Medial prefrontal cortex hyperactivation during social exclusion in borderline personality disorder

Frontal systems dysfunction and abandonment fears represent central features of borderline personality disorder (BPD). BPD subjects (n = 10) and matched non-psychiatric comparison subjects (n = 10) completed a social–cognitive task with two confederates instructed to either include or exclude subjects from a circumscribed interaction. Evoked cerebral blood oxygenation in frontal cortex was measured using 16-channel functional near infrared spectroscopy. BPD subjects showed left medial prefrontal cortex hyperactivation during social exclusion suggesting potential dysfunction of frontolimbic circuitry.     

Positive emotion dysregulation and posttraumatic stress disorder symptoms: Investigating the role of anxiety sensitivity

ObjectivePosttraumatic stress disorder (PTSD) symptoms are prevalent and deleterious among individuals who have experienced a sexual assault. Although an emerging field of research has established a link between positive emotion dysregulation and PTSD symptoms, there is a limited understanding of mechanisms underlying this relation. Individuals who have experienced a sexual assault may begin to fear any arousal-related sensations via stimulus generalization, including that associated with positive emotions, which, in turn, may amplify PTSD symptoms. Thus, the current study examined the role of anxiety sensitivity in the association between positive emotion dysregulation and PTSD symptoms.MethodsA sample of 500 community members reporting a history of sexual assault (M_age = 34.54, 54.4% male, 79.0% white) completed measures of positive emotion dysregulation, anxiety sensitivity, and PTSD symptoms.ResultsFindings detected a significant indirect effect of anxiety sensitivity in the relation between positive emotion dysregulation and PTSD symptoms (β = 0.28, SE = 0.03, 95% CI [0.22, 0.34]). Supplementary analyses revealed that effects held for subscales of anxiety sensitivity (i.e., cognitive, physical, social concerns) and PTSD symptom clusters (i.e., intrusions, avoidance, negative alternations in cognitions and mood, alternations in arousal and reactivity).ConclusionsThis study offers preliminary empirical support for the assertion that fear of arousal-related sensations associated with positive emotions may partially explain the link between positive emotion dysregulation and PTSD symptoms among those who have experienced a sexual assault. Information from this study could advance future research and treatment.     

Serotonin genes and gene–gene interactions in borderline personality disorder in a matched case-control study

Lines of evidence suggest serotonin genes are susceptibility candidates in borderline personality disorder (BPD). However, few molecular genetic studies on BPD have been reported, especially an overall lack of study on epistatic interactions. We genotyped 27 polymorphisms in 7 serotonin genes in 113 Caucasian BPD patients and matched (sex, age and ethnicity) controls. Program UNPHASED was used to perform association analyses for genotypes, alleles and haplotypes with a permutation test of 10,000 simulations. The Multifactor Dimensionality Reduction analysis was used to examine gene–gene interactions in serotonin system, including three other genes (5-HTT, 5-HT2A and MAOA) that we previously reported. Genotype and allele analyses showed that BPD significantly associated with 5-HT2C and TPH2. BPD patients had high frequencies of the 5-HT2C rs6318G allele (p = 0.021) and G/G genotype (OR = 2.25); and TPH2 rs2171363T allele (p = 0.001) and T containing genotypes (OR = 3.40). The 5-HT1A, 5-HT1B, 5-HT1D, 5-HT3A and TPH1 showed no significant association with BPD for genotype, allele and haplotype analyses. We also detected significant interactions between 5-HT2C and TPH2 (p = 0.001), and among 5-HT2C, 5-HTT, MAOA and TPH2 (p = 0.001) in BPD. Patients with 5-HT2C rs6318G/G genotype had a high frequency of TPH2 rs2171363C/T genotype compared with controls. Our study indicates ““that serotonin genes and their interactions may play a role in the susceptibility to borderline personality disorder.     

Attachment style,relationship quality,and psychological distress in patients with psychogenic non-epileptic seizures versus epilepsy

ObjectivesPsychopathology levels are elevated in patients with psychogenic non-epileptic seizures (PNES) and those with epilepsy. However, patients with PNES report higher rates of trauma and neglect, poorer health-related quality of life (HRQoL), and an increased prevalence of insecure attachment. We examined to what extent attachment style and relationship quality with their main informal carer impact on levels of HRQoL, depression, and anxiety in patients with PNES versus those with epilepsy.MethodConsecutive patients with PNES (N = 23) and epilepsy (N = 72) completed questionnaires about attachment style, quality of their relationship with their main informal carer, seizure severity, HRQoL, depression, and anxiety.ResultsPatients with PNES reported higher levels of anxiety and depression and lower HRQoL than those with epilepsy. PNES: No significant correlations were found with HRQoL but depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with attachment avoidance, attachment anxiety, and relationship conflict, and negatively with relationship depth and support. Epilepsy: HRQoL correlated negatively with seizure severity, depression, anxiety, attachment avoidance, and attachment anxiety. Depression correlated positively with attachment avoidance, attachment anxiety, and relationship conflict. Anxiety correlated positively with seizure severity, attachment avoidance, and attachment anxiety. Correlations between measures of relationship quality and anxiety were stronger in patients with PNES versus those with epilepsy (zs = 2.66 to 2.97, ps < 0.004). Attachment style and relationship quality explained larger amounts of variance in depression (45%) and anxiety (60%) in the patients with PNES than those with epilepsy (16% and 13%).SignificanceLevels of anxiety and depression were higher in patients with PNES than those with epilepsy. Interpersonal problems were much more closely associated with anxiety and depression in patients with PNES than those with epilepsy. The findings support the use of therapeutic interventions for PNES focusing on attachment and relationship issues.     

Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI,SCID-II-PQ,and PID-5

BackgroundWith the publication of DSM 5 alternative model for personality disorders it is critical to assess the components of the model against evidence-based models such as the five factor model and the DSM-IV-TR categorical model. This study explored the relative clinical utility of these models in screening for borderline personality disorder (BPD).MethodsReceiver operator characteristics and diagnostic efficiency statistics were calculated for three personality measures to ascertain the relative diagnostic efficiency of each measure. A total of 1653 adult inpatients at a specialist psychiatric hospital completed SCID-II interviews. Sample 1 (n = 653) completed the SCID-II interviews, SCID-II Questionnaire (SCID-II-PQ) and the Big Five Inventory (BFI), while Sample 2 (n = 1,000) completed the SCID-II interviews, Personality Inventory for DSM5 (PID-5) and the BFI.ResultsBFI measure evidenced moderate accuracy for two composites: High Neuroticism + low agreeableness composite (AUC = 0.72, SE = 0.01, p < 0.001) and High Neuroticism + Low + Low Conscientiousness (AUC = 0.73, SE = 0.01, p < 0.0001). The SCID-II-PQ evidenced moderate-to-excellent accuracy (AUC = 0.86, SE = 0.02, p < 0.0001) with a good balance of specificity (SP = 0.80) and sensitivity (SN = 0.78). The PID-5 BPD algorithm (consisting of elevated emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC = 0.87, SE = 0.01, p < 0.0001) with a good balance of specificity (SP = 0.76) and sensitivity (SN = 0.81).ConclusionsFindings generally support the use of SCID-II-PQ and PID-5 BPD algorithm for screening purposes. Furthermore, findings support the accuracy of the DSM 5 alternative model Criteria B trait constellation for diagnosing BPD. Limitations of the study include the single inpatient setting and use of two discrete samples to assess PID-5 and SCID-II-PQ.     

The Emotion Dysregulation Model of Anxiety: A preliminary path analytic examination

Both temperamental (e.g., behavioral inhibition) and environmental (e.g., family emotional environment) factors are associated with etiology and maintenance of anxiety; however, few studies have explored mechanisms through which these risk factors operate. The present study investigation of a developmental model of anxiety (i.e., the Emotion Dysregulation Model of Anxiety; EDMA) that hypothesizes that emotion dysregulation is the mechanism through which temperamental and emotion parenting variables relate to anxiety. Emerging adults (N = 676, M age = 19.5) retrospectively reported on behavioral inhibition and emotion parenting factors in childhood, and current emotion regulation skills and symptoms of anxiety. Results of path analyses provide initial support for the EDMA. Emotion dysregulation fully mediated the relationship between behavioral inhibition and anxiety and partially mediated the relationship between family emotional environment and anxiety.     

Borderline personality disorder: Prevalence and psychiatric comorbidity among male offenders on probation in Sweden

IntroductionBorderline personality disorder (BPD) is a severely disabling condition, associated with substantially increased risk of deliberate self-harm and, particularly in men, also with interpersonal violence and other criminal behavior. Although BPD might be common among prison inmates, little is known about prevalence and psychiatric comorbidity in probationers and parolees.MethodIn 2013, a consecutive sample of 109 newly admitted adult male offenders on probation or parole in all three probation offices of Stockholm, Sweden, completed self-report screening questionnaires for BPD and other psychiatric morbidity. Participants scoring over BPD cut-off participated in a psychiatric diagnostic interview.ResultsWe ascertained a final DSM-5 BPD prevalence rate of 19.8% (95% CI: 12.3–27.3%). The most common current comorbid disorders among subjects with BPD were antisocial personality disorder (91%), major depressive disorder (82%), substance dependence (73%), attention deficit hyperactivity disorder (ADHD) (70%), and alcohol dependence (64%). Individuals diagnosed with BPD had significantly more current psychiatric comorbidity (M = 6.2 disorders) than interviewed participants not fulfilling BPD criteria (M = 3.6). Participants with BPD also reported substantially more symptoms of ADHD, anxiety and depression compared to all subjects without BPD.ConclusionsBPD affected one fifth of probationers and was related to serious mental ill-health known to affect recidivism risk. The findings suggest further study of possible benefits of improved identification and treatment of BPD in offender populations.     

Borderline personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality

BackgroundBorderline personality disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth.Materials and methodsBPD female youth aged 13–21 years with (n = 29) and without (n = 29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, and attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments.ResultsSeveral findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants.ConclusionAs a whole, child abuse – particularly co-occurring physical and sexual abuse – increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population.     

Borderline Personality Disorder and Personality Inventory for DSM-5 (PID-5): Dimensional personality assessment with DSM-5

IntroductionBorderline personality disorder (BPD) diagnosis has been considered highly controversial. The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) proposes an alternative hybrid diagnostic model for personality disorders (PD), and the Personality Inventory for DSM-5 (PID-5) has adequate psychometric properties and has been widely used for the assessment of the dimensional component.MethodsOur aim was to analyze the utility of the personality traits presented in Section III of the DSM-5 for BPD diagnosis in an outpatient clinical sample, using the Spanish version of the PID-5. Two clinical samples were studied: BPD sample (n = 84) and non-BPD sample (n = 45). Between-sample differences in PID-5 scores were analyzed.ResultsThe BPD sample obtained significantly higher scores in most PID-5 trait facets and domains. Specifically and after regression logistic analyses, in BPD patients, the domains of Negative Affectivity and Disinhibition, and the trait facets of emotional lability, [lack of] restricted affectivity, and impulsivity were more significantly associated with BPD.ConclusionsAlthough our findings are only partially consistent with the algorithm proposed by DSM-5, we consider that the combination of the PID-5 trait domains and facets could be useful for BPD dimensional diagnosis, and could further our understanding of BPD diagnosis complexity.     

Factors associated with borderline personality disorder in major depressive patients and their relationship to bipolarity

ObjectiveTo analyze the interface between borderline personality disorder (BPD) and bipolarity in depressed patients comorbid with BPD.MethodsAs part of National Multi-site Study of 493 consecutive DSM-IV major depressive patients evaluated in at least two semi-structured interviews 1 month apart, 19 (3.9%) had comorbid BPD (BPD+), whereas 474 (96.1%) did not manifest this comorbidity (BPD?).ResultsCompared to BPD (?), BPD (+) patients displayed higher rates of bipolar (BP) disorders and temperaments, an earlier age at onset with a family history of affective illness, more comorbidity, more stressors before the first episode which was more often depressive or mixed, as well as a greater number and severity of affective episodes.ConclusionsThe hypothesis which fitted at best our findings was to consider BPD as a contributory factor in the development of BP disorder, which could have favoured the progression from unipolar major depression to BP disorder. We could not however exclude that some features of BP disorder may have contributed to the development of BPD.     

Initial evidence for sex-specific effects of early emotional abuse on affective processing in bipolar disorder

PurposeThis study investigates the effect of sex and childhood trauma on affective processing in bipolar disorder (BPD) patients.MethodsIn a sample of fifty-six BPD patients, we administered the Childhood Trauma Questionnaire (CTQ), and the Iowa Gambling Task (IGT) and the Affective Go/No-Go (AGNG) to measure affective processing. Analysis of Variance (ANOVA) was used to evaluate the effect of sex and childhood trauma on IGT; Repeated-Measures ANOVAs to measure accuracy and bias measures across conditions on the AGNG.ResultsIn the context of childhood abuse, females evidenced a more conservative cognitive style than males by selecting fewer cards from the disadvantageous decks [F(1, 49) = 14.218; P < 0.001] and showed an improvement throughout the task, as noted in a normal learning curve [F(1.49) = 4.385; P = 0.041)]. For the AGNG, an interaction specific to the negative valence stimuli on response bias measures was found. Abused females scored higher (mean = 8.38; SD = 6.39) than abused males (mean = 0.69; SD = 1.19) [F(1.46) = 6.348; P = 0.015].ConclusionSeverity of childhood trauma was significantly different between sexes. In the context of a history of emotional abuse, male bipolar patients tended toward a more risk-taking behavior compared to female. Further investigations are needed to elucidate potential pathophysiological mechanisms underlying this interaction.     

An experimental investigation of mentalization ability in borderline personality disorder

ObjectiveDeficits in mentalization ability have been theorized to underlie borderline personality disorder (BPD) and have led to mentalization-based treatments. Yet there has been little empirical investigation into whether mentalization deficits do differentiate the BPD population from healthy controls, and the specific nature of these differences.MethodFive pre-existing Theory of Mind (ToM) tasks that assessed simple to complex mentalization capacity in both the affective and cognitive domains were administered to the same groups of age and gender matched patients with BPD and controls. Self-report measures assessed cognitive and affective empathy and childhood trauma and abuse.ResultsThe BPD group did not differ significantly from the healthy control group on basic cognitive false-belief picture-sequencing tasks, or on overall accuracy when discriminating mental states from viewing images of eyes, and attributing emotions based on social events. They were, however, significantly less accurate in identifying positive mental states on the Reading the Mind in the Eyes (RME) task and showed significantly more mentalization errors on affective and cognitive understanding of faux pas (faux pas total score p < .01) and on a Joke Appreciation task (p = .01), that required integration of multiple perspectives. They also self-reported less empathic perspective taking (p < .01). Observation of patterns of performance hinted at specific underlying biases (e.g. a default tendency to use superficial black-and-white attributions to others, such as, “he is mean”, when explaining behavior). It was also found that as childhood experiences of punishment increased, adulthood mentalization ability decreased on all affective ToM tasks and on the cognitive and affective components of understanding faux pas.ConclusionsThe BPD group was as capable as controls in undertaking simple mentalization. However, deficits in mentalization capacity became evident when mentalization tasks became more complex and required the integration of multiple perspectives. Increasing childhood experiences of punishment were related to decreasing mentalization ability in adulthood. Findings support the use of treatments to improve mentalization skills in BPD, however, further research is needed to better specify the nature of underlying mentalizing biases in this population.     

Expressive inhibition in response to stress: Implications for emotional processing following trauma

Expressive inhibition – the willful restriction of expressed emotion – is documented in individuals reporting trauma-related distress, but its impact on global affective functioning remains unclear. Theoretical models propose that chronic activation of negative emotion and deliberate restriction of affect operate synergistically to produce trauma-related emotional deficits. The current project examined the impact of these factors on subjective experience and physiological activation following exposure to an analog trauma. University students (N = 192; M_age = 20, 57% female, 42% White/Non-Hispanic) viewed a graphic film depicting scenes of a televised suicide. Participants then viewed either a sadness- or humor-eliciting film under instructions to inhibit [n_sadness = 45, n_humor = 52] or naturally express emotion [n_sadness = 48, n_humor = 47]. Expressive inhibition was associated with restricted amusement specifically among participants viewing the humor film. Inhibition also produced attenuated sympathetic and parasympathetic recovery, irrespective of film assignment. Evidence of disruptions in emotional processing supports models identifying inhibition as a possible mechanism in post-trauma affect dysregulation.     

Residual alterations of brain electrical activity in clinically asymptomatic concussed individuals: An EEG study

ObjectiveTo examine the neural substrates underlying performance on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and HeadRehab Virtual Reality (VR) balance and spatial modules in a concussed and control group.MethodsThirteen controls and seven concussed participants were fitted with a Geodesic 128-channel EEG cap and completed three assessments: EEG baseline, ImPACT testing, and VR balance and spatial modules. Concussed participants completed were tested within 8 (5 ± 1) days after injury.ResultsEEG power was significantly (p < .05) decreased in the concussed group over all testing modalities. EEG coherence was significantly (p < .05) increased in the concussed group during EEG baseline and ImPACT. For VR testing, two conditions showed significant (p < .05) increases in EEG coherence between ROIs, while two different conditions showed significant (p < .05) decreases in coherence levels.ConclusionsConcussed participants passed all clinical concussion testing tools, but showed pathophysiological dysfunction when evaluating EEG variables.SignificanceConcussed participants are able to compensate and achieve normal functioning due to recruiting additional brain networks. This allows concussed participants to pass clinical tests while still displaying electrophysiological deficits and clinicians must consider this information when making return-to-play decisions.     

L’effet modérateur de la pleine conscience dispositionnelle dans la relation entre symptomatologie dépressive,troubles de la personnalité limite et idéations suicidaires chez le jeune adulte

ObjectivesThe aim of the study was to evaluate the influence of dispositional mindfulness on suicidal ideation and its moderating effect on the relationships between depressive symptoms and borderline personality traits, and suicidal ideation.MethodsA sample of 1034 students from France (818 women, mean age = 20.1 ± 2; 216 men, mean age = 20.6 ± 2.2) completed the Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), assessing dispositional mindfulness, the Patient Health Questionnaire-9 (PHQ-9) assessing depression symptoms; the borderline personality disorder scale of the Personality Disorder Questionnaire-4th Edition (PDQ-4), and the three-item scale measuring suicidal ideation proposed by Garrison et al. (1991).ResultsAt least occasional wish to kill oneself was reported by 11% of men and 10% of women. Thirty-eight percent of men and 47% of women had moderate to severe depressive symptoms (P < .001). The mean borderline personality traits score for women was higher than for men (33.44 ± 10.56 versus 31.48 ± 10.35; P = .02), and the mean dispositional mindfulness score for men was higher than for women (77.99 ± 12.3 versus 73.4 ± 12.1; P < .001). In order to explore the role of mindfulness as a moderator between depressive symptoms/borderline traits and the wish to kill oneself, multiple regression analyses were performed separately by gender according to the method of Hayes (2013). To assess whether the presence of dispositional mindfulness decreased the risk for persons with depressive symptoms/borderline personality traits to have suicidal ideation, the effect of the interaction between these disorders and dispositional mindfulness was tested by introducing in a second regression the cross product of these two variables. To assert moderation we had to observe that the interaction explained an additional part of the variance of suicidal ideation. For men, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 32% of the variance of suicidal ideation (R² = .32, s.e. = 1.42). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (β = −.26; t = −4.48, P < .001), accounting for an additional 6% of the variance of suicidal ideation (R² = .38, s.e. = 1.36). For women, in the first multiple regression analysis, the FFMQ-SF score and PHQ-9 score both explained 25% of the variance of suicidal ideation (R² = .25, s.e. = 1.29). In the second analysis, the prediction level of depressive symptoms and dispositional mindfulness scores had slightly decreased. The interaction between dispositional mindfulness and depressive symptoms was a significant predictor in the second stage (β = −.16; t = −5.34, P < .001), accounting for an additional 3% of the variance of suicidal ideation (R² = .28, s.e. = 1.26). For men, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 23% of the variance of suicidal ideation (R² = .23, s.e. = 1.51). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores had decreased. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (β = −.27; t = −4.68, P < .001), accounting for an additional 7% of the variance of suicidal ideation (R² = .30, s.e. = 1.44). For women, in the first multiple regression analysis, the FFMQ-SF score and PDQ-4 subscale score both explained 24% of the variance of suicidal ideation (R² = .24, s.e. = 1.30). In the second analysis, the prediction level of borderline personality traits and dispositional mindfulness scores remained the same. The interaction between dispositional mindfulness and borderline personality traits was a significant predictor in the second stage (β = −.19; t = −6.30, P < .001) accounting for an additional 3% of the variance of suicidal ideation (R² = .27, s.e. = 1.27).ConclusionsDispositional mindfulness appeared to be a moderator between depressive symptoms/borderline personality traits and the wish to kill oneself in both genders. This finding is relevant for prevention and therapy and suggests that mindfulness may be important and useful to reduce suicidal ideation and prevent suicidal attempts in young adults.     

Quality of life and sense of coherence in young people and adults with uncomplicated epilepsy: A longitudinal study

ObjectivesThe aim of the study was, in a ten-year follow-up, to describe and explore potential changes in quality of life and sense of coherence in relation to gender differences among persons with epilepsy in the transition from adolescence to adulthood.Materials and methodsA longitudinal study of sense of coherence (SOC) and quality of life with repeated measurement design (1999, 2004, and 2009) was conducted in a population of persons (n = 69) who were aged 13–22 years in 1999 and 23–33 years in 2009. The Quality-of-Life Index (QLI) and the Sense of Coherence (SOC) scale were used.ResultsThere was a significant decrease (p ≤ 0.001) in seizures compared with the 2004 results, mainly among the women (p = 0.003). When comparing the total QLI scores, no significant differences were found between the three data collections and there were no differences in total scores between men and women. There was a decrease in the SOC total score over the 10-year period study. Total SOC was significantly higher among those being 30–33 years old compared to those being 23–29 years old (p = 0.014) and among those having a driving license (p = 0.029) compared to those not having a driving license.ConclusionsBoth quality of life and sense of coherence are important for maintaining health and well-being. Promoting health and well-being requires effective high-quality multidisciplinary person-centered care.     

Regional electroencephalogram (EEG) spectral power and hemispheric coherence in young adults born at extremely low birth weight

ObjectivesWe examined the effects of extremely low birth weight (ELBW < 1000 g) on adult brain functioning.MethodsWe measured baseline regional EEG spectral power and hemispheric coherence in a cohort of 154 (M age = 23 years) non-impaired young adults who were born at ELBW (n = 71; M birth weight = 874 g, M gestation age = 27.5 weeks) and in a control group of full-term adults born at normal birth weight (NBW; n = 83).ResultsELBW adults exhibited significantly more power in the low EEG frequency bands (delta and theta) and less in the high EEG frequency bands (alpha and beta) than the NBW adults. This relative difference in the amount of high to low-frequency power was especially salient in the frontal regions. ELBW adults also exhibited significantly more short-distance EEG coherence in the right hemisphere compared to the NBW adults.ConclusionsOur results suggest that even among ELBW survivors without impairments, adverse events early in life may result in subtle neurological abnormalities.SignificanceThis study provides a unique EEG profile of young adult survivors of ELBW showing that maturational delays of the brain may persist into late adolescence and emerging adulthood.     

Functional neuronal activity and connectivity within the subthalamic nucleus in Parkinson’s disease

ObjectiveCharacterization of the functional neuronal activity and connectivity within the subthalamic nucleus (STN) in patients with Parkinson’s disease (PD).MethodsSingle units were extracted from micro-electrode recording (MER) of 18 PD patients who underwent STN deep brain stimulation (DBS) surgery. The firing rate and pattern of simultaneously recorded spike trains and their coherence were analyzed. To provide a precise functional assignment of position to the observed activities, for each patient we mapped its classified multichannel STN MERs to a generic atlas representation with a sensorimotor part and a remaining part.ResultsWithin the sensorimotor part we found significantly higher mean firing rate (P < 0.05) and significantly more burst-like activity (P < 0.05) than within the remaining part. The proportion of significant coherence in the beta band (13–30 Hz) is significantly higher in the sensorimotor part of the STN than elsewhere (P =  0.015).ConclusionsThe STN sensorimotor part distinguishes itself from the remaining part with respect to beta coherence, firing rate and burst-like activity and postoperatively was found as the preferred target area.SignificanceOur firing behavior analysis may help to discriminate the STN sensorimotor part for the placement of the DBS electrode.     

Different attachment styles correlate with mood disorders in adults with epilepsy or migraine

PurposeInterpersonal relationships are viewed as important contexts within which psychopathology emerges and persists or desists. Attachment theory describes the dynamics of long-term relationships between humans especially in families and lifelong friendships. The present study was aimed at investigating attachment styles in adult patients with epilepsy as compared to subjects with migraine and their potential correlates with a history of mood disorders.MethodsA consecutive sample of 219 adult outpatients with epilepsy (117) or migraine (102) was assessed with the Attachment Style Questionnaire (ASQ).ResultsPatients with epilepsy and a lifetime history of mood disorders presented elevated scores for Need for approval (p < 0.001) and Preoccupation with relationships (p < 0.001). Age correlated with the Relationships as secondary (r = 0.322; p < 0.001) and Need for approval (r = 0.217; p = 0.019) subscales while age at onset correlated only with Relationships as secondary (r = 0.225; p = 0.015). Seizure-free patients presented lower scores for Need for approval (p = 0.003). Patients with migraine and a lifetime history of mood disorders presented lower scores in Confidence (p = 0.002) and higher scores in Discomfort with closeness (p = 0.026).ConclusionsAn anxious–preoccupied attachment correlated with mood disorders in epilepsy while it was an avoidant pattern in migraine. Our results bring further data on the role of psychological variables in mood disorders in epilepsy. Further studies will allow early identification of patients at risk and the development of preventive strategies.     

Inflammatory biomarkers and emotional approach coping in men with prostate cancer

ObjectiveEmotion-regulating coping is associated with improvements in psychological and physical health outcomes. Yet in the context of prostate cancer-related stressors, limited research has characterized associations of emotion-regulating coping processes (emotional expression, emotional processing) and inflammatory processes that are related to disease risk. This investigation examined the relation of Emotional Approach Coping (EAC) with markers of inflammation to test the hypothesis that higher EAC scores at study entry (T1) would be associated with lower proinflammatory markers four months later (T2), specifically sTNF-RII, CRP, and IL-6.MethodsForty-one men (M age = 66.62 years; SD = 9.62) who had undergone radical prostatectomy or radiation therapy for localized prostate cancer within two years completed questionnaires, including assessments of EAC, at T1, and provided blood samples for immune assessments at T2.ResultsWhen controlling for relevant biobehavioral controls, emotional processing predicted lower IL-6 (B = −.66, p < .01), sTNF-RII (B = −.43, p < .05), and CRP (B = −.43, p < .10), whereas emotional expression was significantly associated with higher levels of sTNF-RII (B = .55, p < .05). Associations of emotional expression and IL-6 (B = .38, p < .10), and CRP (B = .44, p < .10) approached significance. Probing interactions of emotional processing and expression (though only approaching significance) suggested that expression of emotion is associated with higher inflammation (CRP and sTNF-RII) only in the context of low emotional processing.ConclusionsAttempts at emotion regulation via emotional processing appear to modulate inflammatory processes. Understanding, making meaning of, and working through emotional experience may be a promising target of intervention to reduce inflammation with potential effects on psychological and cancer outcomes in men with prostate cancer.