Borderline Personality Disorder (BPD) is a severe mental disorder causing significant, persistent disability, and with a high lifetime risk of suicide. The limited knowledge about the neurobiological underpinnings of BPD is a critical obstacle for the development of new, more effective treatments. There is high comorbidity and overlap in symptoms and neurobiological findings between BPD, anxiety disorders, and post-traumatic stress disorder (PTSD). Moreover, a wealth of evidence suggests that there are abnormalities in fear processing and emotional learning in BPD. Given these findings, it is surprising that very few studies have used fear conditioning paradigms in BPD patients. What follows is a review of the evidence of symptomatic overlap and comorbidity between BPD, anxiety disorders, and PTSD, and the neurobiological findings that suggest abnormal fear processing in BPD. We also discuss fear conditioning and related paradigms that probe the brain systems involved in fear processing and will review studies using the same methodologies in BPD patients. Finally, we describe potential research and treatment implications, and future directions.
- Anxiety disorders
- Borderline personality disorder
- Emotion processing
- Fear conditioning
- Post-traumatic stress disorder