Neural correlates of fears of abandonment and rejection in borderline personality disorder

Liana Romaniuk (Lead / Corresponding author), Merrick Pope, Katie Nicol, John Steele, Jeremy Hall

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    Background: Borderline personality disorder (BPD) is a prevalent and disabling psychiatric condition commonly associated with early life adversity. Social difficulties are a prominent symptom of BPD, particularly a fear of abandonment and rejection. There has recently been a growing interest in the neural basis of these social symptoms and their relationship to early experience.

    Methods: In the current study, we examined social brain function and learning in BPD using functional MRI. Participants with BPD (n=20) and healthy controls (n=16) completed a computerized parametric social exclusion task (the “Cyberball” task). Brain activation was compared between groups and related to social symptom status and experiences of childhood trauma. Additional analyses were conducted using a reinforcement learning model treating social inclusion as a rewarding event.

    Results: Participants with BPD demonstrated a group effect of decreased right temporoparietal junction (TPJ) activation (p < 0.013, FWE-corrected). Increased fear of abandonment in BPD was associated with reduced inclusion-related activation of the inferior frontal gyrus (p = 0.003, FWE-corrected). Across all participants, TPJ inclusion-related activation was modified by prior experience of childhood physical neglect (p < 0.001, FWE-corrected). Reinforcement learning modelling revealed decreased midbrain responses to social inclusion in BPD participants (p = 0.028, FWE-corrected within midbrain mask), with decreased anticipatory midbrain activation in anticipation of social inclusion specifically associated with fears of abandonment (p = 0.019, FWE-corrected within a midbrain mask).

    Conclusions: The findings demonstrate alterations in social brain function and social reinforcement learning in BPD, which are influenced by both early life experience and symptom status.
    Original languageEnglish
    Pages (from-to)1-11
    Number of pages11
    JournalWellcome Open Research
    Issue number33
    Early online date29 Dec 2016
    Publication statusPublished - 29 Dec 2016


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