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Social and emotional processing in Borderline Personality Disorder
Social and emotional processing in Borderline Personality Disorder
James Cusack
Research Fellow in Psychiatry
University of Aberdeen
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My aims
• I would like to get your views on my research plans.
• To understand social and emotional processing in Borderline Personality Disorder.
• To understand the effect of psychotherapy on Borderline Personality Disorder.
Background
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Theory of mind
• The ability to understand the intentions, desires, emotions and beliefs of another individual.
• The Sally-Anne task
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The brain
Images from www.wellcomecollection.org
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The visual cortex
Images from www.wellcomecollection.org
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A face
Images from Nature Neuroscience, Vuilleumeier et al. (2003)
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Processing of faces
Images from www.wellcomecollection.org
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Emotional arousal
Images from www.wellcomecollection.org
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The amygdala
• Rapid response to emotional stimuli
• Emotional arousal
• Emotional learningImage From Frontiers in brain imaging methods, Hanson et al. (2012)
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A face
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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An emotional face
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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Which one excites the amygdala?
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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Introducing BPD
• Characterised by problems with emotional regulation
• We know that forming relationships is something which can present challenges
• Complex interaction between environmental and genetic factors
• The amygdala is important for emotional regulation
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Social cognition in BPD
• Increased sensitivity to facial expression in BPD?
• Yes
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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The amygdala in BPD
• Structurally smaller
• “Hypersensitive”
• “Highly vigilant”Image From Frontiers in brain imaging methods, Hanson et al. (2012)
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Theory of mind in BPD
• Performance on two tasks were studied in people with BPD.
Image from Psychiatry Research, Harai et al. (2010)
Sco
res
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Mirror Neurons
• Neurons which fire during the performance and observation of the same sensory action.
Image from Neuroscience and biobehavioral reviews Molenberghs et al. (2012)
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Mirroring and BPD
• Social development
• Simulation
• Imitation
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Research questions
• How well do people with BPD imitate (copy) the facial expression of others?
• Intensity of simulation process as a consequence of increased affective sensitivity?
• Would this lead to better empathy?
• Or is imitation something which presents challenges?
• How does imitation ability relate to other skills in BPD?
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Social cognition
1. Attend to salient emotion
2. Understand perspective of individual,
3. Regulation of emotion
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How does emotion regulation work?
• They amygdala and the prefrontal cortex
Amygdala
Dorsomedial prefrontal cortex
Ventromedial prefrontal cortex
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Emotional regulation in BPD
• Cortico-limbic disconnection model
• Sensitivity to facial expression
• Current evidence
• A risk factor?
• Cognitive reappraisal
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Performing theory of mind
1. Attend to salient emotion
2. Understand perspective of individual
3. Regulation of emotion
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Research questions
• How well do people with BPD imitate (copy) the facial expression of others?
• Intensity of simulation process as a consequence of increased affective sensitivity?
• Would this lead to better empathy?
• Or is imitation something which presents challenges?
• How does imitation ability relate to other skills in BPD?
• How do any difficulties with regulation relate to imitation?
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Mentalisation-based therapy
• Effective in the treatment of BPD
• Aims to help individual understand the mental states of others and themselves.
• How does this therapy work?
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Research questions
• How well do people with BPD imitate (copy) the facial expression of others?
• Does psychotherapy have an effect on the ability to imitate in BPD?
• What mechanisms does psychotherapy tap in to?
• Does psychotherapy improve imitative ability?
• What about emotional regulation?
Answering our research questions
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Aim: to develop a task to detect subtle deficits of facial imitation
• We need facial expressions that vary in a dimensional and meaningful way
• Morphing
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Blending Darwin’s six emotions
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Blending contrasting emotions in 3D ‘Face-Space’
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Facial imitation task?
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Data analysis?
• Manual rating
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Manual rating
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Data analysis?
• Manual rating
• Image processing and computer vision algorithms
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Facial imitation task?
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Methodological principles
• Quantitative measurements
• Reliably measure threshold of individual performance, not just group average
• Multiple comparison groups
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The plan
• We would like to recruit people with BPD and people who do not have BPD.
• We will compare performance on this task before and after psychotherapy.
• Other tasks.
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Outcome of this study
• Further understanding of mechanisms which underpin BPD and psychotherapy
• What parts of the brain are different in BPD?
• How can we help understand what leads to the difficulties experienced by people with BPD?
• Provide an explanation for BPD.
• How can we improve interventions?
• How can we aid identification of symptoms to ensure rapid treatment?
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Future research questions
• Psychophysiology
• Brain imaging
• Automated measures of face to face interaction – outcome measures
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Thanks
• Thank you to you all for your time
• Thank you to the psychiatry group for their comments
