2.16 PROCESSING OF SOCIAL SITUATIONS IN ADOLESCENTS WITH SELF-INJURY AND ADULTS WITH BORDERLINE PERSONALITY DISORDER

Objectives: Nonsuicidal self-injury (NSSI) is a prominent symptom of borderline personality disorder (BPD). However, predominantly in adolescents, NSSI often occurs independently of BPD. Social exclusion and feelings of loneliness seem to play a significant role in the context of both disorders, NSSI and BPD. Altered neural processing of social exclusion has been shown in adolescents with NSSI and adults with BPD using fMRI. The aims of this study were to investigate differences in neural processing of positive and negative social situations between adolescents with NSSI and young adults with BPD. Methods: By use of fMRI, neural processing of positive and negative social situations (paradigm: "Cyberball," inclusion and exclusion condition) was explored. Of the 60 study participants, 14 were adolescents with repetitive ongoing NSSI but without BPD (mage = 15.4; SD = 1.9), 15 young adults with BPD (mage = 23.3; SD = 4.1), and 15 healthy adolescents (mage = 14.5; SD = 1.7) and 16 healthy adults (mage = 23.2; SD = 4.4). Data were obtained using a 3-Tesla Siemens Allegra scanner and analyzed with SPM 8 for Matlab. Results: Analyses showed differential processing of social exclusion in relevant brain regions (i.e., anterior insula) in adolescents with NSSI and young adults with BPD. In addition and in line with previous reports, participants of the group with BPD showed increased activation in relevant brain regions (i.e., dorsolateral prefrontal cortex) during social inclusion compared with adolescents with NSSI and healthy control subjects. Conclusions: Although the processing of social exclusion in adolescents with NSSI differed from the other groups, patients with BPD also showed differential processing of the positive situation of social inclusion. These results underline current suggestions that NSSI should be conceptualized as a diagnosis distinct from BPD, as the neurobiology of both disorders seems to differ. However, in relatively few adolescent patients with NSSI who develop BPD, the increased reactivity to social exclusion might correspond with increased sensitivity to social situations in young adults with BPD.