The Biological Basis to Personality Disorders

Summary & key facts

Researchers reviewed medical papers to understand the brain differences behind cluster B personality disorders, which include conditions like borderline personality disorder. They found that some brain areas—such as the front part of the brain, the amygdala (which helps process emotions), and a movement/reward area called the striatum—often look different in people with these disorders. Emotional instability and acting without thinking are common features. Right now, talking therapies are the best-proven treatment for borderline personality disorder, and medicines can be added in specific cases, such as when someone also has depression. The review was based on a small set of papers, so more research is needed to turn these brain findings into better treatments.

Key facts:

• The authors searched a medical database and found about 2,800 articles, then used 18 papers for their report.
• People with cluster B personality disorders often show differences in certain brain regions, including the superior frontal cortex, the amygdala (an emotion center), and larger volumes in the striatum (a reward and movement area).
• Two common problems in these disorders are emotional dysregulation (trouble controlling strong emotions) and impulsiveness (acting quickly without thinking).
• Family history or genetics may help explain why some people develop these disorders, according to the review.
• Currently, psychotherapy (talking therapy) is the treatment with the strongest support for borderline personality disorder.
• Medicines are not the main treatment, but they may be added to help specific symptoms or when someone also has depression.
• The authors say understanding the brain better could lead to improved clinical care and new treatments, but the evidence base used in this review was limited to a small number of studies.

Abstract

OBJECTIVE: To provide understanding into the biological basis of thinking and behavior in people with personality disorders, explain anatomic findings, and appraise therapeutic options. DATA SOURCES: PubMed was searched with no date restrictions using the terms personality disorders DSM-5, cluster B personality disorders, biological psychiatry of personality disorders, neurobiology of personality disorders, and neurobiology of cluster B personality disorders. STUDY SELECTION/DATA EXTRACTION: We identified 2,790 English-language articles and utilized 18 in this report. RESULTS: There are anatomic features typical to the brains of individuals with cluster B personality disorders, for example, abnormalities in the superior frontal cortex and amygdala and enlarged striatal volumes. Emotional dysregulation and impulsiveness are 2 prominent symptoms. Hereditary factors may contribute to the development of such conditions. CONCLUSION: Understanding the neurobiology of cluster B personality disorders expands knowledge that hopefully results in better clinical management and development of improved treatments. Psychotherapy is currently the most effective intervention for borderline personality disorders. Symptomatic pharmacotherapies may be prescribed adjunctively on an individualized basis if clinically indicated (eg, with a coexistant depression).

Topics

Bipolar Disorder and Treatment Obsessive-Compulsive Spectrum Disorders Personality Disorders and Psychopathology

Categories

Clinical Psychology Psychology Social Sciences

Tags

Amygdala Clinical psychology Intervention (counseling) Neuroscience Personality Personality disorders Personality pathology Psychiatry Psychology Psychotherapist Sadistic personality disorder Social psychology

Conditions & symptoms

Depression Sadness or low mood