Enhanced processing of painful emotions in patients with borderline personality disorder

  • Previous research has demonstrated that patients with borderline personality disorder (BPD) are more sensitive to negative emotions and often show poor cognitive empathy, yet preserved or even superior emotional empathy. However, little is known about the neural correlates of empathy. Here, we examined empathy for pain in 20 patients with BPD and 19 healthy controls (HC) in a functional magnetic resonance imaging (fMRI) study, which comprised an empathy for pain paradigm showing facial emotions prior to hands exposed to painful stimuli. We found a selectively enhanced activation of the right supramarginal gyrus for painful hand pictures following painful facial expressions in BPD patients, and lower activation to nonpainful pictures following angry expressions. Patients with BPD showed less activation in the left supramarginal gyrus when viewing angry facial expressions compared to HC, independent of the pain condition. Moreover, we found differential activation of the left anterior insula, depending on the preceding facial expression exclusively in patients. The findings suggest that empathy for pain becomes selectively enhanced, depending on the emotional context information in patients with BPD. Another preliminary finding was an attenuated response to emotions in patients receiving psychotropic medication compared to unmedicated patients. These effects need to be replicated in larger samples. Together, increased activation during the observation of painful facial expressions seems to reflect emotional hypersensitivity in BPD.

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Metadaten
Author:Vera FlasbeckORCiDGND, Björn EnziGND, Martin BrüneORCiDGND
URN:urn:nbn:de:hbz:294-71953
DOI:https://doi.org/10.3389/fpsyt.2019.00357
Parent Title (English):Frontiers in psychiatry
Subtitle (English):a functional magnetic resonance imaging study
Publisher:Frontiers Media
Place of publication:Lausanne
Document Type:Article
Language:English
Date of Publication (online):2020/05/29
Date of first Publication:2019/05/27
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
anterior insula; borderline personality disorder; empathy for pain; functional magnetic resonance imaging; supramarginal gyrus
Volume:10
Issue:Artikel 357
First Page:357-1
Last Page:357-10
Note:
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:LWL-Universitätsklinikum Bochum, Klinik für Psychiatrie, Psychotherapie und Präventivmedizin
Dewey Decimal Classification:Philosophie und Psychologie / Psychologie
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International