Neural correlates of personal agency in borderline personality disorder - An fMRI investigation using attachment-informed autobiographical memories.

Individuals with borderline personality disorder (BPD) have identity disturbance and difficulty with self/other distinction which may be linked to difficulties in personal agency. Neuroimaging research has helped inform underlying deficits linked to sociocognitive functioning, however, no research has specifically investigated neural correlates of personal agency in BPD. We used an attachment-informed autobiographical memory recall task to investigate behavioural and neural mechanisms of personal agency in BPD. Individuals with BPD (n = 34) and nonclinical controls (NCC, n = 35) recalled attachment and neutral memories during functional magnetic resonance imaging (fMRI). Behavioural analyses of affect, agency, and vividness of memories, and event-related fMRI analysis compared neutral and attachment-informed memories. Parametric modulation identified changes in neural activation associated with increasing agency. People with BPD felt less agentic and more negative during recall of attachment-informed memories, compared to NCCs. Agency was similar between groups for neutral memories. We found hyperactivation in the temporal parietal junction (TPJ) and superior temporal gyrus particularly during memories involving more distant attachment figures. Differential activation between BPD and NCC groups based on level of agency was found, including in the right-TPJ. Personal agency is influenced by relational contextual factors, with individuals with BPD being affected in agency when recalling memories with attachment figures. The neural hyperactivation findings provide evidence for how attachment distress or negative relational experiences may be associated with poor personal agency. This has implications for interpersonal functioning in BPD and highlights the importance and challenges of fostering personal agency in treatment.