Identification of Neural Signature for Borderline Personality Disorder
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A recent study conducted on the rostro-medial prefrontal region of the brain has the potential to enhance the diagnosis and treatment of Borderline Personality Disorder (BPD). The research, titled “Rejection Distress Suppresses Medial Prefrontal Cortex in Borderline Personality Disorder,” has been published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

The study, led by psychologist Eric A. Fertuck from The City College of New York, in collaboration with Columbia University and the New York State Psychiatric Institute, reveals that the rostro-medial prefrontal area becomes more active in response to higher rates of rejection from others. However, individuals with BPD, who are characterized by their sensitivity to interpersonal rejection and emotional instability, do not exhibit the same level of activity in the rostro-medial prefrontal cortex when facing rejection.

The brain responds to rejection with increased activity in the rostro-medial prefrontal region, perceiving it as a potential threat or problem in the environment. This activation may trigger efforts to restore and maintain close social connections for survival and well-being. This particular brain region is also involved in the process of understanding the mental and emotional states of others.

Fertuck explains that the lack of activity in the rostro-medial prefrontal cortex during rejection may account for why individuals with BPD experience heightened sensitivity and distress in response to rejection. Understanding the underlying reasons for this emotional distress in individuals with BPD will contribute to the development of more targeted therapies for the disorder, which is known for its debilitating effects and high risk.

Highlighting the significance of the study, Fertuck emphasizes the improvement in specificity and resolution in assessing rejection compared to previous research efforts. The researchers have refined their rejection assessment techniques, leading to more accurate findings.

The investigation into the impact of social rejection on various mental health conditions, such as post-traumatic stress disorder, depression, and social anxiety, is ongoing. Multiple studies are currently underway to explore the role of social rejection in these disorders.

Fertuck heads the Social Neuroscience and Psychopathology (SNAP) lab at the Colin Powell School in The City College of New York. The lab conducts collaborative research that combines clinical insights into Borderline Personality Disorder and related psychopathology, psychotherapy research, experimental psychopathology, and social neuroscience.


Eric A. Fertuck, Barbara Stanley, Olena Kleshchova, J. John Mann, Joy Hirsch, Kevin Ochsner, Paul Pilkonis, Jeff Erbe, Jack Grinband. Rejection Distress Suppresses Medial Prefrontal Cortex in Borderline Personality DisorderBiological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2023; 8 (6): 651 DOI: 10.1016/j.bpsc.2022.11.006

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