Print Friendly, PDF & Email

Cooperation and/or trust is very difficult, if not next to impossible for those in the active throes of Borderline Personality Disorder. Researchers from Baylor College of Medicine have identified a brain malfunction that they have associated with borderline personality disorder.

In a new study based upon a “trust” game played between 55 participants with Borderline Personality Disorder and 55 participants described as “normal” scientists now claim they have for the first time clearly captured on MRI scans physical evidence of a difference in the anterior insula region of the brain in those with BPD.

The scans revealed a brain malfunction associated with the disorder, a serious but common mental illness that affects a person’s perceptions of the world and other people.

“This may be the first time a physical signature for a personality disorder has been identified,” said Dr. P. Read Montague, professor of neuroscience at Baylor College of Medicine and director of the BCM Brown Foundation Human Neuroimaging Laboratory.

These findings originate from a study in which 55 people with borderline personality disorder played a “trust” game with 55 normal people of the same age and social and educational status. While the participants in the study played the financial game that was essentially an exercise in trust, their brains were scanned with the help of functional MRI devices and software called hyperscanning.

In the game, in this study, one player called an investor sends $20 dollars to the other, called a trustee. The investment is tripled, and the trustee splits the profits with the investor. The trustee decides how much to send back, thus determining whether the investor recoups a profit or not. Profit requires cooperation between trustee and investor.

During this study in what was a game of give and get the conclusion was that the anterior insula region of the brain only registered what the borderline participants gave – the money they invested – and not the money they received.

In the normal people, the anterior insula showed activity that responded in direct proportion to the amount of money sent and the money received.

The scientists describe the anterior insula region of the brain as the area in the brain that is known to respond when “norms” are violated or when someone is experiencing or perceiving something as a violation.

Brooks King-Casas, assistant professor of neuroscience and psychiatry and
behavioral sciences at BCM, says that the scan provides fresh insights into the neurobiology of borderline personality disorder, which may someday be used as a diagnostic tool or even a way to determine the effectiveness of a treatment.

“It’s new and different because it’s not a lesion (or injury to the brain) but it is a difference in perceiving information that comes from an interaction. That is the area where people with borderline personality disorder have the most problem,” said Dr. Stuart Yudofsky, chair of the Menninger Department of Psychiatry and Behavioral Sciences at BCM.

A research article on this study appears in the current issue of the journal Science

Phoenix Rising Publication

In my opinion, this study seems to be proving what has already been said of Borderline Personality Disorder for years – that there is a neurological/biological component to it. In reading the full article of this study it wasn’t absolutely clear to me if these findings which are considered fairly ground-breaking will be applied more to finding more accurate ways to diagnose BPD or to what scientists may believe will be more effective treatment. Perhaps the aim at first is to learn more about the diagnostic side and then see what else they learn that can be applied to actual treatment.

I find it important to note here that regardless of this finding and its neurological implications, this is not something that cannot be overcome.

When I was diagnosed with BPD, at the age of 19, until my recovery at the age of 38, I had lived a life that had been ripe with misperception and an inability to trust. In my recovery from BPD, both my misperceptions and distrust improved and where I used to be so distrusting that is not the case now. Where I used to misperceive and/or ascribe motives to what people did or didn’t do, did or didn’t say, I no longer do that either – anymore than the “averagely healthy” person, who from time to time may wonder about someone’s intentions. However, it became clear to me, in recovery, that the intentions of others are not something that we can know unless we ask them about it.

Finding any biological signature for Borderline Personality Disorder or various aspects of it that seem to correlate directly with “borderline behaviour and/or perception” is likely going to be a positive thing overall. However, it must be remembered that there are things about brain chemistry and the neurological component of BPD that can be changed in and through psychotherapy.

Whether or not changes are 100% on a neurological level or not may or may not be able to be reliably measured in the future but as one recovers from BPD through hard work in therapy one can learn new ways of thinking that do effect changes in the neurological experience within the brain.

I have concern when I hear this news that again it could be a precursor or taken as evidence to support the quest for the “magical-cure-all pill”. A pill that I doubt will ever be developed. A pill, that if you have BPD, you cannot afford to wait for.

I have concern that this may leave many with BPD believing that they cannot recover. If you have BPD, it is important not to look at this or any other scientific news about BPD in a black-and-white way. The biological component to BPD that is being more accurately identified now does mean that those with BPD need to feel hopeless about recovery or like they are destined to always be borderline.

We can overcome defects in our biology. Psychotherapy of all different modalities can and does positively impact the experience of BPD – biological or nature/nurture. Just as some believe science is attempting to prove an all-biological argument to the cause and course of BPD – still many believe that BPD is a mixture of biology and environment.

In my own recovery from BPD I do not believe that it was all about merely overcoming some biological/neurological reality. It also involved a lot that is best described as psychological in origin.

Science is important. Science, however, cannot speak to the spiritual component of healing and recovery. We are much more than the mere “wiring” of our brains.

Dr. Stuart Yudofsky, chair of the Menninger Department of Psychiatry and Behavioral Sciences at BCM, agrees that the finding my help eliminate the stigma associated with such disorders. The finding will help in three areas:

“- Diagnosis by giving a biologic measure that can be used to determine if a person has the problem.

– Treatment using this brain-based difference to devise cognitive interventions or even medications that will affect the brain reactions.

– Monitoring the effectiveness of treatment by determining how the brain’s dysfunctional responses to the input from others change with treatment.”

© A.J. Mahari, August 9, 2008 – All rights reserved.




The Rupture and Repair of Cooperation in Borderline Personality Disorder – Study Points to Malfunction in the Brain of Those With BPD