PDF(Pubmed)
Abstract：
OBJECTIVE: Patients with borderline personality disorder (BPD) report to be especially prone to social emotions like shame and guilt. At the same time, these emotions seem to play an important role in BPD pathology. The present study aimed to deepen the knowledge about the processes behind shame and guilt in patients with BPD.
METHODS: Twenty patients with BPD and twenty healthy controls (HCs) took part in an experiment that induced shame and guilt by imagining scenarios during scanning using functional brain imaging. Participants also filled out self-report questionnaires and took part in diagnostic interviews.
RESULTS: BPD patients reported more proneness to guilt but not to shame than the HCs. There was no difference in the self-reported intensity rating of experimentally induced emotions between the groups. Between-group contrast of neural signals in the shame condition revealed a stronger activation of cingulate and fusiform gyrus for the BPD patients compared to the controls, and a more pronounced activation in the lingual gyrus and cuneus for the HCs. In the guilt condition, activation in the caudate nucleus, the fusiform gyrus, and the posterior cingulate cortex was stronger in BPD patients, while HC showed stronger activations in cuneus, lingual gyrus, and fronto-temporal regions.
CONCLUSIONS: Differences in the neuro-functional processes between BPD patients and HC were found, even though the two groups did not differ in their self-report of subjective proneness to guilt and emotional intensity of shame and guilt during the experiment. While the HCs may be engaged more by the emotional scenarios themselves, the BPD patients may be more occupied with cognitive regulatory and self-referential processing.
METHODS: Twenty patients with BPD and twenty healthy controls (HCs) took part in an experiment that induced shame and guilt by imagining scenarios during scanning using functional brain imaging. Participants also filled out self-report questionnaires and took part in diagnostic interviews.
RESULTS: BPD patients reported more proneness to guilt but not to shame than the HCs. There was no difference in the self-reported intensity rating of experimentally induced emotions between the groups. Between-group contrast of neural signals in the shame condition revealed a stronger activation of cingulate and fusiform gyrus for the BPD patients compared to the controls, and a more pronounced activation in the lingual gyrus and cuneus for the HCs. In the guilt condition, activation in the caudate nucleus, the fusiform gyrus, and the posterior cingulate cortex was stronger in BPD patients, while HC showed stronger activations in cuneus, lingual gyrus, and fronto-temporal regions.
CONCLUSIONS: Differences in the neuro-functional processes between BPD patients and HC were found, even though the two groups did not differ in their self-report of subjective proneness to guilt and emotional intensity of shame and guilt during the experiment. While the HCs may be engaged more by the emotional scenarios themselves, the BPD patients may be more occupied with cognitive regulatory and self-referential processing.
摘要：
目的：边缘性人格障碍（BPD）患者报告特别容易出现羞耻和内疚等社会情绪。同时,这些情绪似乎在BPD病理学中起重要作用。本研究旨在加深对BPD患者羞愧和内疚背后过程的认识。
方法：20名BPD患者和20名健康对照（HCs）参加了一项实验，该实验通过使用功能性脑成像技术在扫描过程中想象场景来引起羞耻和内。参与者还填写了自我报告问卷，并参加了诊断性访谈。
结果：BPD患者比HCs更倾向于内疚而不是羞耻。两组之间的实验诱发情绪的自我报告强度等级没有差异。与对照组相比，在羞耻状态下神经信号的组间对比显示，BPD患者的扣带回和梭状回激活更强，以及HCs的舌回和cuneus更明显的激活。在有罪的情况下，激活尾状核，梭状回,BPD患者的后扣带皮质更强，而HC在楔子中显示出更强的激活，舌回,和正面时间区域。
结论：发现BPD患者和HC之间的神经功能过程存在差异，即使在实验过程中，两组在主观上对内的自述以及羞耻和内的情绪强度方面没有差异。虽然HC可能更多地受到情绪场景本身的影响，BPD患者可能更专注于认知调节和自我参照处理。
方法：20名BPD患者和20名健康对照（HCs）参加了一项实验，该实验通过使用功能性脑成像技术在扫描过程中想象场景来引起羞耻和内。参与者还填写了自我报告问卷，并参加了诊断性访谈。
结果：BPD患者比HCs更倾向于内疚而不是羞耻。两组之间的实验诱发情绪的自我报告强度等级没有差异。与对照组相比，在羞耻状态下神经信号的组间对比显示，BPD患者的扣带回和梭状回激活更强，以及HCs的舌回和cuneus更明显的激活。在有罪的情况下，激活尾状核，梭状回,BPD患者的后扣带皮质更强，而HC在楔子中显示出更强的激活，舌回,和正面时间区域。
结论：发现BPD患者和HC之间的神经功能过程存在差异，即使在实验过程中，两组在主观上对内的自述以及羞耻和内的情绪强度方面没有差异。虽然HC可能更多地受到情绪场景本身的影响，BPD患者可能更专注于认知调节和自我参照处理。
