Posted by twinleaf on August 15, 2008, at 10:13:23
In this week's edition of Science (8 August 2008) there is an extremely interesting article by several psychoanalysts from Baylor, Menningers' and the University of London. In it, they describe using game theory to understand how people with BPD might differ from normal controls in how they deal with the social interaction involving investing small amounts of money ($20). They found that persons with BPD, described as having "unstable relationships, affective dysregulation and a broad incapacity to trust the actions and motives of others" had great difficulty in assessing the motives of investment partners. The control players were able to assess the motives of their partner-players correctly, and to respond in such away as to foster continued cooperation. For example, if one partner invested $10, the other would invest an equal or higher amount in return. This response allowed these players to progress through 12 rounds, with different amounts being invested, and with trust and cooperation being maintained. If these attitudes were temporarily lost, the player who had misread a cue would engage in "coaxing" behavior- bidding higher so as to regain the partner's trust. This was labelled "rupture and repair".The players with BPD consistently responded with lesser investments (investing only $5 in return for $10). These games ceased after 4-5 rounds, with both players feeling angry and taken advantage of. The BPD players were not able to correctly interpret the social meaning of the investments- i.e. that they indicated cooperation and trust, and needed to be responded to with equal or greater investments. And when rupture occurred, there was no attempt at repair.
Brain imaging studies done on the study participants showed that the anterior insular region of the cortex- a region known to be active in evaluating social behavior-lit up in the normal controls equally when investments were made and received. They were able to make accurate social evaluations of the situation while they were both giving and receiving. In contrast, the anterior insula lit up in the BPD subjects when they made an investment offer, but not when they received one. They had not developed an ability to properly evaluate the degree of cooperation and trust that they were receiving from another individual.
Although this study did not discuss any therapeutic implications, it seems clear that people who have BPD need a very interactive, interpersonal form of therapy, in which the motives and feelings of both the patient and the therapist are talked about at length. At first, studies like this do seem discouraging, because of the brain imaging information. But brains do have plasticity, and all of this increased knowledge is bound to help in terms of better therapy for more people.
poster:twinleaf
thread:846366
URL: http://www.dr-bob.org/babble/psycho/20080810/msgs/846366.html