Functional neuroimaging recently has been used to localize brain
dysfunction in borderline personality disorder (BPD). Initial studies have
examined baseline activity or emotional reactivity, and our group has
investigated what we consider to be a crucial interaction between negative
emotion and behavioral (dys)control. This research is beginning to
identify abnormal frontolimbic circuitry likely underlying core clinical
features of this condition. We review the evidence for dysfunction in
specific frontolimbic regions, leading to a mechanistic model of symptom
formation in BPD. In addition, we offer an integration of these
neuroimaging findings with developmental perspectives on the emergence of
borderline psychopathology, focusing on the ways in which early
psychosocial experience may interact with developing brain systems. We
also consider possible mechanisms of psychotherapeutic change at the
neural systems level in BPD. Finally, we propose that future neuroimaging
studies of BPD should integrate multiple levels of observation
(structural, functional, neurochemical, genetic, and clinical) in a
model-driven fashion to further understand the dynamic relationship
between biological and psychological factors in the development and
treatment of this difficult condition.