Publications (2)9.11 Total impact
Article: Functional imaging of emotion reactivity in opiate-dependent borderline personality disorder.[show abstract] [hide abstract]
ABSTRACT: Opiate dependence (OD) and borderline personality disorder (BPD), separately and together, are significant public health problems with poor treatment outcomes. BPD is associated with difficulties in emotion regulation, and brain-imaging studies in BPD individuals indicate differential activation in prefrontal cingulate cortices and their interactions with limbic regions. Likewise, a similar network is implicated in drug cue responsivity in substance abusers. The present, preliminary study used functional MRI to examine activation of this network in comorbid OD/BPD participants when engaged in an "oddball" task that required attention to a target in the context of emotionally negative distractors. Twelve male OD/BPD participants and 12 male healthy controls participated. All OD/BPD participants were taking the opiate replacement medication Suboxone, and a subset of participants was positive for substances of abuse on scan day. Relative to controls, OD/BPD participants demonstrated reduced activation to negative stimuli in the amygdala and anterior cingulate. Unlike previous studies that demonstrated hyperresponsivity in neural regions associated with affective processing in individuals with BPD versus healthy controls, comorbid OD/BPD participants were hyporesponsive to emotional cues. Future studies that also include BPD-only and OD-only groups are necessary to help clarify the individual and potentially synergistic effects of these two conditions.Personality disorders. 07/2011; 2(3):230-41.
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ABSTRACT: Since the introduction of Linehan's treatment manuals in 1993, dialectical behavior therapy (DBT) has been widely disseminated throughout multiple therapeutic settings and applied to a variety of diagnoses. The enthusiasm with which it was embraced by clinicians early on led some to question whether DBT's popularity was outstripping its empirical foundation. Most of the specific concerns raised regarding DBT's early empirical base have been meaningfully addressed in subsequent randomized controlled trials. This review provides a brief introduction to DBT, followed by a critical appraisal of empirical support for the treatment and a discussion of current research trends.Annual Review of Clinical Psychology 02/2007; 3:181-205. · 9.11 Impact Factor