Neurobiologija graničnoga poremećaja ličnosti

• Post by: Psyche General
• 23.07.2024.
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Sažetak

Granični poremećaj ličnosti (u daljnjem tekstu: GPL) pripada dramatičnoj skupini poremećaja ličnosti, a karakteriziraju ga emocionalna disregulacija, impulzivnost, autodestruktivna ponašanja te nestabilni interpersonalni odnosi u kojima je osoba izrazito osjetljiva na objektivne ili zamišljene znakove napuštanja. Cilj ovoga rada jest cjelovit pregled i sinteza neurobiologije GPL-a. U neurobiološkoj pozadini navedenih simptoma mogu se naći smanjeni volumen amigdala i hipokampusa te disfunkcija frontolimbičkoga sustava, odnosno poremećaj hiperaktivnosti limbičkoga sustava u neugodnim situacijama koju kontrolira prefrontalni režanj – što zbog njegove hipoaktivnosti, a što zbog smanjene povezanosti tih dvaju područja. Postoje i nalazi abnormalne funkcije osi hipotalamus-hipofiza-nadbubrežna žlijezda (što rezultira doživljavanjem veće svakodnevne razine napetosti i većim oprezom od potencijalnih prijetnji), endogenoga opioidnog sustava (preniska bazalna razina endogenih opioida i/ili smanjena osjetljivost endorfinskih receptora) te serotonergičkoga sustava (koji ima ulogu u impulzivnom ponašanju i reguliranju raspoloženja). Srećom, kvalitetna terapija, posebice dijalektička bihevioralna terapija, pokazuje moguće smanjenje simptoma, koje je vidljivo i na neuralnoj razini, što potvrđuje plastičnost ljudskoga mozga te tako daje nadu i alate osobama s GPL-om za uspješnije funkcioniranje i suočavanje sa svakodnevnim problemima.

Ključne riječi: granični poremećaj ličnosti, emocionalna disregulacija, endogeni opioidni sustav, frontolimbička disfunkcija, neurobiologija

Abstract

Borderline personality disorder (BPD) belongs to the dramatic group of personality disorders, and is characterized by emotional dysregulation, impulsivity, self-destructive behaviors and unstable interpersonal relationships in which the person is extremely sensitive to objective or imagined signs of abandonment. The goal of this paper is to summarize and review current findings in the field of neurobiology of BPD. The neurobiological background of the mentioned symptoms can be found in the reduced volume of the amygdala and hippocampus and the dysfunction of the frontolimbic system, i.e., the inadequate control of the hyperactivity of the limbic system in unpleasant situations by the prefrontal lobe – either due to the hypoactivity of the PFC or due to the reduced connection of these two areas. There are also findings pointing to the abnormal function of the hypothalamus-pituitary-adrenal axis (which results in experiencing a higher daily level of tension and greater vigilance against potential threats in these individuals), the endogenous opioid system (too low basal level of endogenous opioids and/or reduced sensitivity of endorphin receptors) and the serotonergic system in BPD (which plays a role in impulsive behaviour and mood regulation). Fortunately, quality therapy, especially dialectical behavioral therapy, has made some progress in possible reduction of symptoms that is also visible at the neural level, which confirms the potential plasticity of the human brain and gives hope and coping skills to people with BPD for more adaptive functioning and dealing with everyday life problems.

Keywords: borderline personality disorder, emotional dysregulation, endogenous opioid system, frontolimbic dysfunction, neurobiology