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Why people with borderline personality disorder cannot maintain interpersonal relationships?

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Posted August 28, 2015

Borderline personality disorder, commonly known as BPD, is a cluster-B personality disorder. People who suffer from BPD often have problems with impulsivity and instability of behaviours, self-image, and interpersonal relationships. However, up until now science did not understand why people with this mental illness have problems maintaining interpersonal relationships. But now scientists at the University of Georgia conducted a study and found that it may be due to lowered brain activity in regions important for empathy.

Friendship comes so naturally to most of us. However, people with borderline personality disorder have problems maintaining interpersonal relationships, because reduced activity in brain regions responsible for empathy. Image credit:  Mathias Klang via Wikimedia, CC BY 2.0

Friendship comes so naturally to most of us. However, people with borderline personality disorder have problems maintaining interpersonal relationships, because reduced activity in brain regions responsible for empathy. Image credit: Mathias Klang via Wikimedia, CC BY 2.0

BPD is also called emotionally unstable personality disorder or emotional intensity disorder, because it features extremely unstable moods. However, there are many mental illnesses that feature mood swings. But BPD sufferers also have problems maintaining interpersonal relationships. As now scientists found it is because people with BPD traits have reduced activity in brain regions that support empathy. It means that these people experience difficulties understanding and predicting feelings of others. Correlation is pretty much direct – the more BPD traits person has, the more difficult for him it is to understand feelings of other people. Of course, in order to gain this knowledge, scientists had to conduct an extensive study.

Team of researchers made a questionnaire, called the Five Factor Borderline Inventory, and gave it for more than 80 participants. This questionnaire was designed to determine the degree to which people participating in the study had various traits associated with borderline personality disorder. To measure brain activity in different regions, scientists used functional magnetic resonance imaging technology.

During this test participants were asked to do an empathetic processing task, which was related to their ability to understand the emotional states of other people, while their brain activity was measured. This task may look rather simple for ordinary people without such mental illnesses. Participants had to match the emotion of faces to a situation’s context. For a control, scientists included shapes, like squares and circles, which participants would have to match from emotion of the faces to the situation.

Researchers found that in the brain of the people with more BPD traits empathetic processes were not as easily activated. Scientists did not focus on people previously diagnosed with the disorder only. Instead they looked at those who scored high on the Five Factor Borderline Inventory questionnaire. This allowed them to get a more comprehensive understanding of the relationship between empathic processing, BPD traits and high levels of neuroticism and openness, as well as lower levels of agreeableness and conscientiousness.

Brian Haas, lead author of the study, said: “oftentimes, borderline personality disorder is considered a binary phenomenon. Either you have it or you don’t. But for our study, we conceptualized and measured it in a more continuous way such that individuals can vary along a continuum of no traits to very many BPD traits.”

This was a very novel way to look at the people with BPD, because usually they are diagnosed or not with the disorder. Up until now there were not any kinds of levels or amount of traits considered. This allowed for a broader perspective on the illness and enabled scientists to find a link between those with high borderline personality traits and a decreased use of neural activity in two parts of the brain.

These two brain areas – the temporoparietal junction and the superior temporal sulcus – are known to be extremely important in empathic processing. This study provided scientists with new knowledge about how people with BPD process emotions of others, but scientists are already looking forward to the next steps that study could take.

Now scientists have more information to explain why people suffering from borderline personality disorder have so many difficulties having successful friendships and romantic relationships. Problems maintaining interpersonal relationships are one of the reasons why BPD is considered to be one of the most severe and troubling personality disorders.

Now scientists are thinking how in the future they could analyse more realistic scenarios. For example, they would like to see how people with BPD traits would be able to read the emotional states of their partners. However, for now there is no information how this new knowledge may help people with BPD, but more information is always better than less.

Source: UGA

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