Grant: CIHR New Investigator

Borderline personality disorder (BPD) is a serious form of mental illness affecting 2% of adults and upwards of 20% of psychiatric inpatients. These patients place an enormous financial burden on the Canadian healthcare system because they typically require frequent hospitalizations and intensive outpatient psychiatric services to treat suicidality and other dangerous behaviours. Efforts to understand the neurobiological causes of BPD have met with limited success. This is because BPD represents a heterogeneous clinical disorder comprised of multiple complex symptoms and traits which may be supported by distinct neurobiological systems. Identification of intermediate phenotypes, or biological liability markers, for BPD may help to unravel the diverse causes of this illness and optimize treatments for subsets of patients with distinct forms of this illness. The goal of this research is to isolate the most promising neurocognitive intermediate phenotypes for BPD as part of a family study to determine whether the first-degree relatives of these patients show abnormalities on cognitive testing and functional brain imaging procedures. Using information derived from these measures, a second study will determine whether specific patterns of brain activation can predict which BPD patients will achieve the greatest benefit from the most effective psychological treatment for reducing self-harming behaviours in this illness. The results of this research program have the potential to improve the future care of these patients by helping to construct the road-map for isolating which genes confer susceptibility to BPD, thereby focusing efforts on early intervention and prevention. Importantly, this research will also assist in directing appropriate treatments to target subsets of BPD patients with specific genetic and neurobiological vulnerabilities, helping to improve the effectiveness of interventions and increasing access to treatment services for patients with this illness.