St Andrew's Academic Centre, St Andrew's, Cliftonville, Northampton, NN1 5DW, UK.
Neuropsychol Rev. 2014 Jun;24(2):166-84. doi: 10.1007/s11065-014-9254-9. Epub 2014 Feb 27.
A body of work has developed over the last 20 years that explores facial emotion perception in Borderline Personality Disorder (BPD). We identified 25 behavioural and functional imaging studies that tested facial emotion processing differences between patients with BPD and healthy controls through a database literature search. Despite methodological differences there is consistent evidence supporting a negative response bias to neutral and ambiguous facial expressions in patients. Findings for negative emotions are mixed with evidence from individual studies of an enhanced sensitivity to fearful expressions and impaired facial emotion recognition of disgust, while meta-analysis revealed no significant recognition impairments between BPD and healthy controls for any negative emotion. Mentalizing studies indicate that BPD patients are accurate at attributing mental states to complex social stimuli. Functional neuroimaging data suggest that the underlying neural substrate involves hyperactivation in the amygdala to affective facial stimuli, and altered activation in the anterior cingulate, inferior frontal gyrus and the superior temporal sulcus particularly during social emotion processing tasks. Future studies must address methodological inconsistencies, particularly variations in patients' key clinical characteristics and in the testing paradigms deployed.
在过去的 20 年中，已经有大量的研究探讨了边缘型人格障碍（BPD）中的面部情绪感知。我们通过数据库文献检索，确定了 25 项行为和功能影像学研究，这些研究测试了 BPD 患者与健康对照组之间的面部情绪处理差异。尽管存在方法学差异，但有一致的证据支持患者对中性和模糊面部表情的负面反应偏见。对于负面情绪的研究结果喜忧参半，有个别研究表明，患者对恐惧表情的敏感性增强，对厌恶表情的面部识别受损，而荟萃分析显示，BPD 患者与健康对照组在任何负面情绪的识别上均无显著差异。心理化研究表明，BPD 患者能够准确地将心理状态归因于复杂的社会刺激。功能神经影像学数据表明，潜在的神经基础涉及到杏仁核对情感面部刺激的过度激活，以及在前扣带、下额前回和颞上回的激活改变，特别是在社会情绪处理任务中。未来的研究必须解决方法学上的不一致性，特别是患者关键临床特征和所采用的测试范式的变化。
