Research into BPD SPDN Jeremy Hall
Borderline Personality Disorder First defined by Gunderson Core features –Affective instability –Interpersonal difficulties –Impulsivity Heritability about 40% Strongly associated with early life stress
The Scale of the Problem BPD affects 1-2% of the population BPD accounts for 10% OPD contacts BPD main diagnosis in 6% admissions Frequent cause of attendance at A&E Associated with a 10% risk of suicide
Current Treatments 1. Pharmacological Treatments –Antidepressants only if concurrent depression –Antipsychotics for perceptual disturbances –Some evidence for mood stabilisers –All trials very small –NICE unable to recommend any treatment
Current Treatments 2. Psychological Treatments –Best evidence is for DBT –Some evidence also for CBT –HOWEVER Trials generally small Limited availability Not suitable for all
How can Research help? Psychological Research –Larger studies –“Real-life” settings Biological Research –Develop measures of deficits in BPD –Relate these to changes in the brain –Develop new treatments
Our Research Developing measures of BPD symptoms –Affective responses –Interpersonal interactions –Impulsivity Determining their specificity to BPD Developing translational assessments
Emotion and Impulse Study 1. Background information 2. Symptom severity 3. Computer tests of: –A. Emotion processing –B. Social responses –C. Impulsivity
Who did we study? 20 people with symptoms 20 people without symptoms Age range % female
What did we find out?
Background and Symptoms
Some things weren’t different… AGEIQ
… and some things were: CHILD STRESSDEPRESSION
Computer tests 1 Emotion Processing
Expression in faces
Facial Emotion Recognition Anger Happiness Fear Sadness Surprise Disgust
Results: Emotions **
Emotion Recognition and Trauma
Computer tests 2 Social Responses
Social decisions Trustworthy?
Social Judgement APPROACHABLENOT APPROACHABLE
Results: Social *** **
Social Judgement Bias BPD
Social Judgement and Trauma
Computer tests 3 Impulsivity
Motor Impulsivity
Delayed Reward £10 Straight away £20 In two weeks Which would you prefer?:
Delayed Reward
Conclusions
We could measure difficulties in core areas: –Emotion processing –Social responses –Impulsivity What does this mean in the brain?
Basis in the brain? PFC AMY
The future!
Acknowledgements CSO / SFC Merrick Pope Katie Nicol All the participants
Contacts Jeremy Hall – –Tel: Merrick Pope – –Tel: