Research into BPD SPDN Jeremy Hall. Borderline Personality Disorder First defined by Gunderson Core...
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Transcript of Research into BPD SPDN Jeremy Hall. Borderline Personality Disorder First defined by Gunderson Core...
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 20-55
• 75% female
What did we find out?
Background and Symptoms
Some things weren’t different…
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CON SYMPT
Group
Ag
e
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CON SYMPT
Group
IQ
AGE IQ
… and some things were:
CHILD STRESS DEPRESSION
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CON SYMPT
Group
Ch
ild S
tres
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CON SYMPT
Group
Ham
ilto
n
Computer tests 1
Emotion Processing
Expression in faces
Facial Emotion Recognition
Anger
Happiness
Fear
Sadness
Surprise
Disgust
Results: Emotions
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ANG HAP SAD SUR FEAR DIS
Task
Sco
re CON
SYMPT
**
Emotion Recognition and Trauma
Computer tests 2
Social Responses
Social decisions
Trustworthy?
Social Judgement
APPROACHABLE NOT APPROACHABLE
Results: Social
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AGE ATT DIS INT TRU APP
Task
Sco
re CON
SYMPT
***
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Social Judgement Bias
BPD
Social Judgement and Trauma
Computer tests 3
Impulsivity
Motor Impulsivity
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CON SYMPT
Group
SS
RT
(m
s)
Delayed Reward
£10 Straight away
£20 In two weeks
Which would you prefer?:
Delayed Reward
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2 7 30 180
Delay (days)
% w
aiti
ng
fo
r la
ter
CON
SYMPT
Conclusions
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– Email: [email protected]– Tel: 0131 537 6313
• Merrick Pope– Email: [email protected]– Tel: 0131 537 6390
