An fMRI study of cognitive reappraisal in major depressive disorder and borderline personality disorder

Understanding borderline personality disorder: Clinical features, neurobiological insights, and therapeutic strategies

Borderline personality disorder (BPD) is a complex personality disorder characterised by immense emotional dysregulation, impulsivity, aggression and substantial interpersonal difficulties. This review begins with examining DSM-5-TR diagnostic clusters for BPD, highlighting the importance of accurate classification. It provides an in-depth analysis of BPD, starting with its epidemiology, diagnostic subtypes, core symptoms, and the challenges these symptoms pose for patients and their support networks. The review explores common co-occurring conditions, such as mood disorders, anxiety disorders, and other personality disorders, which frequently compound the effects of BPD and complicate its management. A detailed examination of BPD's neurobiological underpinnings is presented, focusing on structural and functional alterations in brain, aberrant connectivity, and neurotransmitter dysregulation, particularly within serotonin, dopamine, and glutamate pathways, being vital to understanding the effects of this disorder on impulsivity and emotional instability. Therapeutic strategies for BPD are also reviewed, encompassing psychotherapeutic methods like Dialectical Behavior Therapy (DBT) and other validated therapies, alongside pharmacological treatments that target mood stabilisation, impulsivity, and affective control through antidepressants, antipsychotics, and mood stabilisers. Neuromodulation techniques, such as neurofeedback and transcranial magnetic stimulation (TMS), are discussed for their potential to enhance cognitive and emotional control in BPD. The review closes with future directions, emphasizing the value of integrated, personalised treatment approaches to optimise outcomes for individuals with BPD and reduce the broader social and emotional impact of the disorder.

Abnormal resting-state brain networks and their relationship with cognitive reappraisal preferences in depressive tendencies

OBJECTIVE

Currently, the neural mechanisms underlying the topological changes in the brains of individuals with depressive tendencies and the decline in their emotion regulation abilities remain largely unknown. Therefore, this study investigates resting-state brain network characteristics in college students with depressive tendencies (DT) and their preference to cognitive reappraisal strategies.

METHOD

A group of 38 DT students and 41 healthy controls (HCs) were assessed using questionnaires on cognitive reappraisal sub-strategies, followed by alpha and beta frequency band EEG feature extraction.

RESULTS

Through complex network analysis, DT participants showed significantly reduced preferences for positive reappraisal and detached reappraisal compared to HCs, while exhibiting higher preferences for involved reappraisal and negative reappraisal. Additionally, abnormalities in brain network centrality were observed, particularly in the frontal and limbic lobes across various frequency bands. A significant correlation was found between the preference for cognitive reappraisal sub-strategies in DT participants and significant changes in graph indices.

CONCLUSIONS

The findings highlight substantial alterations in the resting-state brain networks of DT individuals, closely associated with cognitive reappraisal strategy preferences. These alterations may affect emotion regulation strategy choices, offering insights into the neural mechanisms of emotional regulation difficulties in DT.

Reduction of rejection-related emotions by transcranial direct current stimulation over right ventrolateral prefrontal cortex in borderline personality disorder: A double-blind randomized pilot study

AIMS

Borderline personality disorder (BPD) patients show negative emotional reactions to both excluding and including social scenarios, with levels normalizing only during extreme inclusion. Prior research among healthy individuals highlights the right ventrolateral prefrontal cortex (rVLPFC) role in regulating emotional responses to social exclusion, since transcranial direct current stimulation (tDCS) of rVLPFC decreases rejection-related emotions following social exclusion. This pilot study investigated whether, in BPD patients, tDCS over the rVLPFC reduces rejection-related emotions not only after social exclusion but also after fair social inclusion.

METHODS

Forty BPD patients randomly received either real or sham tDCS on rVLPFC before participating in the Cyberball paradigm, which involved phases of inclusion, exclusion, and over-inclusion. Participants self-reported their level of rejection-related emotions following each phase.

RESULTS

Transcranial direct current stimulation reduced rejection-related emotions during both social exclusion and fair inclusion, but not during over-inclusion. Specifically, those in the Real tDCS group exhibited comparable emotional responses to fair and over-including scenarios, unlike those in the Sham group who experienced heightened rejection-related emotions during fair inclusion compared to over-inclusion.

CONCLUSIONS

Transcranial direct current stimulation over the rVLPFC reduces BPD patients' tendency to feel rejected both in fairly including and excluding scenarios. These findings confirm the rVLPFC involvement in emotional regulation and highlight a therapeutic potential for tDCS in moderating BPD's typical heightened rejection-related emotional responses to fairly including scenarios. This study supports the application of tDCS in BPD treatment, providing new insights into neuromodulatory interventions that can aid BPD patients to better regulate their emotions during varying social scenarios.

Characterization of neural networks involved in transdiagnostic emotion dysregulation from a pilot randomized controlled trial of a neurostimulation-enhanced behavioral intervention

BACKGROUND

Emotional dysregulation is a serious and impairing mental health problem. We examined functional activity and connectivity of neural networks involved in emotional dysregulation at baseline and following a pilot neurostimulation-enhanced cognitive restructuring intervention in a transdiagnostic clinical adult sample.

METHODS

Neuroimaging data were analyzed from adults who scored 89 or higher on the Difficulties with Emotion Regulation (DERS) scale and had at least one DSM-5 diagnosis. These participants were part of a pilot randomized, double-blind, placebo-controlled trial combining a single therapeutic session of cognitive restructuring with active or sham transcranial magnetic stimulation over the dorsolateral prefrontal cortex. During the study, participants engaged in an emotional regulation task using personalized autobiographical stressors while undergoing functional magnetic resonance imaging (fMRI) before and after the pilot intervention. The fMRI task required participants to either experience the emotions associated with the memories or apply cognitive restructuring strategies to reduce their distress.

RESULTS

Whole-brain fMRI results during regulation at baseline revealed increased activation in the dorsal frontoparietal network but decreased activation in the supplementary motor area, cingulate cortex, insula, and ventrolateral prefrontal cortex (vlPFC). Emotion dysregulation was associated with greater vmPFC and amygdala activation and functional connectivity between these regions. The strength of functional connectivity between the dlPFC and other frontal regions was also a marker of emotional dysregulation. Preliminary findings from a subset of participants who completed the follow-up fMRI scan showed that active neurostimulation improved behavioral indices of emotion regulation more than sham stimulation. A whole-brain generalized psychophysiological interaction analysis indicated that active neurostimulation selectively increased occipital cortex connectivity with both the insula and the dlPFC. Region-of-interest functional connectivity analyses showed that active neurostimulation selectively increased dlPFC connectivity with the insula and orbitofrontal cortex (OFC).

CONCLUSION

Insufficient neural specificity during the emotion regulation process and over-involvement of frontal regions may be a marker of emotional dysregulation across disorders. OFC, vlPFC, insula activity, and connectivity are associated with improved emotion regulation in transdiagnostic adults. In this pilot study, active neurostimulation led to neural changes in the emotion regulation network after a single session; however, the intervention findings are preliminary, given the small sample size. These functional network properties can inform future neuroscience-driven interventions and larger-scale studies.

The deficit in cognitive reappraisal capacity in individuals with anxiety or depressive disorders: meta-analyses of behavioral and neuroimaging studies

BACKGROUND

The deficit in cognitive reappraisal capacity is a key factor in developing and maintaining emotional disorders such as anxiety disorders and depressive disorders. However, the results from both neuroimaging and behavioral studies are mixed. Therefore, we systematically conducted a series of meta-analyses based on behavioral and neuroimaging studies to clarify this issue.

METHODS

In behavioral meta-analyses, we used three-level random-effects models to summarize the overall effect sizes based on Hedges' g. In neuroimaging meta-analyses, we used SDM-PSI to summarize the brain activation patterns.

RESULTS

Behavioral meta-analyses found that individuals with anxiety disorders or depressive disorders could reduce negative reactivity through reappraisal; the reduction of negative emotions through reappraisal by individuals with anxiety disorders was similar to that by healthy individuals; the reduction by depressive disorders was lower than that of healthy individuals. Neuroimaging meta-analyses showed that individuals with anxiety disorders or depressive disorders activated regions of cognitive control during cognitive reappraisal; the activation in individuals with anxiety disorders was lower than in healthy individuals; while the activation in individuals with depressive disorders was similar to that in healthy individuals.

CONCLUSION

Individuals with anxiety and depressive disorders showed dissociation in behaviour and neuroimaging patterns of cognitive reappraisal capacity deficit.

Update on the Neurobiology of Borderline Personality Disorder: A Review of Structural, Resting-State and Task-Based Brain Imaging Studies

PURPOSE OF REVIEW

This review summarizes recent advances in research on the neurobiology of borderline personality disorder (BPD) according to structural brain imaging investigations and resting-state and task-based functional brain activation studies.

RECENT FINDINGS

Extending established findings on differences in regional brain volumes and cortical thickness between BPD and healthy controls, recent research illuminates shared and distinct brain structural characteristics compared to other psychiatric diagnoses, and uncovers relations of these brain structures with transdiagnostic symptoms and clinical features. Resting-state functional brain imaging studies reveal disruptions among adolescents and adults with BPD in frontolimbic and default-mode networks, which primarily underlie affect regulation and self-referential processes, respectively. Recent task-based functional brain imaging research builds on existing neurobiological understanding of emotion and cognition in BPD by revealing novel intersections with interpersonal- and stress-related processes. Studies of psychological and pharmacological interventions suggest possible effects on neural regions underlying emotion processing and behavioral control. Recent advances in neurobiological research on BPD underscore the pathophysiology of affective, behavioral and self-interpersonal symptoms, with growing interest in adolescents with BPD and the impacts of psychological and biological interventions. Corresponding with the increased prominence of alternative dimensional models of personality disorder in recent years, there is a gradual rise in studies examining the relationships of brain structures and functional brain activation with BPD-relevant symptom dimensions, including within transdiagnostic samples.

Altered neural activities during emotion regulation in depression: a meta-analysis

BACKGROUND

Deficient neural activities during emotion regulation have been reported in depression. We sought to conduct a meta-analysis to provide a comprehensive description of these neural alterations during use of emotion regulation strategies among patients with depression, including major depressive disorder (MDD) and bipolar disorder (BD).

METHODS

We identified neuroimaging studies of abnormal neural activities during emotion regulation in depression. We extracted the peak coordinates and effect sizes of differences in brain activity between patients and healthy controls. Using seed-based d mapping, we conducted voxel-wise meta-analyses of the neural activation pattern differences between the 2 groups across conditions involving emotion regulation and those where emotion regulation was not needed.

RESULTS

We included 33 studies reporting 34 data sets, including 23 involving MDD (571 people with MDD and 578 matched controls) and 11 involving BD (358 people with BD and 369 matched controls). Overall, compared with controls, patients with depression showed hyperactivity in the insula and postcentral gyrus, and hypoactivity in the prefrontal part of the inferior, middle, and superior frontal gyrus, the middle temporal gyrus, and the supplementary motor area. In subgroup analyses, data from patients with MDD and studies focused on decreasing negative emotions or using the emotional strategy of reappraisal reported specific hypoactivity in the middle cerebellar peduncles.

LIMITATIONS

Given limited studies involving patients with BD, we were unable to detect the common and distinct abnormalities in neural activation between MDD and BD. We did not conduct any meta-regression analyses because of limited information.

CONCLUSION

In this meta-analysis, we identified hyperactivity in brain regions associated with emotional experience and hypoactivity in brain regions associated with cognitive control during emotion regulation among patients with depression, relative to healthy controls. These findings could help indicate a target for future interventions aimed at increasing emotion regulation capacity for patients with depression.

Brain activity during reappraisal and associations with psychotherapy response in social anxiety and major depression: a randomized trial

BACKGROUND

Cognitive behavioral therapy (CBT) is an effective treatment for patients with social anxiety disorder (SAD) or major depressive disorder (MDD), yet there is variability in clinical improvement. Though prior research suggests pre-treatment engagement of brain regions supporting cognitive reappraisal (e.g. dorsolateral prefrontal cortex [dlPFC]) foretells CBT response in SAD, it remains unknown if this extends to MDD or is specific to CBT. The current study examined associations between pre-treatment neural activity during reappraisal and clinical improvement in patients with SAD or MDD following a trial of CBT or supportive therapy (ST), a common-factors comparator arm.

METHODS

Participants were 75 treatment-seeking patients with SAD (n = 34) or MDD (n = 41) randomized to CBT (n = 40) or ST (n = 35). Before randomization, patients completed a cognitive reappraisal task during functional magnetic resonance imaging. Additionally, patients completed clinician-administered symptom measures and a self-report cognitive reappraisal measure before treatment and every 2 weeks throughout treatment.

RESULTS

Results indicated that pre-treatment neural activity during reappraisal differentially predicted CBT and ST response. Specifically, greater trajectories of symptom improvement throughout treatment were associated with less ventrolateral prefrontal cortex (vlPFC) activity for CBT patients, but more vlPFC activity for ST patients. Also, less baseline dlPFC activity corresponded with greater trajectories of self-reported reappraisal improvement, regardless of treatment arm.

CONCLUSIONS

If replicated, findings suggest individual differences in brain response during reappraisal may be transdiagnostically associated with treatment-dependent improvement in symptom severity, but improvement in subjective reappraisal following psychotherapy, more broadly.

Childhood adversity modulates structural brain changes in borderline personality but not in major depression disorder

Adverse childhood experiences (ACEs) negatively affect the function and structure of emotion brain circuits, increasing the risk of various psychiatric disorders. It is unclear if ACEs show disorder specificity with respect to their effects on brain structure. We aimed to investigate whether the structural brain effects of ACEs differ between patients with major depression (MDD) and borderline personality disorder (BPD). These disorders share many symptoms but likely have different etiologies. To achieve our goal, we obtained structural 3T-MRI images from 20 healthy controls (HC), 19 MDD patients, and 18 BPD patients, and measured cortical thickness and subcortical gray matter volumes. We utilized the Adverse Childhood Experiences (ACE) questionnaire to quantify self-reported exposure to childhood trauma. Our findings suggest that individuals with MDD exhibit a smaller cortical thickness when compared to those with BPD. However, ACEs showed a significantly affected relationship with cortical thickness in BPD but not in MDD. ACEs were found to be associated with thinning in cortical regions involved in emotional behavior in BPD, whereas HC showed an opposite association. Our results suggest a potential mechanism of ACE effects on psychopathology involving changes in brain structure. These findings highlight the importance of early detection and intervention strategies.

Reduced frontocingulate theta connectivity during emotion regulation in major depressive disorder

BACKGROUND

Cognitive reappraisal is an essential emotion regulation skill for social life and psychological health. However, individuals with major depressive disorder (MDD) cannot use this skill effectively. Successful cognitive reappraisal in healthy controls (HC) has been shown to be associated with theta activity in a frontal and subcortical network. In the present study, we investigated whether MDD patients are characterized by altered theta power and connectivity pattern during cognitive reappraisal compared to HC.

METHODS

Using EEG and eLORETA, we examined both theta activity and connectivity when 25 controls and 24 patients with MDD were asked to complete the emotion cognitive reappraisal task of viewing neutral and negative pictures and reappraise negative pictures. Habitual use of emotion regulation skills was collected using the Cognitive Emotion Regulation Questionnaire (CERQ).

RESULTS

The results showed that MDD patients had (1) reduced theta activity in the left dorsolateral (dlPFC), dorsomedial prefrontal (dmPFC), and rostral-ventral cingulate cortices (rvACC), as well as (2) reduced dlPFC-rvACC theta connectivity than HC during reappraisal. In addition, left dlPFC-rvACC theta connectivity was positively correlated with self-reported cognitive reappraisal in HC. This relation was not observed in MDD. In contrast, CERQ revealed significantly greater use of inadequate regulations skills and significantly lower use of adaptive skills in MDD.

LIMITATION

Sample size, limited solution space to cortical grey matter excluding regions such as the amygdala.

CONCLUSION

This study may indicate a putative frontocingulate dysfunction leading either to an increased use of inadequate emotion regulation or a decreased use of skills that serve to boost positive emotion.

Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies

Borderline personality disorder (BPD) was introduced in the DSM-III in 1980. From the DSM-III to the DSM-5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self-image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self-mutilation behavior, and transient stress-related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi-structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self-mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in outpatient and 22% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various approaches have been empirically supported in randomized controlled trials, including dialectical behavior therapy, mentalization-based therapy, transference-focused therapy, and schema therapy. No approach has proved to be superior to others. Compared to treatment as usual, psychotherapy has proved to be more efficacious, with effect sizes between 0.50 and 0.65 with regard to core BPD symptom severity. However, almost half of the patients do not respond sufficiently to psychotherapy, and further research in this area is warranted. It is not clear whether some patients may benefit more from one psychotherapeutic approach than from others. No evidence is available consistently showing that any psychoactive medication is efficacious for the core features of BPD. For discrete and severe comorbid anxiety or depressive symptoms or psychotic-like features, pharmacotherapy may be useful. Early diagnosis and treatment of BPD can reduce individual suffering and societal costs. However, more high-quality studies are required, in both adolescents and adults. This review provides a comprehensive update of the BPD diagnosis and clinical characterization, risk factors, neurobiology, cognition, and management. It also discusses the current controversies concerning the disorder, and highlights the areas in which further research is needed.

Dynamic fronto-amygdalar interactions underlying emotion-regulation deficits in women at higher weight

OBJECTIVE

The regulation of negative emotions entails the modulation of subcortical regions, such as the amygdala, by prefrontal regions. There is preliminary evidence suggesting that individuals at higher weight may present with hypoactivity in prefrontal regulatory systems during emotional regulation, although the directionality of these pathways has not been tested. In this study, we compared fronto-amygdalar effective connectivity during cognitive reappraisal as a function of BMI in 48 adult women with obesity and 54 control participants.

METHODS

Dynamic causal modeling and parametric empirical Bayes were used to map effective connectivity between the dorsomedial prefrontal cortex, orbitofrontal cortex, dorsolateral prefrontal cortex, and the amygdala.

RESULTS

Difficulty in Emotion Regulation Scale scores were higher in the obesity group compared with control participants (p < 0.001). A top-down cortical model best explained our functional magnetic resonance imaging data (posterior probability = 86%). Participants at higher BMI were less effective at inhibiting activity in the amygdala via the orbitofrontal cortex and dorsomedial prefrontal cortex during reappraisal compared with those at lower BMI. In contrast, increased excitatory modulation of dorsolateral prefrontal cortex-to-amygdalar connectivity was found in participants at lower BMI.

CONCLUSIONS

These findings support a framework involving alterations in fronto-amygdalar connectivity contributing to difficulties in regulating negative affect in individuals at higher weight.

The plasticity of ChatGPT's mentalizing abilities: personalization for personality structures

This study evaluated the potential of ChatGPT, a large language model, to generate mentalizing-like abilities that are tailored to a specific personality structure and/or psychopathology. Mentalization is the ability to understand and interpret one's own and others' mental states, including thoughts, feelings, and intentions. Borderline Personality Disorder (BPD) and Schizoid Personality Disorder (SPD) are characterized by distinct patterns of emotional regulation. Individuals with BPD tend to experience intense and unstable emotions, while individuals with SPD tend to experience flattened or detached emotions. We used ChatGPT's free version 23.3 and assessed the extent to which its responses akin to emotional awareness (EA) were customized to the distinctive personality structure-character characterized by Borderline Personality Disorder (BPD) and Schizoid Personality Disorder (SPD), employing the Levels of Emotional Awareness Scale (LEAS). ChatGPT was able to accurately describe the emotional reactions of individuals with BPD as more intense, complex, and rich than those with SPD. This finding suggests that ChatGPT can generate mentalizing-like responses consistent with a range of psychopathologies in line with clinical and theoretical knowledge. However, the study also raises concerns regarding the potential for stigmas or biases related to mental diagnoses to impact the validity and usefulness of chatbot-based clinical interventions. We emphasize the need for the responsible development and deployment of chatbot-based interventions in mental health, which considers diverse theoretical frameworks.

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Background

Non-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations.

Methods

The current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants.

Results

Patients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression.

Conclusion

This study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.

Distinct patterns of functional brain network integration between treatment-resistant depression and non treatment-resistant depression: A resting-state functional magnetic resonance imaging study

BACKGROUND

Previous neuroimaging has paid little attention to the differences in brain network integration between patients with treatment-resistant depression(TRD) and non-TRD (nTRD), and the relationship between their impaired brain network integration and clinical symptoms has not been elucidated.

METHOD

Eighty one major depressive disorder (MDD) patients (40 in TRD, 41 in nTRD) and 40 healthy controls (HCs) were enrolled for the functional magnetic resonance imaging (fMRI) scans. A seed-based functional connectivity (FC) method was used to investigate the brain network abnormalities of default mode network (DMN), affective network (AN), salience network (SN) and cognitive control network (CCN) for the MDD. Finally, the correlation was analyzed between the abnormal FCs and 17-item Hamilton Rating Scale for Depression scale (HAMD-17) scores.

RESULTS

Compared with the HC group, the FCs in DMN, AN, SN, CCN were altered in both the TRD and nTRD groups. Compared with the nTRD group, FC alterations in the AN and CCN were more abnormal in the TRD group, and the FC alterations were generally decreased at the SN in the TRD group. In addition, the FC values of right dorsolateral prefrontal cortices and left caudate nucleus in the TRD group and the FC values of right subgenual anterior cingulate cortex and left middle temporal gyrus in the nTRD group were positively correlated with HAMD-17 scale scores.

CONCLUSIONS

Abnormal FCs are present in four brain networks (DMN, AN, SN, CCN) in both the TRD and nTRD groups. Except of DMN, FCs in AN, SN and CCN maybe underlay the neurobiological mechanism in differentiating TRD from nTRD.

Electrophysiological evidence for inhibition hypothesis of micro-expressions based on tensor component analysis and Physarum network algorithm

The inhibition hypothesis advocated by Ekman (1985) states when an emotion is concealed or masked, the true emotion is manifested as a micro-expression (ME) which is a fleeting expression lasting for 40 to 500 ms. However, research about the inhibition hypothesis of ME from the perspective of electrophysiology is lacking. Here, we report the electrophysiological evidence obtained from an electroencephalography (EEG) data analysis method. Specifically, we designed an ME elicitation paradigm to collect data of MEs of positive emotions and EEG from 70 subjects, and proposed a method based on tensor component analysis (TCA) combined with the Physarum network (PN) algorithm to characterize the spatial, temporal, and spectral signatures of dynamic EEG data of MEs. The proposed TCA-PN methods revealed two pathways involving dorsal and ventral streams in functional brain networks of MEs, which reflected the inhibition processing and emotion arousal of MEs. The results provide evidence for the inhibition hypothesis from an electrophysiological standpoint, which allows us to better understand the neural mechanism of MEs.

Borderline Personality Disorder: Updates in a Postpandemic World

Progress in understanding borderline personality disorder has unfolded in the last decade, landing in a new COVID-19-influenced world. Borderline personality disorder is now firmly established as a valid diagnosis, distinct from its co-occurring mood, anxiety, trauma-related, and behavioral disorders. Further, it is also understood as a reflection of general personality dysfunction, capturing essential features shared among all personality disorders. Neuroimaging research, representing the vast neurobiological advances made in the last decade, illustrates that the disorder shares frontolimbic dysfunction with many psychiatric diagnoses but has a distinct signature of interpersonal and emotional hypersensitivity. This signature is the conceptual basis of the psychotherapies and clinical management approaches proven effective for the disorder. Medications remain adjunctive and are contraindicated by some guidelines internationally. Less invasive brain-based therapeutics show promise. The most significant change in the treatment landscape is a focus on briefer, less intensive formats of generalist management. Shorter variants of therapies, such as dialectical behavior therapy and mentalization-based treatment, are in the process of being shown to be adequately effective. Earlier intervention and greater emphasis on functional improvement are needed to more effectively curb the disabilities and risks of borderline personality disorder for patients and their families. Remote interventions show promise in broadening access to care.

Oversampled and undersolved: Depressive rumination from an active inference perspective

Rumination is a widely recognized cognitive deviation in depression. Despite the recognition, researchers have struggled to explain why patients cannot disengage from the process, although it depresses their mood and fails to lead to effective problem-solving. We rethink rumination as repetitive but unsuccessful problem-solving attempts. Appealing to an active inference account, we suggest that adaptive problem-solving is based on the generation, evaluation, and performance of candidate policies that increase an organism's knowledge of its environment. We argue that the problem-solving process is distorted during rumination. Specifically, rumination is understood as engaging in excessive yet unsuccessful oversampling of policy candidates that do not resolve uncertainty. Because candidates are sampled from policies that were selected in states resembling one's current state, "bad" starting points (e.g., depressed mood, physical inactivity) make the problem-solving process vulnerable for generating a ruminative "halting problem". This problem leads to high opportunity costs, learned helplessness and diminished overt behavior. Besides reviewing evidence for the conceptual paths of this model, we discuss its neurophysiological correlates and point towards clinical implications.