Dissociation and Alterations in Brain Function and Structure: Implications for Borderline Personality Disorder

Curr Psychiatry Rep. 2017 Jan;19(1):6. doi: 10.1007/s11920-017-0757-y.

Abstract

Dissociation involves disruptions of usually integrated functions of consciousness, perception, memory, identity, and affect (e.g., depersonalization, derealization, numbing, amnesia, and analgesia). While the precise neurobiological underpinnings of dissociation remain elusive, neuroimaging studies in disorders, characterized by high dissociation (e.g., depersonalization/derealization disorder (DDD), dissociative identity disorder (DID), dissociative subtype of posttraumatic stress disorder (D-PTSD)), have provided valuable insight into brain alterations possibly underlying dissociation. Neuroimaging studies in borderline personality disorder (BPD), investigating links between altered brain function/structure and dissociation, are still relatively rare. In this article, we provide an overview of neurobiological models of dissociation, primarily based on research in DDD, DID, and D-PTSD. Based on this background, we review recent neuroimaging studies on associations between dissociation and altered brain function and structure in BPD. These studies are discussed in the context of earlier findings regarding methodological differences and limitations and concerning possible implications for future research and the clinical setting.

Keywords: Borderline personality disorder; Brain structure and function; Depersonalization disorder; Dissociation; Dissociative identity disorder; Neuroimaging; Posttraumatic stress disorder (PTSD); Trauma.

Publication types

  • Review

MeSH terms

  • Borderline Personality Disorder / diagnostic imaging*
  • Borderline Personality Disorder / physiopathology*
  • Borderline Personality Disorder / psychology
  • Brain / physiopathology*
  • Brain Mapping
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology
  • Depersonalization / diagnostic imaging*
  • Depersonalization / physiopathology*
  • Depersonalization / psychology
  • Dissociative Disorders / diagnostic imaging*
  • Dissociative Disorders / physiopathology*
  • Dissociative Disorders / psychology
  • Humans
  • Limbic System / diagnostic imaging
  • Limbic System / physiopathology
  • Neuroimaging
  • Stress Disorders, Post-Traumatic / diagnostic imaging*
  • Stress Disorders, Post-Traumatic / physiopathology*
  • Stress Disorders, Post-Traumatic / psychology