One of the main themes of
this blog is how researchers in psychiatry continually mix up learned or
conditioned responses with disease states. These include misinterpreting fMRI
findings and data derived from twin
studies. I have also discussed something called Error
Management Theory, which predicts that if you come from a toxic and
crazy environment like someone with borderline personality disorder (BPD) does,
and have to learn how to react to it, it is in your interest to have a high
index of suspicion about the others around you. Somehow this has turned into emotional
“hyper-reactivity” as some of sort of brain pathology or abnormality.
Now comes a study that
seems to be strong evidence for my point of view. (Borrolla, B., Cavicchioli, C,.,
Fossati, A., and Maffei, C. “Emotional Reactivity Borderline Personality
Disorder: Theoretical Considerations based on Meta-Analytic Review of
Laboratory Studies.” Journal of
Personality Disorders 34[1], 64-87, 2020).
The authors did a meta-analysis
(combining the data from several studies) which addressed the question.
Variables measured in
these studies included heart rate, respiratory heart sinus arrhythmia, skin
conductance, cortisol (stress hormone) levels, startle response, blood
pressure, and patient self report.
Their conclusion: the hyper-reactivity
hypothesis was in general not supported. The apparent
increase in reactivity in BPD could instead be attributable to their tendency
to evaluate emotional stimuli more
negatively than controls. Exactly what error management theory would predict!
The study authors go on to
say that amygada functioning (basically fight/flight/freeze reactions) concerns
“several processes that go beyond emotional arousal (salience and novelty
detection, reward learning, memory, attention modulation, decision making…” (p.
79).
Exactly. And Amen.
