Neural Changes in Borderline Personality Disorder After Dialectical Behavior Therapy-A Review

Front Psychiatry. 2021 Dec 17:12:772081. doi: 10.3389/fpsyt.2021.772081. eCollection 2021.


The biological component of the biosocial theory of emotion regulation stipulates that borderline personality disorder (BPD) arises from biological vulnerabilities to heightened emotional reactivity. Comprehensive reviews have consistently implicated abnormalities in the amygdala, anterior cingulate cortex, and hippocampus in the neurobiology of BPD. While Dialectical Behavior Therapy (DBT) is the leading evidence-based psychotherapy for the treatment of BPD, there remains a paucity of literature examining changes in the neurobiology of BPD following DBT treatment. Nine studies were identified that examined neurobiological changes in BPD after the completion of DBT. Results indicated that there was significant deactivation of amygdala activity as well as the anterior cingulate cortex in patients with BPD after DBT treatment. As well, several studies found after DBT treatment, BPD patients had a decreased activity in the inferior frontal gyrus in response to arousing stimuli and increased activity in response to inhibitory control. Future research on the neurobiological change after DBT treatment can help clarify biological mechanisms of change in BPD.

Keywords: borderline personality disorder; dialectical behavior therapy (DBT); magnetic resonance imaging (MRI); near-infrared reflectance spectra (NIRS); neurobiology.

Publication types

  • Review