. Journal of Personality Disorders. 2009;23(2):141-155.Current research indicates altered inhibitory functioning in borderline personality disorder (BPD). The emotional stroop task is a widely used method for investigating inhibition of interference. In the present study we used an individualized version of the emotional stroop task to investigate inhibitory functioning in BPD with respect not only to valence but also to personal relevance of the stimuli. Thirty-one BPD patients and 49 healthy controls performed the individual emotional stroop task that consisted of (1) words related to personal negative life events that were currently relevant (2) words related to personal negative life events that were not currently relevant, (3) negative words that were not personally relevant, and (4) neutral words. BPD patients showed greater interference only for words related to personal negative life events with current relevance. A comparison between BPD patients with and without posttraumatic stress disorder (PTSD) revealed reduced inhibitory functioning only in BPD patients with PTSD. Inhibition of interference in BPD patients seems not to be altered in general but is exclusively disturbed in those with comorbid PTSD when highly relevant personal factors are the focus of attention

Neural correlates of the individual emotional Stroop in borderline personality disorder

Wingenfeld K, Rullkoetter N, Mensebach C, et al. Neural correlates of the individual emotional Stroop in borderline personality disorder. PSYCHONEUROENDOCRINOLOGY. 2009;34(4):571-586.Objective: Emotional dysregulation is a key feature of borderline personality disorder (BPD) with altered inhibitory functions having suggested as being crucial. The anterior cingulate cortex and further prefrontal brain regions are crucial for response inhibition. The regulation of emotions is ensured via inhibitory control over the amygdala. The present study aimed to investigate neural correlates of response inhibition in BPD by using an emotional Stroop paradigm extending the task to word stimuli which were related to stressful life events. Methods: Twenty BPD patients and 20 healthy controls underwent functional magnetic resonance imaging (fMRI) while performing the individual emotional Stroop task. A block design was used with the following word type conditions: neutral words, general negative words, and individual negative words. The individual negative words were recruited from a prior interview conducted with each participant. Results: While BPD patients had overall slower reaction times in the Stroop task compared to healthy controls, there was no increased slowing with emotional interference. Controls exhibited significant fMRI blood oxygenation level-dependent signal increases in the anterior cingulate cortex as welt as in frontal cortex contrasting generally negative vs. neutral and individual negative vs. neutral conditions, respectively. BPD patients did not show equivalent signal changes. Conclusions: These results provide further evidence for a dysfunctional network of brain areas in BPD, including the ACC and frontal brain regions. These areas are crucial for the regulation of stress and emotions, the core problems of BPD patients. (C) 2008 Elsevier Ltd. All rights reserved