A New Perspective on the Pathophysiology of Borderline Personality Disorder: A Model of the Role of Oxytocin

The American Journal of Psychiatry
Sabine C Herpertz, Katja Bertsch

Abstract

Borderline personality disorder is characterized by three domains of dysfunction: affect dysregulation, behavioral dyscontrol, and interpersonal hypersensitivity. Interpersonal hypersensitivity is associated with a (pre)attentive bias toward negative social information and, on the level of the brain, enhanced bottom-up emotion generation, while affect dysregulation results from abnormal top-down processes. Additionally, the problems of patients with borderline personality disorder in interpersonal functioning appear to be related to alterations in the (social) reward and empathy networks. There is increasing evidence that the oxytocinergic system may be involved in these domains of dysfunction and may thus contribute to borderline psychopathology and even open new avenues for targeted pharmacotherapeutic approaches. From studies in healthy and clinical subjects (including first studies with borderline personality disorder patients), the authors provide a conceptual framework for future research in borderline personality disorder that is based on oxytocinergic modulation of the following biobehavioral mechanisms: 1) the brain salience network favoring adaptive social approach behavior, 2) the affect regulation circuit normalizin...Continue Reading

Citations

Mar 5, 2016·Psychodynamic Psychiatry·Myron L Glucksman
Mar 22, 2016·Biological Psychiatry·Sabine C Herpertz, Katja Bertsch
Apr 12, 2016·Frontiers in Human Neuroscience·Andrea JobstAnna Buchheim
Mar 2, 2017·Psychodynamic Psychiatry·Michael H Stone
Mar 22, 2018·Journal of Personality Disorders·John G GundersonLois Choi-Kain
Sep 12, 2018·Social Cognitive and Affective Neuroscience·Emilie OliéSophie Schwartz
Oct 16, 2016·Development and Psychopathology·Robert-Paul JusterMartin Picard
Feb 6, 2020·Annual Review of Clinical Psychology·Patrick LuytenPeter Fonagy
Feb 26, 2020·European Psychiatry : the Journal of the Association of European Psychiatrists·Igor NenadićChristian Gaser
Jan 9, 2019·Frontiers in Behavioral Neuroscience·Deborah L Cabaniss
Jun 10, 2020·Molecular Psychiatry·Valery Grinevich, Inga D Neumann
Feb 23, 2018·Journal of Personality Disorders·Barbara StanleySteven Roose
Nov 21, 2018·Brain Sciences·Filiz Kulacaoglu, Samet Kose
Apr 20, 2019·Frontiers in Psychology·Manuela FilippaPierre Kuhn
Mar 3, 2021·Journal of Personality Disorders·Tahira GulamaniAnthony C Ruocco
Apr 27, 2021·Neuroscience and Biobehavioral Reviews·Celine De MeulemeesterPatrick Luyten
May 25, 2021·Human Psychopharmacology·Charles TimäusDirk Wedekind

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