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Remnants and changes in facial emotion processing in women with remitted borderline personality disorder: an EEG study

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Abstract

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.

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Acknowledgements

This work was supported by the German Research Foundation (KFO-256; He 2660/12-1). The authors would like to thank Kerstin Herwig, Monica Pinca-Barth, Andrea Gäbel, Krisztina Nagy, and Lucas Kramer for supporting the data acquisition and analyses and the team of the Clinical Research Group on Mechanisms of Disturbed Emotion Processing in Borderline Personality Disorder (KFO 256) for participant recruitment and organization.

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Authors and Affiliations

  1. Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany

    Isabella Schneider, Katja Bertsch, Natalie A. Izurieta Hidalgo, Laura E. Müller & Sabine C. Herpertz

  2. Department of Psychosomatic Medicine, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany

    Christian Schmahl

  3. Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Christian Schmahl

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  1. Isabella Schneider
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  2. Katja Bertsch
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  4. Laura E. Müller
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  5. Christian Schmahl
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  6. Sabine C. Herpertz
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Correspondence to Isabella Schneider.

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Ethical standards

The Ethics Committee of the Medical Faculty of the University of Heidelberg approved the study and the study was conducted according to the 1964 Declaration of Helsinki and its later amendments. All participants received monetary compensation.

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All participants gave their informed consent prior to their inclusion in the study.

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The authors declare that they have no conflict of interest.

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Schneider, I., Bertsch, K., Izurieta Hidalgo, N.A. et al. Remnants and changes in facial emotion processing in women with remitted borderline personality disorder: an EEG study. Eur Arch Psychiatry Clin Neurosci 268, 429–439 (2018). https://doi.org/10.1007/s00406-017-0841-7

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