Hypersensitivity to Social Threat, Anger, and Aggression in BPD
Final Report Abstract
Within two funding periods we have identified important biological and psychological mediators of reactive aggression in borderline personality disorder (BPD). These proposed biobehavioral mechanisms could be published and have been targeted in a randomized-controlled clinical study. In particular, the results of the first funding period indicate that a heightened sensitivity for interpersonal threat related with increase early, visual but reduced structural and categorical processing, a tendency to approach rather than avoid interpersonal threats related to decreased lateral prefrontal-amygdala functional coupling, as well as deficient anger regulation related to prefrontal-amygdala imbalance could be important mechanisms for aggression in BPD. Furthermore, increased baseline testosterone and cortisol awakening responses might be endocrine correlates of aggression. Therefore, a 6-week group therapy which targets these as well as further mechanisms suggested by the literature (emotional contagion and reduced cognitive theory of mind) was tested against a non-specific supportive psychotherapy. The project has already resulted in a list of publications, several doctoral theses, and a habilitation. Further analyses are still ongoing. Importantly, the RCT has been almost completed with final follow-up measures.
Publications
- (2014). Impairments of interpersonal functioning: Empathy and intimacy in borderline personality disorder. Psychopathology, 47(4), 220-234
Jeung, H., & Herpertz, S. C.
(See online at https://doi.org/10.1159/000357191) - (2014). Social dysfunctioning and brain in borderline personality disorder. Psychopathology, 47(6), 417-424
Herpertz, S. C., Jeung, J., Mancke, F., & Bertsch, K.
(See online at https://doi.org/10.1159/000365106) - (2014). The social-cognitive basis of personality disorders. Current Opinion in Psychiatry, 27(1), 73-77
Herpertz, S. C., & Bertsch, K.
(See online at https://doi.org/10.1097/YCO.0000000000000026) - (2015). Aggression in borderline personality disorder: A multidimensional model. Personality Disorders: Theory, Research, and Treatment, 6(3), 278-291
Mancke, F., Herpertz, S. C., & Bertsch, K.
(See online at https://doi.org/10.1037/per0000098) - (2015). Gender differences in aggression of borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 2(1), 7
Mancke, F., Bertsch, K., & Herpertz, S. C.
(See online at https://doi.org/10.1186/s40479-015-0028-7) - (2016). Time course of facial emotion processing in women with borderline personality disorder: An ERP study. Journal of Psychiatry & Neuroscience: JPN, 41(1), 16-26
Hidalgo, N. A. I., Oelkers-Ax, R., Nagy, K., Mancke, F., Bohus, M., Herpertz, S. C., & Bertsch, K.
(See online at https://doi.org/10.1503/jpn.140215) - (2017). Brain mechanisms underlying reactive aggression in borderline personality disorder - Sex matters. Biological Psychiatry, 82(4), 257-266
Herpertz, S. C., Nagy, K., Ueltzhöffer, K., Schmitt, R., Mancke, F., Schmahl, C., & Bertsch, K.
(See online at https://doi.org/10.1016/j.biopsych.2017.02.1175) - (2017). Emotion dysregulation and trait anger sequentially mediate the association between borderline personality disorder and aggression. Journal of Personality Disorders, 31(2), 256-272
Mancke, F., Herpertz, S. C., Kleindienst, N., & Bertsch, K.
(See online at https://doi.org/10.1521/pedi_2016_30_247) - (2018). Borderline personality disorder. Nature Reviews Disease Primers, 4, 18029
Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S., & Zanarini, M. C.
(See online at https://doi.org/10.1038/nrdp.2018.29) - (2018). Correlates of aggression in personality disorder: An update. Current Psychiatry Reports, 20(8), 53
Mancke, F., Herpertz, S. C., & Bertsch, K.
(See online at https://doi.org/10.1007/s11920-018-0929-4) - (2018). Heightened salience of anger and aggression in female adolescents with borderline personality disorder—A script-based fMRI study. Frontiers in Behavioral Neuroscience, 12(57)
Krauch, M., Ueltzhöffer, K., Brunner, R., Kaess, M., Hensel, S., Herpertz, S. C., & Bertsch, K.
(See online at https://doi.org/10.3389/fnbeh.2018.00057) - (2018). Neural correlates of emotional action control in anger-prone women with borderline personality disorder. Journal of Psychiatry & Neuroscience: JPN, 43(3), 161-170
Bertsch, K., Roelofs, K., Roch, P. J., Ma, B., Hensel, S., Herpertz, S. C., & Volman, I.
(See online at https://doi.org/10.1503/jpn.170102) - (2018). Neurobiological mechanisms mediating emotion dysregulation as targets of change in borderline personality disorder. Psychopathology, 51(2), 96-104
Herpertz, S. C., Schneider, I., Schmahl, C., & Bertsch, K.
(See online at https://doi.org/10.1159/000488357) - (2018). Neurobiology of Criterion A: self and interpersonal personality functioning. Current Opinion in Psychology, 21, 23-27
Herpertz, S. C., Bertsch, K., & Jeung, H.
(See online at https://doi.org/10.1016/j.copsyc.2017.08.032) - (2018). Out of control? Acting out anger is associated with deficient prefrontal emotional action control in male patients with borderline personality disorder. Neuropharmacology
Bertsch, K., Krauch, M., Roelofs, K., Cackowski, S., Herpertz, S. C., & Volman, I.
(See online at https://doi.org/10.1016/j.neuropharm.2018.12.010) - (2018). Remnants and changes in facial emotion processing in women with remitted borderline personality disorder: An EEG study. European Archives of Psychiatry and Clinical Neuroscience, 268(4), 429-439
Schneider, I., Bertsch, K., Hidalgo, N. A. I., Müller, L. E., Schmahl, C., & Herpertz, S. C.
(See online at https://doi.org/10.1007/s00406-017-0841-7) - (2019). Whole-brain functional connectivity during script-driven aggression in borderline personality disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 93, 46-54
Ueltzhöffer, K., Herpertz, S. C., Krauch, M., Schmahl, C., & Bertsch, K.
(See online at https://doi.org/10.1016/j.pnpbp.2019.03.004)
