Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine.
Department of Psychology, The Pennsylvania State University.
Personal Disord. 2014 Apr;5(2):178-85. doi: 10.1037/per0000032. Epub 2013 Dec 23.
Borderline personality disorder (BPD) and major depressive disorder (MDD) share numerous features, including dysphoric affect, irritability, suicidality, and a heightened sensitivity to perceived interpersonal rejection. However, these disorders are associated with divergent profiles of reactivity to rejection: Individuals with MDD are more likely to respond with withdrawal and isolation, and those with BPD appear to respond with increased approach behaviors and greater hostility. Potential mechanisms underlying these divergent patterns of response have not been elaborated. The goal of the present study was to assess whether prefrontal cortical asymmetry is associated with these behavioral profiles. EEG alpha activity was recorded at baseline and after individuals with BPD, MDD and healthy controls (HCs) participated in a rejection task. Although no differences were found at baseline, results demonstrated that following rejection, individuals with BPD showed greater left cortical activation, consistent with approach motivation, whereas those with MDD showed greater right cortical activation, consistent with withdrawal motivation. HCs evidenced a more balanced cortical profile, as hypothesized. Although BPD and MDD are highly comorbid, are easily confused, and are phenomenologically similar in a number of ways, individuals with these two disorders respond in very different ways to perceived rejection.
边缘型人格障碍（BPD）和重度抑郁症（MDD）有许多共同的特征，包括情绪低落、易怒、自杀倾向和对感知到的人际拒绝的高度敏感。然而，这些疾病与对拒绝的反应存在不同的模式：患有 MDD 的人更可能表现出回避和孤立，而患有 BPD 的人似乎表现出更多的接近行为和更强的敌意。这些不同反应模式的潜在机制尚未详细阐述。本研究的目的是评估前额叶皮层不对称是否与这些行为模式有关。在边缘型人格障碍、重度抑郁症和健康对照组（HC）的个体参与拒绝任务之前和之后记录 EEG 阿尔法活动。尽管在基线时没有发现差异，但结果表明，在拒绝后，BPD 患者表现出更强的左侧皮质激活，与接近动机一致，而 MDD 患者表现出更强的右侧皮质激活，与回避动机一致。如假设所示，HC 表现出更平衡的皮质特征。尽管 BPD 和 MDD 高度共病，容易混淆，并且在许多方面表现出类似的症状，但这两种疾病的个体对感知到的拒绝反应方式非常不同。
