The Rupture and Repair of Cooperation in Borderline Personality Disorder

To sustain or repair cooperation during a social exchange, adaptive creatures must understand social gestures and the consequences when shared expectations about fair exchange are violated by accident or intent. We recruited 55 individuals afflicted with borderline personality disorder (BPD) to play a multiround economic exchange game with healthy partners. Behaviorally, individuals with BPD showed a profound incapacity to maintain cooperation, and were impaired in their ability to repair broken cooperation on the basis of a quantitative measure of coaxing. Neurally, activity in the anterior insula, a region known to respond to norm violations across affective, interoceptive, economic, and social dimensions, strongly differentiated healthy participants from individuals with BPD. Healthy subjects showed a strong linear relation between anterior insula response and both magnitude of monetary offer received from their partner (input) and the amount of money repaid to their partner (output). In stark contrast, activity in the anterior insula of BPD participants was related only to the magnitude of repayment sent back to their partner (output), not to the magnitude of offers received (input). These neural and behavioral data suggest that norms used in perception of social gestures are pathologically perturbed or missing altogether among individuals with BPD. This game-theoretic approach to psychopathology may open doors to new ways of characterizing and studying a range of mental illnesses.

[1]  E. Rowland.  Theory of Games and Economic Behavior , 1946, Nature.

[2]  J. Rotter.  A new scale for the measurement of interpersonal trust. , 1967, Journal of personality.

[3]  R. Trivers.  The Evolution of Reciprocal Altruism , 1971, The Quarterly Review of Biology.

[4]  W. Güth,et al.  An experimental analysis of ultimatum bargaining , 1982 .

[5]  W. Hamilton,et al.  The Evolution of Cooperation , 1984 .

[6]  R. Axelrod,et al.  The Further Evolution of Cooperation , 1988, Science.

[7]  J. Talairach,et al.  Co-Planar Stereotaxic Atlas of the Human Brain: 3-Dimensional Proportional System: An Approach to Cerebral Imaging , 1988 .

[8]  D. Fudenberg,et al.  Evolution and Cooperation in Noisy Repeated Games , 1990 .

[9]  Roderick M. Kramer,et al.  When in Doubt... , 1991 .

[10]  M. Nowak,et al.  Tit for tat in heterogeneous populations , 1992, Nature.

[11]  R. Axelrod,et al.  How to Cope with Noise in the Iterated Prisoner's Dilemma , 1995 .

[12]  M. First,et al.  Structured clinical interview for DSM-IV axis I disorders : SCID-I: clinical version : administration booklet , 1996 .

[13]  M. Milinski,et al.  Human cooperation in the simultaneous and the alternating Prisoner's Dilemma: Pavlov versus Generous Tit-for-Tat. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[14]  Klaus M. Schmidt,et al.  A Theory of Fairness, Competition, and Cooperation , 1999 .

[15]  J. Bjork,et al.  Laboratory measures of aggression and impulsivity in women with borderline personality disorder , 1999, Psychiatry Research.

[16]  D. Wilkin,et al.  Neuron , 2001, Brain Research.

[17]  Daniel Houser,et al.  A functional imaging study of cooperation in two-person reciprocal exchange , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[18]  H. Critchley,et al.  Neural Activity in the Human Brain Relating to Uncertainty and Arousal during Anticipation , 2001, Neuron.

[19]  G. Pagnoni,et al.  A Neural Basis for Social Cooperation , 2002, Neuron.

[20]  Colin Camerer.  Behavioral Game Theory: Experiments in Strategic Interaction , 2003 .

[21]  Corianne Rogalsky,et al.  Increased activation in the right insula during risk-taking decision making is related to harm avoidance and neuroticism , 2003, NeuroImage.

[22]  K. Yau,et al.  Interoception: the sense of the physiological condition of the body , 2003, Current Opinion in Neurobiology.

[23]  A. Craig,et al.  Pain mechanisms: labeled lines versus convergence in central processing. , 2003, Annual review of neuroscience.

[24]  Jonathan D. Cohen,et al.  The Neural Basis of Economic Decision-Making in the Ultimatum Game , 2003, Science.

[25]  D. D. de Quervain,et al.  The Neural Basis of Altruistic Punishment , 2004, Science.

[26]  Klaus Lieb,et al.  Borderline personality disorder , 2004, The Lancet.

[27]  S. Quartz,et al.  Getting to Know You: Reputation and Trust in a Two-Person Economic Exchange , 2005, Science.

[28]  A. Arntz,et al.  Evaluations of emotional noninterpersonal situations by patients with borderline personality disorder. , 2005, Journal of behavior therapy and experimental psychiatry.

[29]  宁北芳,et al.  疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A , 2005 .

[30]  M. Delgado,et al.  Perceptions of moral character modulate the neural systems of reward during the trust game , 2005, Nature Neuroscience.

[31]  K. Putnam,et al.  Emotion dysregulation and the development of borderline personality disorder , 2005, Development and Psychopathology.

[32]  G. Pagnoni,et al.  Neurobiological Substrates of Dread , 2006, Science.

[33]  M. Nowak.  Evolutionary Dynamics: Exploring the Equations of Life , 2006 .

[34]  Susan T. Fiske,et al.  Toward socially inspired social neuroscience , 2006, Brain Research.

[35]  Jonathan D. Cohen,et al.  Neuroeconomics: cross-currents in research on decision-making , 2006, Trends in Cognitive Sciences.

[36]  M. Brüne,et al.  Theory of mind—evolution, ontogeny, brain mechanisms and psychopathology , 2006, Neuroscience & Biobehavioral Reviews.

[37]  S. Quartz,et al.  Neural Differentiation of Expected Reward and Risk in Human Subcortical Structures , 2006, Neuron.

[38]  Á. Pascual-Leone,et al.  Diminishing Reciprocal Fairness by Disrupting the Right Prefrontal Cortex , 2006, Science.

[39]  Peter Fonagy,et al.  Mechanisms of change in mentalization-based treatment of BPD. , 2006, Journal of clinical psychology.

[40]  T. Singer.  The neuronal basis and ontogeny of empathy and mind reading: Review of literature and implications for future research , 2006, Neuroscience & Biobehavioral Reviews.

[41]  U. Frith,et al.  Autism spectrum disorder and psychopathy: shared cognitive underpinnings or double hit? , 2006, Psychological Medicine.

[42]  Evan M. Gordon,et al.  Neural Signatures of Economic Preferences for Risk and Ambiguity , 2006, Neuron.

[43]  J. O'Doherty,et al.  Empathic neural responses are modulated by the perceived fairness of others , 2006, Nature.

[44]  C. Frith,et al.  How we predict what other people are going to do , 2006, Brain Research.

[45]  N. Kriegeskorte,et al.  Neural correlates of trust , 2007, Proceedings of the National Academy of Sciences.

[46]  Ellen Vos,et al.  Theory of mind in schizophrenia: meta-analysis. , 2007, The British journal of psychiatry : the journal of mental science.

[47]  K. Preuschoff,et al.  Adding Prediction Risk to the Theory of Reward Learning , 2007, Annals of the New York Academy of Sciences.

[48]  G. Pagnoni,et al.  Neural Correlates of Social Cooperation and Non-Cooperation as a Function of Psychopathy , 2007, Biological Psychiatry.

[49]  Martin P Paulus,et al.  Decision-Making Dysfunctions in Psychiatry—Altered Homeostatic Processing? , 2007, Science.

[50]  Colin Camerer,et al.  Social neuroeconomics: the neural circuitry of social preferences , 2007, Trends in Cognitive Sciences.

[51]  Terry Lohrenz,et al.  To Detect and Correct: Norm Violations and Their Enforcement , 2007, Neuron.

[52]  U. Fischbacher,et al.  The Neural Signature of Social Norm Compliance , 2007, Neuron.

[53]  R. Dolan,et al.  The neurobiology of punishment , 2007, Nature Reviews Neuroscience.

[54]  Murray B. Stein,et al.  Intolerance of uncertainty correlates with insula activation during affective ambiguity , 2008, Neuroscience Letters.

[55]  S. Quartz,et al.  Human Insula Activation Reflects Risk Prediction Errors As Well As Risk , 2008, The Journal of Neuroscience.

[56]  Pearl H. Chiu,et al.  Self Responses along Cingulate Cortex Reveal Quantitative Neural Phenotype for High-Functioning Autism , 2008, Neuron.

[57]  M. Budoff,et al.  National Institute of Neurological Disorders and Stroke , 2008 .

[58]  R. Rosenfeld.  Nature , 2009, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.