Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany.
Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):429-439. doi: 10.1007/s00406-017-0841-7. Epub 2017 Sep 27.
According to longitudinal studies, most individuals with borderline personality disorder (BPD) achieve remission. Since BPD is characterized by disturbed emotion recognition, this study investigated behavioral and electrophysiological correlates of facial emotion classification and processing in remitted BPD. 32 women with remitted BPD (rBPD), 32 women with current BPD (cBPD), and 28 healthy women (HC) participated in an emotion classification paradigm comprising blends of angry and happy faces while behavioral and electroencephalographic (event-related potentials) data were recorded. rBPD demonstrated a convergence in behavior towards HC in terms of responses and reaction times. They evaluated maximally ambiguous faces more positively and exhibited faster reaction times when classifying predominantly happy faces compared to cBPD. Group × facial emotion interaction effects were found in early electrophysiological processes with post hoc tests indicating differences between rBPD and cBPD but not between rBPD and HC. However, BPD-like impairments were still found in rBPD in later processing (P300). Our results suggest a reduction in negativity bias in rBPD on the behavioral level and a normalization of earlier stages of facial processing on the neural level, while alterations in later, more cognitive processing do not remit. Early processing may be more state-like, while later impairments may be more trait-like. Further research may need to focus on these stable components.
根据纵向研究，大多数边缘型人格障碍（BPD）患者都能达到缓解。由于 BPD 的特征是情绪识别障碍，因此本研究调查了缓解期 BPD 患者在面部情绪分类和处理方面的行为和电生理相关性。32 名缓解期 BPD（rBPD）女性、32 名现患 BPD（cBPD）女性和 28 名健康女性（HC）参与了一个情绪分类范式，该范式包含愤怒和快乐混合的面孔，同时记录行为和脑电图（事件相关电位）数据。rBPD 在反应和反应时间方面表现出与 HC 趋同的行为。与 cBPD 相比，她们对最大程度的模糊面孔的评价更为积极，对主要为快乐面孔的分类反应时间更快。在早期的电生理过程中发现了组间×面部情绪的交互作用效应，事后检验表明 rBPD 和 cBPD 之间存在差异，但 rBPD 和 HC 之间不存在差异。然而，在 P300 等较晚的处理阶段仍发现 rBPD 存在 BPD 样损伤。我们的研究结果表明 rBPD 在行为水平上降低了消极偏见，在神经水平上正常化了面部处理的早期阶段，而较晚的、更多认知处理的改变并未缓解。早期处理可能更具状态性，而后期的损伤可能更具特质性。进一步的研究可能需要集中在这些稳定的成分上。
