http://community.victoriaadvocate.com/home/Blog/Crobar/6133 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 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 en-us One might argue that personality disorders are a luxury of a first world nation. In society's that live more hand to mouth these idiosyncrasy's may well manifest themselves but the afflicted so consumed by survival will not display these traits for fear of genuine punishment by the social group. Also many of these traits run contrary to norms . Abandonment might stems from independent thought such as a desire not to pledge an oath or other social expectation punished by virtual or actual abandonment. It is conceivable that these characteristics have a coinciding biological home base- is it fair to say that this bundling of neurons are in fact the etiology of the personality manifestation or these traits more maladaptive coping with actual environmental stresses ? If I was a Japanese American after Pearl Harbor and my community came and seized me days after we had socialized as a community it would not be out of the realm of possibility that I would manifest many of these symptoms as maladaptive coping to a very real scenario. The although interesting factor would be how could one do a compare and contrast of a persons neurological mapping to determine if the biology caused the maladaptive behaviors or did the circumstances cause the biology to change much like new nuropathways manifesting themselves after a stroke in an attempt to restore some level of functioning ? http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30314 http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30314 One might argue that personality disorders are a luxury of a first world nation. In society's that live more hand to mouth these idiosyncrasy's may well manifest themselves but the afflicted so consumed by survival will not display these traits for fear of genuine punishment by the social group. Also many of these traits run contrary to norms . Abandonment might stems from independent thought such as a desire not to pledge an oath or other social expectation punished by virtual or actual abandonment. It is conceivable that these characteristics have a coinciding biological home base- is it fair to say that this bundling of neurons are in fact the etiology of the personality manifestation or these traits more maladaptive coping with actual environmental stresses ? If I was a Japanese American after Pearl Harbor and my community came and seized me days after we had socialized as a community it would not be out of the realm of possibility that I would manifest many of these symptoms as maladaptive coping to a very real scenario. The although interesting factor would be how could one do a compare and contrast of a persons neurological mapping to determine if the biology caused the maladaptive behaviors or did the circumstances cause the biology to change much like new nuropathways manifesting themselves after a stroke in an attempt to restore some level of functioning ? It occurred to me that it sounded like Borderline might be related to ADHD - while people with ADHD "miss" social cues coming from others, Borderlines seem to misinterpret the cues and overreact.  New research also seems to indicate that people with ADHD have a slower maturing brain - that might also related to this new Borderline information as well, since most Borderlines "grow out of it" by about age 30 and many children with ADHD grow out of it as their brains reach maturity, about 5 years after non-ADHD people.  Very interesting stuff....thanx. http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30325 http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30325 It occurred to me that it sounded like Borderline might be related to ADHD - while people with ADHD "miss" social cues coming from others, Borderlines seem to misinterpret the cues and overreact.  New research also seems to indicate that people with ADHD have a slower maturing brain - that might also related to this new Borderline information as well, since most Borderlines "grow out of it" by about age 30 and many children with ADHD grow out of it as their brains reach maturity, about 5 years after non-ADHD people.  Very interesting stuff....thanx. Sounds to me like you were talking about RMHOLY http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30418 http://community.victoriaadvocate.com/home/Blog/Crobar/6133/#c_30418 Sounds to me like you were talking about RMHOLY