A new light on the brains of people with borderline personality disorder
August 7th, 2008In a game of give and get, the brains of people with borderline personality disorder often don't get it.
In fact, an interactive economic game played between two people in functional magnetic resonance imaging (fMRI) devices revealed a brain malfunction associated with the disorder, a serious but common mental illness that affects a person's perceptions of the world and other people, said researchers from Baylor College of Medicine in a report that appears in the current issue of the journal Science.
"This may be the first time a physical signature for a personality disorder has been identified," said Dr. P. Read Montague, professor of neuroscience at Baylor College of Medicine and director of the BCM Brown Foundation Human Neuroimaging Laboratory.
In the study, directed by Dr. Brooks King-Casas, assistant professor of neuroscience and psychiatry and behavioral sciences at BCM and a member of the College's new Computational Psychiatry Unit, 55 people with borderline personality disorder played a "trust" game with 55 normal people of the same age and social and educational status.
In the game, one player called an investor sends $20 to the other called a trustee. The investment is tripled, and the trustee splits the profits with the investor. The trustee decides how much to send back, thus determining whether the investor recoups a profit or not. Profit requires cooperation between trustee and investor.
Both investor and trustee play the game while their brains are scanned by functional MRI devices through use of software called hyperscanning. The fMRI shows areas of blood flow in parts of the brain during the interaction between two people.
In this study, activity in an area of the brain called the anterior insula, known to respond when "norms" are violated, showed up on the scans. In the normal people, the anterior insula showed activity that responded in direct proportion to the amount of money sent and the money received. However, in people with borderline personality disorder, that part of the brain responded only to sending the money – not to the money received.
The scan casts a new light on the neurobiology of borderline personality disorder, said King-Casas, the study's lead author. Some day, he said, it could be used as a diagnostic tool or even a way to determine the effectiveness of a treatment.
"For the first time, to my knowledge, we have a specific brain association for people with a personality disorder," said Dr. Stuart Yudofsky, chair of the Menninger Department of Psychiatry and Behavioral Sciences at BCM. "It's new and different because it's not a lesion (or injury to the brain) but it is a difference in perceiving information that comes from an interaction." That is the area where people with borderline personality disorder have the most problem.
People with borderline personality disorder suffer from an inability to understand the actions of others. They frequently have unstable relationships, fly into rages inappropriately, or become depressed and cannot trust the actions and motives of other people.
"It's important that this biological signature has been identified," said King-Casas. "It's not just a matter of bad attitudes or a lack of will."
Yudofsky agrees that the finding my help eliminate the stigma associated with such disorders. The finding will help in three areas:
-- Diagnosis by giving a biologic measure that can be used to determine if a person has the problem.
-- Treatment using this brain-based difference to devise cognitive interventions or even medications that will affect the brain reactions.
-- Monitoring the effectiveness of treatment by determining how the brain's dysfunctional responses to the input from others change with treatment.
"We have great strength in the area of personality disorders through our relationship with The Menninger Clinic," said Yudofsky.
Source: Baylor College of Medicine
Jun 11, 2009 |
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Can't we move on from the 1900s?
If fMRI is able to follow thought patterns and it is known that certain individual acts differently in certain setting then others then it is not surprising that fMRI scans are different, but it doesn't prove whether it's due to an inborn illness, poor upbringing or conscious choice.
I'm not saying that the condition isn't real, only that these results can't prove it is to those who think otherwise.
I have the benefit (if you will) of relating with someone clinically diagnosed with BPD and she has a good heart, tremendous will, but repeatedly demonstrates anti-social behavior (primarily in disrespect for the boundaries of others.) It kills her (almost literally) that she's unable to discern what "normal" people would say are obvious social boundaries. She simply cannot do it and ends up ruining relationships as a result.
People like jburchel have probably been on the receiving end of people like her, so his disdain may be understandable, although juvenile.
Yes they can have tremendous mood swings and one moment quite high and then into self harm or suicidal behaviour. They do seem to see the world very differently to the majority of people. They struggle with everyday things, which most of us will take for granted.
But then who's to say if their perception is really wrong or just different. I know who I would rather spend time with if the choice was between someone with BPD or jburchel.
Those BPD's I know are non-judgemental and child-like.
I still have a lot to learn...maybe Im responding because it upset me to see that other people have horrible things like that to say about BPD, but Im also interested in this new discovery and options for treatment. I also feel confused and I am looking for some feedback if anyone has any advice or opinions. Thanks!
I read what you had to say about yourself. I am sorry for you. But, believe me, when you could assess to this extent about yourself, it's just a matter of time before you get out of that problem. Its only with those who just cannot be convinced ... they are problem for themselves and others. I am very familiar with a person who has BPD (in my assessment - not confirmed by doctors, because she could not be convinced that she has a problem). She smells different when she goes into that "rage". I am not sure if some chemical secretes more when she gets into the "rage". May be my observation will help someone doing research to cure this problem.
Find a therapist who specializes in BPD (or Emotionally Unstable Personality Disorder of Borderline Type.)
They are hard to find, because, frankly, it's a very difficult field.
But if you are lucky enough to find someone you can gain a lot.
As TruthSeeker suggests, your awareness of your differences is a huge advantage over others who deny or cannot perceive any differences.
Take care.