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Psychiatry Res. 2015 Sep 30;233(3):339-51. doi: 10.1016/j.pscychresns.2015.05.018. Epub 2015 Jun 15.

Dissociation in borderline personality disorder: Disturbed cognitive and emotional inhibition and its neural correlates.

Author information

1
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany. Electronic address: Dorina.Winter@zi-mannheim.de.
2
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Institute of Psychology, Leiden University; Institute of Brain and Cognition, Leiden, the Netherlands.
3
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany.
4
Department of Psychology, Clinical and Health Psychology Centre, and Centre for Cognition and Brain Studies, The Chinese University of Hong Kong, Hong Kong.
5
Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
6
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Germany; Faculty of Health, University of Antwerp, Belgium.

Abstract

Evidence is heterogeneous regarding whether patients with borderline personality disorder (BPD) display disturbed emotional inhibition in the emotional Stroop task. Previous findings suggest that state dissociation may influence cognitive inhibition of task-irrelevant material, particularly with negative content. Our aim was to examine performance in an emotional Stroop task including negative, neutral, and positive words in BPD patients and healthy controls during functional magnetic resonance imaging. In advance, half of the BPD patients underwent a dissociation induction using script-driven imagery. BPD patients without dissociation induction showed behavioural performance comparable to that of healthy controls but displayed stronger neural responses, especially to positive stimuli, in the superior temporal gyrus, dorsomedial prefrontal cortex, and anterior cingulate cortex. BPD patients with dissociation induction showed overall slower and less accurate responses as well as increased reaction times for negative versus neutral words compared with BPD patients without dissociation induction. Moreover, they showed comparatively decreased neuronal activity in the fusiform gyrus and parietal cortices independent of valence, but elevated activity in the left inferior frontal gyrus in response to negative versus neutral words. In conclusion, experimentally induced dissociation in BPD was associated with inefficient cognitive inhibition, particularly of negative stimuli, in the emotional Stroop task.

KEYWORDS:

cognitive functioning; emotion; emotional Stroop task; executive functioning; memory; script-driven imagery; state dissociation

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