Date of Award


Document Type


Degree Name

Philosophy (Ph.D)



First Advisor

Robin Wellington

Second Advisor

Melissa Peckins

Third Advisor

Wilson McDermutt


Borderline personality disorder (BPD) is a severe mental illness affecting over four million individuals in the United States alone. Emotion dysregulation is a core feature underlying BPD; however, the neural underpinnings of emotion dysregulation and how neural correlates relate to treatment response is not well understood. The present study examines BOLD activation during a functional magnetic resonance imaging (fMRI) task of emotion regulation to understand neural correlates of reappraisal and how this neural activity is related to treatment outcomes. Individuals with BPD (N=37) underwent fMRI at baseline and were randomized to 6-months of either dialectical behavioral therapy (DBT; N=17) or selective serotonin reuptake inhibitor (SSRI; N=20) treatment. Group analyses found brain activity in prefrontal regions, anterior cingulate, insula, thalamus, hippocampus, caudate, and putamen were associated with distancing. Neural activation during distancing was associated with change in the Beck Depression Inventory (BDI) and the Affective Lability Scale (ALS) when including treatment type as a covariate. This study adds to the existing literature on the neural correlates of emotion regulation, and it is the first to explore whether baseline BOLD activation during a task of emotional regulation can help predict response to treatment. Further work is needed to better understand how we can use neural data to provide more targeted and effective treatment to individuals with BPD.

Available for download on Saturday, July 19, 2025