Borderline Personality Disorder -
Raising questions, finding answers
(continued)
NIMH-funded neuroscience research is revealing brain mechanisms underlying
the impulsivity, mood instability, aggression, anger, and negative emotion
seen in BPD. Studies suggest that people predisposed to impulsive aggression
have impaired regulation of the neural circuits that modulate emotion. (10)
The amygdala, a small almond-shaped structure deep inside the brain, is an
important component of the circuit that regulates negative emotion. In
response to signals from other brain centers indicating a perceived threat,
it marshals fear and arousal. This might be more pronounced under the
influence of drugs like alcohol, or stress. Areas in the front of the brain
(pre-frontal area) act to dampen the activity of this circuit. Recent brain
imaging studies show that individual differences in the ability to activate
regions of the prefrontal cerebral cortex thought to be involved in
inhibitory activity predict the ability to suppress negative emotion
Serotonin, norepinephrine and acetylcholine are among the chemical
messengers in these circuits that play a role in the regulation of emotions,
including sadness, anger, anxiety, and irritability.
Drugs that enhance brain serotonin function may improve emotional symptoms
in BPD. Likewise, mood-stabilizing drugs that are known to enhance the
activity of GABA, the brain's major inhibitory neurotransmitter, may help
people who experience BPD-like mood swings. Such brain-based vulnerabilities
can be managed with help from behavioral interventions and medications, much
like people manage susceptibility to diabetes or high blood pressure
Future Progress
Studies that translate basic findings about the neural basis of temperament,
mood regulation, and cognition into clinically relevant insights—which bear
directly on BPD—represent a growing area of NIMH-supported research.
Research is also underway to test the efficacy of combining medications with
behavioral treatments like DBT, and gauging the effect of childhood abuse
and other stress in BPD on brain hormones. Data from the first prospective,
longitudinal study of BPD, which began in the early 1990s, is expected to
reveal how treatment affects the course of the illness. It will also
pinpoint specific environmental factors and personality traits that predict
a more favorable outcome. The Institute is also collaborating with a private
foundation to help attract new researchers to develop a better understanding
and better treatment for BPD.
For More Information
Please visit the following link for more information about organizations
that focus on borderline personality disorder.
All material in this fact sheet is in the public domain and may be copied or
reproduced without permission from the Institute. Citation of the source is
appreciated.
NIH Publication No. 01-4928
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