Emotionally distressing, aversive or painful experiences are a part of everyday life experience. Crucial to emotional resilience is the capacity to voluntarily regulate one?s emotional reaction to such experiences. Some people, however, have difficulty modulating their emotional reactions and are subject to sudden, extreme emotional states, especially in response to interpersonal events. This vulnerability, referred to as affective instability (AI), is prototypic of borderline personality disorder (BPD), but is found across a range of psychiatric disorders, and is prevalent, occuring in about 14% of the population. The mechanisms underlying affective instability are not well understood, but there is evidence that adaptive emotion regulation strategies used by healthy individuals are impaired in those with BPD and other disorders characterized by affective instability, and that the brain circuits that typically support these regulation strategies are dysfunctional. This study is designed to determine the extent to which two emotion regulation strategies, cognitive reapprasial and attentional distraction, are dysfunctional across a spectrum of individuals with varying degrees of AI. It will use functional neuroimaging (fMRI) to assess the functioning of underlying brain circuits as these regulation strategies are implemented. In addition to studying AI across a spectrum of disorders, this study will also focus on how spoken emotion is regulated. To date, the strategies of cognitive reappraisal and attentional distraction have been examined as they modulate emotion conveyed via still pictures, but not emotion conveyed by speech directed at the subject, yet the spoken word is one of the most important channels of emotional communication in interpersonal interaction and therefore particularly relevant to AI. The present study will address this knowledge gap. To achieve these aims this project will collect behavioral, physiologic, and functional imagng (fMRI) data as subjects, spanning the full range of AI, employ cognitive reapprasial and attentional distraction to down-regulate their responses to negative emotional cues and cogntive reappraisal to upregulate their responses to positive cues. The same subjects will apply these strategies to emotion presented via both pictures and the spoken word. We will examine activation of brain regions of interest and functionally connected circuits implicated in emotion regulation, as well as skin conductance and pupillary dilation responses, in addition to behavioral responses.

Public Health Relevance

Affective instability is a common and debilitating emotional disturbance in which individuals are unstable, react rapidly and with exteme emotion and suffer abrupt mood swings, have difficulties in personal relationships and in the workplace and may even experience suicidal impulses. This study uses neuroimaging methods to determine whether affective instablity is associated with an impairment in the ability to use effective emotion regulation mechanisms and whether such impairments are related to disturbances in the activity of the brain systems which typically regulate emotion. Such knowledge could help to develop new treatments specifically targeted to reduce emotional instablity.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH109730-03
Application #
9519012
Study Section
Adult Psychopathology and Disorders of Aging Study Section (APDA)
Program Officer
Rumsey, Judith M
Project Start
2016-09-23
Project End
2021-05-31
Budget Start
2018-07-01
Budget End
2019-05-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Icahn School of Medicine at Mount Sinai
Department
Psychiatry
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029