Socialand
and emotional
emotional processing
processing in
Social
in
Borderline
Personality
Disorder
Borderline
Personality
Disorder
James Cusack
Research Fellow in Psychiatry
University of Aberdeen
www.abdn.ac.uk
My aims
• I would like to get your views on my research
plans.
• To understand social and emotional
processing in Borderline Personality
Disorder.
• To understand the effect of psychotherapy
on Borderline Personality Disorder.
www.abdn.ac.uk
Background
Theory of mind
• The ability to understand the intentions,
desires, emotions and beliefs of another
individual.
• The Sally-Anne task
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The brain
Images from www.wellcomecollection.org
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The visual cortex
Images from www.wellcomecollection.org
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A face
Images from Nature Neuroscience, Vuilleumeier et al. (2003)
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Processing of faces
Images from www.wellcomecollection.org
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Emotional arousal
Images from www.wellcomecollection.org
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The amygdala
• Rapid response to
emotional stimuli
• Emotional arousal
• Emotional learning
Image From Frontiers in brain imaging
methods, Hanson et al. (2012)
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A face
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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An emotional face
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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Which one excites the amygdala?
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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Introducing BPD
• Characterised by problems with emotional
regulation
• We know that forming relationships is
something which can present challenges
• Complex interaction between environmental
and genetic factors
• The amygdala is important for emotional
regulation
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Social cognition in BPD
• Increased sensitivity to facial expression in
BPD?
• Yes
Image from Nature Neuroscience, Vuilleumeier et al. (2003)
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The amygdala in BPD
• Structurally smaller
• “Hypersensitive”
• “Highly vigilant”
Image From Frontiers in brain imaging
methods, Hanson et al. (2012)
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Theory of mind in BPD
Scores
• Performance on two tasks were studied in
people with BPD.
Image from Psychiatry Research, Harai et al. (2010)
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Mirror Neurons
• Neurons which fire during the performance
and observation of the same sensory action.
Image from Neuroscience and biobehavioral reviews Molenberghs et al. (2012)
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Mirroring and BPD
• Social development
• Simulation
• Imitation
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Research questions
•
How well do people with BPD imitate (copy)
the facial expression of others?
• Intensity of simulation process as a consequence of increased
affective sensitivity?
• Would this lead to better empathy?
• Or is imitation something which presents challenges?
• How does imitation ability relate to other skills in BPD?
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Social cognition
1. Attend to salient emotion
2. Understand perspective of individual,
3. Regulation of emotion
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How does emotion regulation work?
• They amygdala and the prefrontal cortex
Dorsomedial
prefrontal cortex
Amygdala
Ventromedial
prefrontal cortex
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Emotional regulation in BPD
• Cortico-limbic
disconnection
model
• Sensitivity to facial
expression
• Current evidence
• A risk factor?
• Cognitive
reappraisal
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Performing theory of mind
1. Attend to salient emotion
2. Understand perspective of individual
3. Regulation of emotion
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Research questions
• How well do people with BPD imitate (copy)
the facial expression of others?
• Intensity of simulation process as a consequence of increased
affective sensitivity?
• Would this lead to better empathy?
• Or is imitation something which presents challenges?
• How does imitation ability relate to other skills in BPD?
• How do any difficulties with regulation relate to imitation?
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Mentalisation-based therapy
• Effective in the treatment of BPD
• Aims to help individual understand the
mental states of others and themselves.
• How does this therapy work?
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Research questions
• How well do people with BPD imitate (copy)
the facial expression of others?
• Does psychotherapy have an effect on the
ability to imitate in BPD?
• What mechanisms does psychotherapy tap in to?
• Does psychotherapy improve imitative ability?
• What about emotional regulation?
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Answering our research questions
Aim: to develop a task to detect subtle deficits
of facial imitation
• We need facial expressions that vary in a
dimensional and meaningful way
• Morphing
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Blending Darwin’s six emotions
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Blending contrasting emotions in 3D ‘Face-Space’
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Facial imitation task?
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Data analysis?
• Manual rating
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Manual rating
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Data analysis?
• Manual rating
• Image processing and computer vision
algorithms
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Facial imitation task?
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Methodological principles
• Quantitative measurements
• Reliably measure threshold of individual
performance, not just group average
• Multiple comparison groups
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The plan
• We would like to recruit people with BPD and
people who do not have BPD.
• We will compare performance on this task
before and after psychotherapy.
• Other tasks.
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Outcome of this study
• Further understanding of mechanisms which
underpin BPD and psychotherapy
• What parts of the brain are different in BPD?
• How can we help understand what leads to the difficulties
experienced by people with BPD?
• Provide an explanation for BPD.
• How can we improve interventions?
• How can we aid identification of symptoms to ensure rapid
treatment?
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Future research questions
• Psychophysiology
• Brain imaging
• Automated measures of face to face
interaction – outcome measures
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Thanks
• Thank you to you all for your time
• Thank you to the psychiatry group for their
comments
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j.cusack@abdn.ac.uk
James Cusack
Research Fellow in Psychiatry
University of Aberdeen