Browsing by Author "Feigenbaum, Janet"

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    A machine-learning approach for differentiating borderline personality disorder from community participants with brain-wide functional connectivity
    Lahnakoski, Juha M.; Nolte, Tobias; Solway, Alec; Vilares, Iris; Hula, Andreas; Feigenbaum, Janet; Lohrenz, Terry; Casas, Brooks; Fonagy, Peter; Montague, P. Read; Schilbach, Leonhard (Elsevier, 2024-05-26)
    Background: Functional connectivity has garnered interest as a potential biomarker of psychiatric disorders including borderline personality disorder (BPD). However, small sample sizes and lack of within-study replications have led to divergent findings with no clear spatial foci. Aims: Evaluate discriminative performance and generalizability of functional connectivity markers for BPD. Method: Whole-brain fMRI resting state functional connectivity in matched subsamples of 116 BPD and 72 control individuals defined by three grouping strategies. We predicted BPD status using classifiers with repeated cross-validation based on multiscale functional connectivity within and between regions of interest (ROIs) covering the whole brain—global ROI-based network, seed-based ROI-connectivity, functional consistency, and voxel-to-voxel connectivity—and evaluated the generalizability of the classification in the left-out portion of non-matched data. Results: Full-brain connectivity allowed classification (∼70 %) of BPD patients vs. controls in matched inner cross-validation. The classification remained significant when applied to unmatched out-of-sample data (∼61–70 %). Highest seed-based accuracies were in a similar range to global accuracies (∼70–75 %), but spatially more specific. The most discriminative seed regions included midline, temporal and somatomotor regions. Univariate connectivity values were not predictive of BPD after multiple comparison corrections, but weak local effects coincided with the most discriminative seed-ROIs. Highest accuracies were achieved with a full clinical interview while self-report results remained at chance level. Limitations: The accuracies vary considerably between random sub-samples of the population, global signal and covariates limiting the practical applicability. Conclusions: Spatially distributed functional connectivity patterns are moderately predictive of BPD despite heterogeneity of the patient population.
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    Attachment and borderline personality disorder as the dance unfolds: A quantitative analysis of a novel paradigm
    Mancinelli, Federico; Nolte, Tobias; Griem, Julia; Lohrenz, Terry; Feigenbaum, Janet; Casas, Brooks; Montague, P. Read; Fonagy, Peter; Mathys, Christoph (Elsevier, 2024-04-17)
    Current research on personality disorders strives to identify key behavioural and cognitive facets of patient functioning, to unravel the underlying root causes and maintenance mechanisms. This process often involves the application of social paradigms — however, these often only include momentary affective depictions rather than unfolding interactions. This constitutes a limitation in our capacity to probe core symptoms, and leaves potential findings uncovered which could help those who are in close relationships with affected individuals. Here, we deployed a novel task in which subjects interact with four unknown virtual partners in a turn-taking paradigm akin to a dance, and report on their experience with each. The virtual partners embody four combinations of low/high expressivity of positive/negative mood. Higher scores on our symptomatic measures of attachment anxiety, avoidance, and borderline personality disorder (BPD) were all linked to a general negative appraisal of all the interpersonal experiences. Moreover, the negative appraisal of the partner who displayed a high negative/low positive mood was tied with attachment anxiety and BPD symptoms. The extent to which subjects felt responsible for causing partners’ distress was most strongly linked to attachment anxiety. Finally, we provide a fully-fledged exploration of move-by-move action latencies and click distances from partners. This analysis underscored slower movement initiation from anxiously attached individuals throughout all virtual interactions. In summary, we describe a novel paradigm for second-person neuroscience, which allowed both the replication of established results and the capture of new behavioural signatures associated with attachment anxiety, and discuss its limitations.
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    Impaired mentalizing in depression and the effects of borderline personality disorder on this relationship
    Rifkin-Zybutz, R. P.; Moran, P.; Nolte, Tobias; Feigenbaum, Janet; Casas, Brooks; Fonagy, Peter; Montague, P. Read (2021-05-04)
    Background Mentalizing, the ability to understand the self and others as well as behaviour in terms of intentional mental states, is impaired in Borderline Personality Disorder (BPD). Evidence for mentalizing deficits in other mental disorders, such as depression, is less robust and these links have never been explored while accounting for the effects of BPD on mentalizing. Additionally, it is unknown whether BPD symptoms might moderate any relationship between depressive symptoms and mentalizing. Methods Using multivariate regression modelling on cross-sectional data obtained from a sample of 274 participants recruited from clinical settings, we investigated the association between mentalizing impairment and depression and examined whether this was moderated by the presence and number of concurrent BPD symptoms, while adjusting for socio-demographic confounders. Results Impaired mentalizing was associated with depressive symptoms, after adjustment for socio-demographic confounders and BPD symptoms (p = 0.002, β = − 0.18). BPD symptoms significantly moderated the association between impaired mentalizing and depressive symptoms (p = 0.003), with more severe borderline symptoms associated with a stronger effect of poor mentalization on increased depressive symptoms. Conclusion Mentalizing impairments occur in depression even after adjusting for the effect of BPD symptoms. Our findings help further characterise mentalizing impairments in depression, as well as the moderating effect of BPD symptoms on this association.. Further longitudinal work is required to investigate the direction of association.
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    Linking mentalizing capacity, shame, and depressive symptoms in the context of childhood maltreatment
    Schwarzer, Nicola-Hans; Nolte, Tobias; Fonagy, Peter; Feigenbaum, Janet; Casas, Brooks; Rüfenacht, Eva; Gingelmaier, Stephan; Leibowitz, Judy; Pilling, Steve; Montague, P. Read (Elsevier, 2024-08-01)
    Background: Experiences of childhood maltreatment have been shown to be a crucial predictor of depressive symptoms. Objective: This study investigated the association between a history of maltreatment and depressive symptoms in a mixed sample of adults, exploring whether feelings of shame and impairments in mentalizing mediate this association and potentially represent health-affecting factors associated with an increase in depressive symptoms. Further, the association between feelings of shame and depressive symptoms was expected to be moderated by impairments in mentalizing. Participants and setting: A mixed sample of 796 adults, including clinical and non-clinical participants, completed questionnaires assessing retrospectively rated experiences of childhood maltreatment, feelings of shame, mentalizing capacities, and current depressive symptoms in a cross-sectional design. Methods: The hypotheses were tested using structural equation modelling. Results: Associations were found between childhood maltreatment, feelings of shame, impairments in mentalizing, and depressive symptoms. Impairments in mentalizing and feelings of shame partially mediated the link between maltreatment and depressive symptoms. However, impairments in mentalizing did not moderate the link between shame and depressive symptoms. Conclusion: The current study provides evidence for the role of metacognitive processes that affect mental health problems in the domain of depression. Psychological treatments that promote mentalizing capacities might be helpful in reducing feelings of shame, and consequently in reducing depressive symptoms.
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    The mediating role of attachment and mentalising in the relationship between childhood maltreatment, self-harm and suicidality
    Stagaki, Maria; Nolte, Tobias; Feigenbaum, Janet; Casas, Brooks; Lohrenz, Terry; Fonagy, Peter; Personality Mood Disorder Research Consortium; Montague, P. Read (Pergamon-Elsevier, 2022-06)
    Background: Although the relationship between childhood maltreatment, self-harm and suicidality is well-established, less is known about the mediating mechanisms explaining it. Based on a developmental mentalisation-based theoretical framework, childhood adversity compromises mentalising ability and attachment security, which in turn increase vulnerability to later stressors in adulthood.Objective: This study aimed to investigate the role of attachment and mentalising as potential mechanisms in the relationship between childhood maltreatment, self-harm and suicidality. Participants and setting: We recruited 907 adults from clinical and community settings in Greater London.Methods: The study design was cross-sectional. Participants completed self-report questionnaires on retrospectively rated childhood trauma, and current attachment to the romantic partner, mentalising, self-harm, suicidal ideation and attempt. We used structural equation modelling to examine the data and conceptualized childhood maltreatment as a general factor in a confirmatory bifactor model.Results: The results showed that childhood maltreatment was both directly associated with self harm and suicidality and indirectly via the pathways of attachment and mentalising.Conclusions: These findings indicate that insecure attachment and impaired mentalising partially explain the association between childhood maltreatment, self-harm and suicidality. Clinically, they provide support for the potential of mentalisation-based therapy or other psychosocial interventions that aim to mitigate the risk of self-harm and suicidality among individuals who have experienced childhood maltreatment via increasing understanding of self and other mental states.
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    Multidirectional Pathways between Attachment, Mentalizing, and Posttraumatic Stress Symptomatology in the Context of Childhood Trauma
    Huang, Yu Lien; Fonagy, Peter; Feigenbaum, Janet; Montague, P. Read; Nolte, Tobias (2020-05)
    Introduction:Exposure to traumatic stressful events in childhood is an important risk factor for the development of posttraumatic symptomatology. From a mentalization-based developmental perspective, childhood adversity can affect attachment in children and may result in insecure attachment and impaired mentalizing abilities, which increase the lifetime risk for psychopathology. The present cross-sectional study examined the potential mediating role of attachment insecurity and impaired mentalizing on the relationship between childhood trauma and posttraumatic symptomatology. Method: Adults who had experienced childhood neglect and abuse (n = 295, 184 patients with personality disorder and 111 community controls) completed self-report measures of posttraumatic stress disorder (PTSD) symptoms, dissociative experiences, adult attachment insecurity, and mentalizing. Results: Structural equation modelling results revealed that attachment insecurity together with lower mentalizing mediated the link between childhood trauma and PTSD symptoms, and lower mentalizing mediated the link between childhood trauma and dissociative experiences. Conclusion: The findings show that attachment insecurity and lower mentalizing play significant mediating roles in the reporting of posttraumatic symptomatology among survivors of childhood abuse and neglect, with treatment implications for mentalization-based therapy as beneficial for individuals with a history of childhood trauma.