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10b - Integrating Neuroscience and Psychotherapy: Commentary on Borderline Personality Disorder

from Part III - Individual Disorders and Clusters

Published online by Cambridge University Press:  24 February 2020

By
Inga Niedtfeld ,
Christian Paret  and
Christian Schmahl
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
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Summary

This commentary gives an overview of two types of interaction between neuroscience and psychotherapy in BPD and beyond. First, neuroscientific research, particularly neuroimaging, can be used to better understand the mechanisms how successful psychotherapy exerts its effects. Since emotion dysregulation is one of the core features of BPD and the main target of Dialectical Behavior Therapy (DBT), neuroimaging studies have investigated emotional hyperreactivity and dysfunctional regulation before and after DBT. These studies found normalization of limbic hyper-reactivity as well as a decrease of dysfunctional pain-induced emotion regulation, which is assumed to underly self-injurious behavior. A second line of research tries to use neuroimaging in the development of new therapeutic approaches such as real-time fMRI neurofeedback. Preliminary studies revealed rapid normalization of amygdala hyperreactivity and restoration of the connectivity between amygdala and medial prefrontal cortex. This was accompanied by reductions of BPD symptomatology, affective instability, and startle response. With these new approaches, there is hope to better understand mechanisms of change in BPD treatment as well as to develop innovative therapy approaches for severe emotion dysregulation.

Keywords

neuroimagingemotion regulationamygdalaprefrontal cortexreal-time fMRIneurofeedbackDialectical Behavior Therapy
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 246 - 248
Publisher: Cambridge University Press
Print publication year: 2020

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