A new study published in the American Journal of Psychiatry has given some insight into the biological underpinnings of BPD.  For those who do not know what BPD is, I'll go over it quickly.  BPD is characterized by "a pervasive pattern of instability of interpersonal realationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts (APA, 2000, pp. 706)*".  BPD can have difficult diagnostic considerations since some of the aspects of BPD also fit with other disorders such as schizotypal personality disorder and it often is co-morbid with another personality disorder.

For those who are curious, the DSM-IV-TR diagnostic criteria for BPD are as follows:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impuslivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the follow:

(1)  frantic efforts to avoid real or imagined abandonment.  NOTE: Do not include suicidal of self-mutilating behavior covered in Criterion 5.

(2)  a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

(3)  identity disturbance: markedly and persistently unstable self-image or sense of self

(4)  impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).  NOTE: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5)  recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6)  affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7)  chronic feelings of emptiness

(8)  inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physcial fights).

(9)  transient, stress-related paranoid ideation or severe dissociative symptoms.

Okay, still with me?  Good.  Within the criteria a pattern of inability for inhibition of emotions, especially negative ones, seems to be present.  This is explained in the paper by Silbersweig et al. as a dysfunction in key areas of the prefrontal cortex.

The prefrontal cortex, along with other tasks, performs what is called the "executive function" - it filters, so to speak the signals from other areas of the brain, especially the limbic system (the seat of our emotions).  Silbersweig et al found decreased activity in a portion of the PFC called the ventromedial prefrontal cortex.  This area has been associated with inhibition of emotional responses in particular situations that would normally elicit an emotional response.  In a group of BPD patients, the researchers found disinhibition in that area when compared to healthy controls.  They also say increased activity in limbic areas, especially the amygdala - the limbic structure associated with fear and aggression.

This study is important as it provides specific anatomical areas to focus on for further study and may lead to more effective treatments for those who suffer from this disorder.

* American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., Text Revision).  Washington, D.C.: American Psychiatric Association

I have my pole ready to put up in the living room, a long list of grievances to air and I've been working out in preparation for the feats of strength.  Yes folks, it's that time of year again, time for Festivus.  Time to shine that pole.

So...did ya know that there were two popular competing theories for vesicular recycling at neuronal synapses?  Well there are, you'll just have to take my word for it.  One of the popular theories and one which seemed logical to most was nicknamed the "kiss and run" theory.  It proposed that a vesicle would fuse with the membrane, release its contents and then reform and go on its merry way to be reused.  Well, along come a couple of scientific upstarts from the Weill Cornell Medical College to squash that theory.  They utilized fluorescence tagging to follow vesicles and watch them work in real time.  What they found was that the vesicles definitely didn't kiss and run.  The vesicles fused with the membrane then would breakdown.  They have to be rebuilt by enzymes in the cell to be used again.  The researchers published their findings in the latest issue of the Proceedings of the National Academy of Sciences (PNAS).

Now, when you're shining that pole and drink that nice cup of eggnog and it tastes so good, remember the poor vesicles.

Happy Holidays Folks.

Like half of the world's population, I have a MySpace account.  On MySpace, your friends can post "bulletins" about whatever they wish to talk about.  Many are "surveys" which people fill out - they answer questions about themselves so that anyone who reads it can know the person better.

Now, another large portion of the total bulletins posted there are chain bulletins.  They take the same form as chain e-mails - "repost this or <insert whatever improbable horrible event you can think of here>".  So people repost this bulletin without hesitation.  The same goes for chain e-mails...but why?

Chain e-mails play on people's superstition and our basic human ability to make causal inferences and connections between events real, perceived and imagined.  The other ingredient is fear.  Just maybe, just maybe if I don't repost this bulletin or send this e-mail to everyone I know my mother will die at midnight!  Is it possible?  In the realm of probability, yes.  Is it likely?  Not at all.  You'd probably be more likely to be hit by lightening, be in a car accident or even hit by a meteor than that event perfect correlating with you not reposting that bulletin or sending that e-mail.

Another aspect at work in this area is something called attributional error.  With the e-mail or bulletin working as something called a "primer" people will be more likely to attribute any "bad" event to their non-compliance of forwarding that e-mail.  It's truly just a common psychological phenomenon and objectively there cannot be shown any link between whatever event might occur and not posting some e-mail.

All it takes is a little high effort thinking, understanding of the psychological principles at work and realizing that you won't have a horrible love life for 10 years if you don't comment on my blog.