Background: Understanding why individuals with borderline personality disorder (BPD) ruminate on prior provocations, despite its negative outcomes, is crucial to improving interventions. Provocation-focused rumination may be rewarding in the short term by amplifying anger and producing feelings of justification, validation, and increased energy, while reducing self-directed negative affect. If provocation-focused rumination is utilized regularly as a rewarding emotion regulation strategy, it could result in increased activation in reward-related neural regions. The present pilot study examined neural correlates of provocation-focused rumination, relative to other forms of thought, in BPD. Method: Functional magnetic resonance imaging (fMRI) was utilized to examine this theory in a pilot study of women diagnosed with BPD (n = 13) and healthy controls (n = 16). All participants received highly critical feedback on a previously written essay in the scanner, followed by prompts to engage in provocation-focused, self-focused, and neutral thought. Results: Whole-brain analyses showed that in response to the provocation, participants with BPD (compared to controls) demonstrated increased activation in the ventrolateral prefrontal cortex (PFC). BPD participants also showed greater activation in the dorsomedial PFC during provocation-focused rumination (relative to neutral-focus). Subsequent ROI analyses revealed that provocation-focused rumination (compared to neutral-focus) increased activation in the nucleus accumbens for the BPD group only. Conclusions: These findings, while preliminary due to the small sample size and limitations of the protocol, provide initial data consistent with the proposed neurobiological mechanism promoting provocation-focused rumination in BPD. Directions for further research are discussed.
|Journal||Borderline Personality Disorder and Emotion Dysregulation|
|State||Published - Jan 16 2018|
Bibliographical noteFunding Information:
This study was supported by a research support grant from the University of Kentucky. JRP is supported by a grant from the National Institute of Mental Health (T32MH019927), and ECW is supported by the National Center for Advancing Translational Sciences (KL2TR001109). The content is solely the responsibility of the authors and does not necessarily reflect the official views of the National Institutes of Health or the University of Kentucky. None of the funding bodies were involved in the design of the study, the collection, analysis, and interpretation of data, or in writing the manuscript.
© 2018 The Author(s).
- Borderline personality disorder
- Nucleus accumbens
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health
- Biological Psychiatry