NEU30004 Literature Review on Personality Disorders Assessment Answer

Introduction:

A literature review is the procedure or study of academic data on a certain subject. It presents all of the prior knowledge alongside the current data, allowing for the identification of pertinent approaches, theories, restrictions, and research gaps. All pertinent publications, including books, journals, and critical analyses of our deserted results are included in the literature review. A dynamic tool, a literature review will offer the pertinent information for the best clinical treatment and the lines of future study. A thorough, well-organized, and complete survey of the literature. Additionally, it offers a modern instrument for authoring, synthesis, and critical analysis of the literature in the field of healthcare. Personality disorders are widespread, persistent patterns of cognition, mood, and behavior that are not adaptive. People with personality disorders have abnormal affective reactions and incorrect perceptions of reality, which leads to distress in many facets of the person's life, including work-related challenges, poor social skills, and interpersonal challenges. A study conducted by Chen et al., (2019) indicates that neurological developmental disorders such as autism spectrum disorder are characterized by atypical functional integration of brain regions. The great majority of ASD neuroimaging research has concentrated on older kids, teens, and adults who have the condition (Wolff et al., 2018). The functional connectivity of the complete brain in young children with ASD has seldom ever been studied. In context to this, the study was conducted to review the literature on personality disorders associated with the aberrant neurological system. 

Aim:

This study aims to review the literature on how personality disorder is linked with an aberrant neurological system. 

Research question:

The question for this review literature is outlined utilizing the PIO.

P = Neurological disorder patient

I = how personality disorder

O= linked?

Search strategy:

The systemic search tactics for this literature are examined by utilizing the following approaches: data is collected through authenticated and well-organized sites on personality disorders associated with aberrant neurological systems. PRISMA strategies were shown on multiple databases such as Web of Science, CINHAL, NCBI, PubMed, Medline, BMC Nursing, and Science Direct from 2016-2022. Following are the terms that were used to search the database: personality disorder, neurological system, the link between personality disorder and neurological system, neurological developmental disorder, and borderline personality disorder. 

Inclusion and exclusion criteria:

Nine authors used standardized data to retrieve the data. This literature review only comprises dependable, unique research articles. The work contains research portions that were accompanied between 2016 and 2022, available in English, published in a peer-studied journal, and provided online. Stages for appropriateness and screening were removed for the study range. In order to correctly find the inclusion measures, the journals were primarily appraised on the basis of their labels and précises. Writers distinctly selected and examined the studies for this determination by first understanding the headings and summaries of the studies. Each study paper was systematically appraised. The residents of the healthcare specialists were suitably studied as the complete text of the research in question was examined. It was also patterned for extra or accompanying methods in the orientation segment of the study articles.

During the sequence of this literature findings process, those study journals that were not completely observed or inspected are omitted. The investigation does not comprise perspectives, explanations, or research that did not follow the inclusion necessities.

Result:

The table mentioned below gives the conclusion of the study in a summary form. For this literature review, more than 250 distinct publications were located on various databases (PubMed, CINHAL, Medline, NBI, and Science Direct). After the duplicate item was removed, 300 distinct articles remained for the title evaluation. Additionally, some papers were eliminated because their titles did not fit the search criteria or the study. Some papers were disregarded because their abstracts, conclusions, and outcomes did not adhere to the review's criteria. 50 research papers were left to have their abstracts evaluated after titles had been checked or evaluated. The remaining studies and candidate abstracts were eliminated because they were inappropriate or did not fit the search criteria. Only 9 papers in total met the criteria for this literature evaluation.

Discussion:

A personality disorder is a condition that affected people globally, in this the individual has an unhealthy and rigid pattern of functioning, thinking, and behaving. Further, by studying various studies it has been observed how personality disorder is connected with the aberrant neurological system. In a meta-analysis study performed by Chen et al., (2019), it was found that a neurodevelopmental disorder with an early start is an autism spectrum disorder (ASD). Understanding early-life brain functioning changes is crucial for comprehending the molecular causes behind ASD (Laimhart, 2015). Here, they discovered two abnormal brain functional circuits related to social and sensorimotor function in young children with ASD. These conclusions emphasize the potential role of aberrant brain functional connectivity patterns in the development of core ASD symptoms in young children. Further, the discussion of this study indicates that deficits in social interaction are important traits of ASD. Abridged associates between brain regions included in social functions have been found in earlier studies based on people with ASD. The study investigated unusual FC shapes in young ASD patients (Ha et al., 2015). The researchers investigated two atypical FC circuits in ASD using a recurrent-seek approach: one primarily made up of social brain regions that showed under-connectivity and the other primarily made up of sensorimotor and optical regions that showed over-connectivity (Chen et al., 2019). These results showed abnormal FC patterns specific to brain circuits in early ASD patients, which may shed light on the neurological underpinnings of the onset of behavioral symptoms in ASD. In support of this study, the finding of another study conducted by Tang et al., (2016) suggests that contempt for social responsibility and callous disregard for other people's feelings are traits of antisocial personality disorder (ASPD). According to studies, ASPD is linked to aberrant functional connectivity and abnormalities in specific brain areas. This study looked at the functional brain systems' topological organization in people with ASPD. The wavelet scale four (0.016-0.031 Hz), which is a component of the frequency range (0.01-0.073 Hz) for grey matter-associated fluctuations, was where the functional connectome was abnormally organized in the brains of ASPD participants (Retico et al., 2014). The following description of this anomaly in ASPD subjects: a rise in the gathering measurement; (ii) anomalous nodal betweenness in the temporal, parietal, and frontal lobes; and (iii) a decline in-betweenness centralities in the limbic and subcortical systems, care module, somatosensory and auditory modules, and limbic and subcortical systems. Therefore proposed that individuals with these ASPD-linked features might show advanced movement in some brain parts within particular regularity ranges, which would be imitated by an amplified bunching coefficient (Tang et al., 2016). Irritability, mania, impulsivity, and aggressive behavior are characteristics that are frequently associated with ASPD. Lei et al., (2019) indicate that an all-prevalent pattern of expressive liability, impulsivity, relational issues, individuality troubles, and disordered cognition characterizes the prevalent mental disease known as a borderline personality disorder. Debilitated inhibitory impacts of the prefrontal cortex (PFC) on overactive limbic brain areas in reaction to emotional inputs have been linked to expressive dysregulation, which is thought to be a key pathological hallmark of BPD (Mahajan & Mostofsky, 2016). The bilateral ACC served as seeds in the current investigation, which studied the SC and FC of the ACC and looked at relationships between aberrant neuroimaging directories and psychosocial factors in BPD patients. It was discovered that the ACC-CC-frontal brain circuit, which is involved in emotion regulation, showed aberrant SC and FC in BPD patients. These results imply that aberrant SC and FC in front limbic brain regions may mediate emotional dysregulation in BPD patients (Lei et al., 2019). Further, this study indicates that ACC plays a significant role in emotional cognitive regulation, and irregular connectivity of the ACC provisions the likelihood that BPD might be considered by lacking emotional regulation circuitry. Jointly, the data of this study advise that connectivity of brain areas can be a significant imaging biomarker in BPD inhabitants that could have scientific consequences for the treatment of the disorder. The study conducted by Quattrini et al., (2022) indicates that a complex psychiatric disorder called borderline personality disorder (BPD) is characterized by unpredictability in interpersonal relationships, emotional dysregulation (such as inappropriately extreme anger or disturbing self-image, persistent empty feelings, and fear of abandonment), and behavioral dysregulation (thoughtless and violent behaviors, recurrent self-hurting and suicide efforts). According to the "three network model," BPD symptoms have been linked to the dysfunction of key expressive and cognitive networks, including the salience network (SN), the executive control network (ECN), and the default mode network (DMN). The triple network's FC abnormalities in BPD have been well-recognized (Hiremath et al., 2021). Our findings add to existing evidence by demonstrating, for the first time, that while the circuits' morphology is unaffected, the triple system's disruption in BPD also impairs WM microstructure. The first-level study brought attention to the MD's selective uptick in BPD when likened to HC (Quattrini et al., 2022). The putative underlying mechanism was revealed by the second-level analysis: WM changes were likely connected to axonal demyelination (improved RD) and axonal impairment (augmented AD). In BPD, behavioral dysregulation was also linked to this dysconnectivity pattern. The findings of this investigation support the hypothesis that BPD is characterized by a triple network system connectivity deficit, and they also revealed a distinct anterior and right-lateralized shape of microstructural alterations. It is significant that this pattern was linked to behavioral dysregulation, serving as both a potential illness marker and a potential aim for upcoming non-aggressive treatments involving brain stimulus. Orth et al., (2020) conducted a study that indicates that impact regulation, controlling of impulse, self-image, and relational interactions are frequently unstable in BPD patients. There is already evidence that a central brain system is tuned to resolutions regarding SR, but recent research has shown a variety of regions that seem to be engaged in the appraisal of SR (Tan et al., 2022). Patients with BPD have impaired connection between these cortical brain regions and the subcortical reward-, salience-, and feeling-associated (e.g., hippocampus, basal ganglia, and amygdala) structures and the thalamus. A disrupted sense of self, characterized by an unbalanced intelligence terminating in self-destructive conduct, self-regard, and self-damage, is likely associated with altered functional connectivity (Orth et al., 2020). The identification of the brain endophenotypes for self-linked signs in BPD may aid in the growth of pertinent diagnostic and therapeutic approaches. The characterization of neuronal aberrations associated with SR processing. Another study conducted by Zhuo et al., (2020) indicates that about 25% of people with borderline personality disorder experience auditory verbal hallucinations (AVHs) (BPD). The groundbreaking results from this investigation into whole-brain FCD, as assessed by gFCD in BPD participants with or without AVH, have significant ramifications for our knowledge of the neurological bases of the psychotic symptoms of AVH in BPD patients. To the best of our knowledge, it is recommended that BPD patients with or without AVH examine the gFCD for measuring whole-brain FC. In networks that are highly related to the AVH in BPD patients, we have discovered malfunctioning FC (Zhuo et al., 2020). Additionally, the gFCD-measured AVH-associated patterns of FC may aid in the creation of novel therapeutic strategies for AVH in BPD patients as well as provide fresh perspectives on BPD-AVH. 

Khoweiled et al., (2021) in their study suggest that the emphasis of interest in current years has been on examining the relationship between medical or behavioral data and fundamental structural and functional brain conclusions in borderline personality disorder (BPD), an advanced psychiatric condition with numerous psychopathological dimensions. According to the study's findings, patients with BPD have milder neurological abnormalities than the control group overall, but especially in the sensual addition and original reflex areas. In this study, we discovered a resilient association between NSS and the complete harshness of borderline symptoms (measured by the total BPQ score), specifically impulsivity, suicidal ideation and behavior, acute anger, feeling empty within, and quasi-psychosis. This study's findings that BPD patients have a greater rate of NSS support the notion that these individuals have non-localized CNS dysfunction (Khoweiled et al., 2021). NSS and borderline symptoms have a positive relationship, especially impulsivity, suicidal ideation, self-inflicted injuries, strong rage, a sensation of barrenness, and quasi-psychosis. The domain of impulsivity was shown to have the strongest link to NSS.

The study performed by Jimenez et al., (2018) result suggests that despite performing similarly on the task, patients displayed overall decreased activity in the pSTS relative to controls and at a tendency level in the amygdala through emotions. Additionally, a functional connectivity analysis showed that during the feeling in biological sign test, panels but not patients demonstrated a strong positive connection between the pSTS and left frontal areas as well as bilateral angular gyrus (Jimenez et al., 2018). According to these results, schizophrenia patients exhibit abnormal brain action and functional connectivity when deriving complicated social evidence from basic motion cues, which may be a factor in the disorder's deficiencies in social perception. King et al., (2020) in their study indicate that previous studies on personality and behavior changes in individuals who have experienced a neurological incident (such as a stroke, surgery, or traumatic brain damage) have generally concentrated on detrimental results in a variety of functional areas. There is a wealth of evidence linking specific personality and behavioral changes to damage to specific brain regions. In patients with prefrontal injury, for instance, an increase in irritability, moodiness, and improper social behavior has long been documented. According to this research, patients with acquired prefrontal dysfunction have behavioral dysfunction that is defined in part by deficits in the capacity to regulate behavior and apathetic attitudes (King et al., 2020). Further, this study shows that patients who improved in personality and behavior in one or more functional domains. According to lesion studies, positive alterations in personality and conduct were consistently linked to an injury to the right anterior dorsolateral prefrontal region and the bilateral frontal polar regions. These results provide credence to the idea that changes in personality and behavior can emerge following a neural incident and that they are systematically correlated with neuroanatomical alterations. Patients who experienced positive behavioral and personality improvements after a neurological incident were judged to have had more dysfunctional functioning before the event.

The results of the studies cited above suggest a connection between personality disorder and an abnormal neurological system. The results of the study should be understood in light of the ensuing restrictions. Only a few papers could be included in this investigation. Comparisons are challenging since even within these studies, the method employed to determine the prevalence of psychological disorders varied.

Conclusion:

A personality disorder is a deeply ingrained behavior of the person that deviates markedly from the norms of the usually accepted behavior, characteristically apparent by the time of adolescence and resulting long term harm or issues in the personal relation or functional potential in society. According to the findings of the performed studies, it has been observed that personality disorders affect the person's neurological system. Several studies indicate that borderline personality disorder is a condition that affects the structural and functional connectivity of the person in the brain and disturbed their pattern of performing activities. Thus, in the conclusion of this literature review, it can be said that Personality disorder and aberrant neurological systems are associated. 

References:

Chen, H., Wang, J., Uddin, L. Q., Wang, X., Guo, X., Lu, F., Duan, X., Wu, L., & Chen, H. (2018). Aberrant functional connectivity of neural circuits associated with social and sensorimotor deficits in young children with autism spectrum disorder. Autism Research: Official Journal of the International Society for Autism Research, 11(12), 1643–1652. https://doi.org/10.1002/aur.2029

Ha, S., Sohn, I. J., Kim, N., Sim, H. J., & Cheon, K. A. (2015). Characteristics of Brains in Autism Spectrum Disorder: Structure, Function, and Connectivity across the Lifespan. Experimental Neurobiology, 24(4), 273–284. https://doi.org/10.5607/en.2015.24.4.273

Hiremath, C. S., Sagar, K., Yamini, B. K., Girimaji, A. S., Kumar, R., Sravanti, S. L., Padmanabha, H., Vykunta Raju, K. N., Kishore, M. T., Jacob, P., Saini, J., Bharath, R. D., Seshadri, S. P., & Kumar, M. (2021). Emerging behavioral and neuroimaging biomarkers for early and accurate characterization of autism spectrum disorders: A systematic review. Translational Psychiatry, 11(1), 42. https://doi.org/10.1038/s41398-020-01178-6

Jimenez, A. M., Lee, J., Reavis, E. A., Wynn, J. K., & Green, M. F. (2018). Aberrant patterns of neural activity when perceiving emotion from biological motion in schizophrenia. NeuroImage: Clinical, 20, 380-387. https://doi.org/10.1016/j.nicl.2018.08.014

Khoweiled, A. A., Gaafar, Y., El Makawi, S. M., Kamel, R. M., & Ayoub, D. R. (2021). Neurological soft signs correlation with symptom severity in borderline personality disorder. Middle East Current Psychiatry, 28(1), 1-8.

King, M. L., Manzel, K., Bruss, J., & Tranel, D. (2020). Neural correlates of improvements in personality and behavior following a neurological event. Neuropsychologia, 145, 106579. https://doi.org/10.1016/j.neuropsychologia.2017.11.023

Lainhart J. E. (2015). Brain imaging research in autism spectrum disorders: in search of neuropathology and health across the lifespan. Current Opinion in Psychiatry, 28(2), 76–82. https://doi.org/10.1097/YCO.0000000000000130

Lei, X., Zhong, M., Zhang, B., Yang, H., Peng, W., Liu, Q., & Yi, J. (2019). Structural and functional connectivity of the anterior cingulate cortex in patients with borderline personality disorder. Frontiers in Neuroscience, 13, 971. https://doi.org/10.3389/fnins.2019.00971

Mahajan, R., & Mostofsky, S. H. (2015). Neuroimaging endophenotypes in autism spectrum disorder. CNS Spectrums, 20(4), 412–426. https://doi.org/10.1017/S1092852915000371

Orth, L., Zweerings, J., Ibrahim, C. N., Neuner, I., & Sarkheil, P. (2020). Altered functional connectivity during evaluation of self-relevance in women with borderline personality disorder. NeuroImage: Clinical, 27, 102324. https://doi.org/10.1016/j.nicl.2020.102324

Quattrini, G., Magni, L. R., Lanfredi, M., Pedrini, L., Carcione, A., Riccardi, I., & CLIMAMITHE Study Group. (2022). Aberrant structural connectivity of the triple network system in borderline personality disorder is associated with behavioral dysregulation. Journal of Clinical Medicine, 11(7), 1757. 10.3390/jcm11071757 

Retico, A., Tosetti, M., Muratori, F., & Calderoni, S. (2014). Neuroimaging-based methods for autism identification: a possible translational application? Functional Neurology, 29(4), 231–239.

Tan, Z., Wei, H., Song, X., Mai, W., Yan, J., Ye, W., Ling, X., Hou, L., Zhang, S., Yan, S., Xu, H., & Wang, L. (2022). Positron Emission Tomography in the Neuroimaging of Autism Spectrum Disorder: A Review. Frontiers in Neuroscience, 16, 806876. https://doi.org/10.3389/fnins.2022.806876

Tang, Y., Long, J., Wang, W., Liao, J., Xie, H., Zhao, G., & Zhang, H. (2016). Aberrant functional brain connectome in people with antisocial personality disorder. Scientific Reports, 6(1), 1-12.

Wolff, J. J., Jacob, S., & Elison, J. T. (2018). The autism journey: Insights from neuroimaging studies of infants and toddlers. Development and Psychopathology, 30(2), 479–495. https://doi.org/10.1017/S0954579417000980

Zhuo, C., Ji, F., Lin, X., Tian, H., Wang, L., Xu, Y., & Lin, X. (2021). Common and distinct brain functional alterations in pharmacotherapy treatment-naïve female borderline personality disorder patients with and without auditory verbal hallucinations: a pilot study. European Archives of Psychiatry and Clinical Neuroscience, 271(6), 1149-1157.

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