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9.11 - Borderline Personality Disorder

from 9 - Integrated Neurobiology of Specific Syndromes and Treatments

Published online by Cambridge University Press:  08 November 2023

By
Patrick Luyten ,
Peter Fonagy  and
Chloe Campbell
Edited by
Mary-Ellen Lynall ,
Peter B. Jones  and
Stephen M. Stahl
Mary-Ellen Lynall
Affiliation:
University of Cambridge
Peter B. Jones
Affiliation:
University of Cambridge
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

This chapter considers the neuroscience of borderline personality disorder, also known as emotionally unstable personality disorder, focusing on three domains: neuroendocrinological, structural and functional findings. Research in these areas is related to clinical understanding of borderline personality disorder as characterised by (a) emotional dysregulation, (b) impulsivity and (c) social dysfunction. In patients with borderline personality disorder, the hypothalamic–pituitary–adrenal (HPA) axis tends to show showing elevated continuous cortisol output and blunted cortisol following psychosocial challenges. The amygdala and hippocampus differ from healthy controls in terms of both reduced volume and measurable activity, and the dorsolateral prefrontal cortex tends to be less active. The neurobiology of borderline personality disorder can be characterised as a proneness to flooding by cortisol, with the amygdala working to heighten the affective meaning of stressful stimuli, and the prefrontal cortex underperforming in the task of downregulating emotional experience. The chapter also considers genetic findings in relation to borderline personality disorder.

Type
Chapter
Information
Cambridge Textbook of Neuroscience for Psychiatrists , pp. 477 - 483
Publisher: Cambridge University Press
Print publication year: 2023

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