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Cognitive memory control in borderline personality disorder patients

Published online by Cambridge University Press:  20 August 2008

M. Sala ,
E. Caverzasi ,
E. Marraffini ,
G. De Vidovich ,
M. Lazzaretti ,
G. d'Allio ,
M. Isola ,
M. Balestrieri ,
E. D'Angelo  and
F. Zappoli Thyrion
...Show all authors
M. Sala*
Affiliation:
Department of Physiological, Pharmacological and Cellular Sciences, University of Pavia, Pavia, Italy Department of Mental Health, Azienda Sanitaria Locale 21, Casale Monferrato (Alessandria), Italy
E. Caverzasi
Affiliation:
Interdepartmental Centre for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
E. Marraffini
Affiliation:
Interdepartmental Centre for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
G. De Vidovich
Affiliation:
Interdepartmental Centre for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
M. Lazzaretti
Affiliation:
Interdepartmental Centre for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
G. d'Allio
Affiliation:
Department of Mental Health, Azienda Sanitaria Locale 21, Casale Monferrato (Alessandria), Italy
M. Isola
Affiliation:
Section of Statistics, Department of Medical and Morphological Research, University of Udine, Udine, Italy
M. Balestrieri
Affiliation:
Inter-University Centre for Behavioural Neurosciences, Department of Pathology and Experimental and Clinical Medicine, University of Udine, Udine, Italy
E. D'Angelo
Affiliation:
Department of Physiological, Pharmacological and Cellular Sciences, University of Pavia, Pavia, Italy
F. Zappoli Thyrion
Affiliation:
Servizio di Radiodiagnostica, IRCCS Policlinico San Matteo, Pavia, Italy
P. Scagnelli
Affiliation:
Servizio di Radiodiagnostica, IRCCS Policlinico San Matteo, Pavia, Italy
F. Barale
Affiliation:
Interdepartmental Centre for Research on Personality Disorders, Department of Applied and Behavioural Health Sciences, Section of Psychiatry, University of Pavia, Pavia, Italy
P. Brambilla
Affiliation:
Inter-University Centre for Behavioural Neurosciences, Department of Pathology and Experimental and Clinical Medicine, University of Udine, Udine, Italy Scientific Institute, IRCCS ‘E. Medea’, Udine, Italy CERT-BD, Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
*
*Address for correspondence: M. Sala, Azienda Sanitaria Locale 21, viale Giolitti 2, 15033, Casale Monferrato (Alessandria), Italy. (Email: michelasalacap@yahoo.it)
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Abstract

Background

It has been demonstrated that the mechanism of cognitive memory control in humans is sustained by the hippocampus and prefrontal cortices, which have been found to be structurally and functionally abnormal in borderline personality disorder (BPD). We investigated whether the memory control mechanism is affected in BPD.

Method

Nineteen Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV BPD patients and 19 matched healthy controls (HC) performed a specific think/no-think paradigm exploring the capacity of remembering and suppressing pair of words previously learned. After the think–no think phase, the second member of each word pair has to be remembered either when subjects are presented with the cue word showed at the beginning of the test (Same Probe Test; SPT) or when they are presented with an extra-list categorical word (Independent Probe Test; IPT). We evaluated the effect of suppression and of retrieval activity on later retention of words.

Results

Both on the SPT and on the IPT, HC showed the expected improvement of memory retrieval on to-be-remembered words, unlike BPD patients. On the SPT, HC, but not BPD patients, correctly recalled significantly more words among remembered words (RW) than among suppressed words (SW). Similarly to HC, subjects with BPD without a history of childhood abuse showed a significantly higher percentage of correctly recalled words among RW than among SW.

Conclusions

The mechanism of active retrieval of memories and of improvement through repetition is impaired in BPD, particularly in those who experienced traumatic experiences. This impairment might play an important role, possibly resulting in the emergence of unwanted memories and dissociative symptoms.

Keywords

Borderline personality disorderhippocampusmemorystresstrauma
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 5 , May 2009 , pp. 845 - 853
Copyright
Copyright © Cambridge University Press 2008

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References

Andersen, J, Larsen, JK, Schultz, V, Nielsen, BM, Korner, A, Behnke, K, Munk Andersen, E, Butler, B, Allerup, P, Bech, P (1989). The Brief Psychiatric Rating Scale. Dimension of schizophrenia – reliability and construct validity. Psychopathology 22, 168–176.CrossRefGoogle ScholarPubMed
Anderson, MC, Bell, T (2001). Forgetting our facts: the role of inhibitory processes in the loss of propositional knowledge. Journal of Experimental Psychology. General 130, 544–570.CrossRefGoogle ScholarPubMed
Anderson, MC, Green, C (2001). Suppressing unwanted memories by executive control. Nature 410, 366–369.CrossRefGoogle ScholarPubMed
Anderson, MC, Ochsner, KN, Kuhl, B, Cooper, J, Robertson, E, Gabrieli, SW, Glover, GH, Gabrieli, JD (2004). Neural systems underlying the suppression of unwanted memories. Science 303, 232–235.CrossRefGoogle ScholarPubMed
Arntz, A, Appels, C, Sieswerda, S (2000). Hypervigilance in borderline disorder: a test with the emotional Stroop paradigm. Journal of Personality Disorders 14, 366–373.CrossRefGoogle ScholarPubMed
Biaggio, MK, Supplee, K, Curtis, N (1981). Reliability and validity of four anger scales. Journal of Personality Assessment 45, 639–648.CrossRefGoogle ScholarPubMed
Brambilla, P, Cerini, R, Fabene, PF, Andreone, N, Rambaldelli, G, Farace, P, Versace, A, Perlini, C, Pelizza, L, Gasparini, A, Gatti, R, Bellani, M, Dusi, N, Barbui, C, Nose, M, Tournikioti, K, Sbarbati, A, Tansella, M (2007). Assessment of cerebral blood volume in schizophrenia: a magnetic resonance imaging study. Journal of Psychiatric Research 41, 502–510.CrossRefGoogle ScholarPubMed
Brambilla, P, Soloff, PH, Sala, M, Nicoletti, M, Keshavan, M, Soares, J (2004). Anatomical MRI study of borderline personality disorder patients. Psychiatry Research 131, 125–133.CrossRefGoogle ScholarPubMed
Brewin, CR (2001). A cognitive neuroscience account of posttraumatic stress disorder and its treatment. Behaviour Research and Therapy 39, 373–393.CrossRefGoogle ScholarPubMed
Cipolotti, L, Shallice, T, Chan, D, Fox, N, Scahill, R, Harrison, G, Stevens, J, Rudge, P (2001). Long-term retrograde amnesia … the crucial role of the hippocampus. Neuropsychologia 39, 151–172.CrossRefGoogle ScholarPubMed
Depue, BE, Banich, MT, Curran, T (2006). Suppression of emotional and nonemotional content in memory: effects of repetition on cognitive control. Psychological Science 17, 441–447.CrossRefGoogle ScholarPubMed
Depue, BE, Curran, T, Banich, MT (2007). Prefrontal regions orchestrate suppression of emotional memories via a two-phase process. Science 317, 215–219.CrossRefGoogle Scholar
Domes, G, Winter, B, Schnell, K, Vohs, K, Fast, K, Herpertz, SC (2006). The influence of emotions on inhibitory functioning in borderline personality disorder. Psychological Medicine 36, 1163–1172.CrossRefGoogle ScholarPubMed
Driessen, M, Herrmann, J, Stahl, K, Zwaan, M, Meier, S, Hill, A, Osterheider, M, Petersen, D (2000). Magnetic resonance imaging volumes of the hippocampus and the amygdala in women with borderline personality disorder and early traumatization. Archives of General Psychiatry 57, 1115–1122.CrossRefGoogle ScholarPubMed
Eldridge, LL, Engel, SA, Zeineh, MM, Bookheimer, SYKnowlton, BJ (2005). A dissociation of encoding and retrieval processes in the human hippocampus. Journal of Neuroscience 25, 3280–3286.CrossRefGoogle ScholarPubMed
Gunderson, JK, Kolb, JE, Austin, V (1981). The Diagnostic Interview for Borderline Patients. American Journal of Psychiatry 131, 896–903.Google Scholar
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Hidalgo, MP, Zanette, C, Pedrotti, M, Souza, C, Nunes, P, Chaves, M (2004). Performance of chronotypes on memory tests during the morning and the evening shifts. Psychological Reports 95, 75–85.CrossRefGoogle ScholarPubMed
Irle, E, Lange, C, Sachsse, U (2005). Reduced size and abnormal asymmetry of parietal cortex in women with borderline personality disorder. Biological Psychiatry 57, 173–182.CrossRefGoogle ScholarPubMed
Korfine, L, Hooley, JM (2000). Directed forgetting of emotional stimuli in borderline personality disorder. Journal of Abnormal Psychology 109, 214–221.CrossRefGoogle ScholarPubMed
Lansdale, M, How, TT (1996). An analysis of errors in the learning, overlearning, and forgetting of sequences. Quarterly Journal of Experimental Psychology 49, 341–356.CrossRefGoogle ScholarPubMed
Levy, BJ, Anderson, MC (2002). Inhibitory processes and the control of memory retrieval. Trends in Cognitive Sciences 6, 299–305.CrossRefGoogle ScholarPubMed
Monarch, ES, Saykin, A, Flashman, L (2004). Neuropsychological impairment in borderline personality disorder. Psychiatric Clinics of North America 27, 67–82, viii–ix.CrossRefGoogle ScholarPubMed
Oldfield, RC (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9, 97–113.CrossRefGoogle ScholarPubMed
Patton, JH, Stanford, M, Barratt, E (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology 51, 768–774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Sala, M, Perez, J, Soloff, P, Ucelli Di Nemi, S, Caverzasi, E, Soares, J, Brambilla, P (2004). Stress and hippocampal abnormalities in psychiatric disorders. European Neuropsychopharmacology 14, 393–405.CrossRefGoogle ScholarPubMed
Saud de Nunez, G, Rodriguez Rojas, S, Niaz, M (1993). Further evidence relating mental capacity, short-term storage space, and operational efficiency. Perceptual and Motor Skills 76, 735–738.CrossRefGoogle ScholarPubMed
Schmahl, CG, Elzinga, B, Vermetten, E, Sanislow, C, McGlashan, T, Bremner, J (2003 a). Neural correlates of memories of abandonment in women with and without borderline personality disorder. Biological Psychiatry 54, 142–151.CrossRefGoogle ScholarPubMed
Schmahl, CG, Vermetten, E, Elzinga, B, Bremner, J (2004). A positron emission tomography study of memories of childhood abuse in borderline personality disorder. Biological Psychiatry 55, 759–765.CrossRefGoogle ScholarPubMed
Schmahl, CG, Vermetten, E, Elzinga, B, Douglas, , Bremner, J (2003 b). Magnetic resonance imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder. Psychiatry Research 122, 193–198.CrossRefGoogle ScholarPubMed
Sieswerda, S, Arntz, A, Mertens, I, Vertommen, S (2007). Hypervigilance in patients with borderline personality disorder: specificity, automaticity, and predictors. Behaviour Research and Therapy 45, 1011–1024.CrossRefGoogle ScholarPubMed
Siever, LJ, Torgersen, S, Gunderson, J, Livesley, W, Kendler, K (2002). The borderline diagnosis III: identifying endophenotypes for genetic studies. Biological Psychiatry 51, 964–968.CrossRefGoogle ScholarPubMed
Skodol, AE, Gunderson, J, Pfohl, B, Widiger, T, Livesley, W, Siever, LJ (2002 a). The borderline diagnosis I: psychopathology, comorbidity, and personality structure. Biological Psychiatry 51, 936–950.CrossRefGoogle ScholarPubMed
Skodol, AE, Siever, LJ, Livesley, W, Gunderson, J, Pfohl, B, Widiger, T (2002 b). The borderline diagnosis II: biology, genetics, and clinical course. Biological Psychiatry 51, 951–963.CrossRefGoogle ScholarPubMed
Soloff, PH, Lis, J, Kelly, T, Cornelius, J, Ulrich, R (1994). Risk factors for suicidal behavior in borderline personality disorder. American Journal of Psychiatry 151, 1316–1323.Google ScholarPubMed
Soloff, PH, Lynch, K, Kelly, T (2002). Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. Journal of Personality Disorders 16, 201–214.CrossRefGoogle ScholarPubMed
Soloff, PH, Lynch, KG, Kelly, T, Malone, K, Mann, J (2000). Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study. American Journal of Psychiatry 157, 601–608.CrossRefGoogle ScholarPubMed
Squire, LR, Alvarez, P (1995). Retrograde amnesia and memory consolidation: a neurobiological perspective. Current Opinion in Neurobiology 5, 169–177.CrossRefGoogle ScholarPubMed
Tebartz van Elst, L, Hesslinger, B, Thiel, T, Geiger, E, Haegele, K, Lemieux, L, Lieb, K, Bohus, M, Hennig, J, Ebert, D (2003). Frontolimbic brain abnormalities in patients with borderline personality disorder: a volumetric magnetic resonance imaging study. Biological Psychiatry 54, 163–171.CrossRefGoogle ScholarPubMed
University of Padova, Facoltà di Psicologia (2005) (http://dpss.psy.unipd.it/psydata/associations/). Accessed 20 March 2005.Google Scholar
Williams, J, Gibbon, M, First, M, Spitzer, R, Davies, M, Borus, J, Howes, M, Kane, J, Pope, H, Rounsaville, B (1992). The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Archives of General Psychiatry 49, 630–636.CrossRefGoogle ScholarPubMed
Wittenberg, GM, Tsien, JZ (2002). An emerging molecular and cellular framework for memory processing by the hippocampus. Trends in Neuroscience 25, 501–505.CrossRefGoogle ScholarPubMed
Zanarini, MC, Vujanovic, A, Parachini, E, Boulanger, J, Frankenburg, F, Hennen, J (2003). Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. Journal of Personality Disorders 17, 233–242.CrossRefGoogle ScholarPubMed