Borderline and cluster C personality disorders manifest distinct physiological responses to psychosocial stress

Aleknavičiūtė, Jūratė; Tulen, Joke H.M.; Kamperman, Astrid M.; Rijke, Yolanda B. de; Kooiman, Cornelis G.; Kushner, Steven A.

doi:10.1016/j.psyneuen.2016.06.010

Cited by 38 publications

(49 citation statements)

References 48 publications

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“…Thus, we excluded patients with comorbid MDD. Furthermore, higher skin conductance and heart rate responsivity to the TSST have been found in BPD .…”

Section: Discussionmentioning

confidence: 95%

“…In our BPD sample, there were no differences in the cortisol response to the stressor compared to healthy controls. Up to now, only few studies investigated endocrine reactions including HPA axis parameters to psychosocial stress in BPD, suggesting rather a reduced than enhanced cortisol response to stress . Other authors reported dissociation to be an important mediator of the cortisol response to stress in BPD .…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls

Wingenfeld

Duesenberg

Fleischer

et al. 2018

Acta Psychiatr Scand

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The current finding provides first evidence that stress differentially affects emotional empathy in patients with BPD and healthy individuals such that patients with BPD showed reduced emotional empathy compared to healthy women after stress. Given the strong impact of stress on acute psychopathology in patients with BPD, such a response may exacerbate interpersonal conflicts in stress contexts and may be an important target for therapeutic interventions.

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“…Thus, we excluded patients with comorbid MDD. Furthermore, higher skin conductance and heart rate responsivity to the TSST have been found in BPD .…”

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls

Wingenfeld

Duesenberg

Fleischer

et al. 2018

Acta Psychiatr Scand

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“…Physiological alterations potentially linked to hypothalamic function have repeatedly been identified in recent studies of BPD pathophysiology. For example, social stress led to high psychological distress, but blunted physiological stress response in the ANS and the hypothalamic‐pituitary‐adrenal‐ axis in several studies of BPD patients, while the finding of more normal physiological responses in clinical controls suggests that a dissociation between subjective and objective stress response could be specific to BPD . Furthermore, plasma concentration of oxytocin, a hypothalamic neuropeptide exerting profound influence on social behavior, was found to be reduced in BPD patients .…”

Section: Discussionmentioning

confidence: 99%

Patterns of altered regional brain glucose metabolism in borderline personality disorder and bipolar II disorder

Bøen

Hjørnevik

Hummelen

et al. 2019

Acta Psychiatr Scand

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S, Malt UF. Patterns of altered regional brain glucose metabolism in borderline personality disorder and bipolar II disorder.Objective: The relationship between borderline personality disorder (BPD) and bipolar II disorder (BIP-II) is disputed but understudied. Here, we investigated brain glucose metabolism in these patient groups and healthy control subjects (HCs). Methods: Sixty-five subjects, 22 BPD (19 females), 22 BIP-II (17 females), and 21 HC (14 females), were examined using 2-deoxy-2[18F]-fluoro-dglucose positron-emission tomography (PET) scanning. Only patients without reciprocal comorbidity were recruited; BPD participants without bipolar spectrum pathology; BIP-II participants without cluster A/B personality pathology. Groups were compared pairwise. Associations with mood state and childhood trauma were analyzed. Results: Both patient groups exhibited hypometabolism compared with HCs in insula, brainstem, and frontal white matter. Additionally, BPD patients showed hypometabolism in hypothalamus, midbrain, and striatum; BIP-II patients in cerebellum. Uncorrected analyses showed cortical areas of higher metabolism in BIP-II than BPD, and associations with clinical variables differed between the groups. Conclusion: Reduced metabolism in the insula regions was shown in both disorders, suggesting shared pathophysiological mechanisms. The observed patterns of altered metabolism specific to each patient group, as well as the uncorrected results, may also suggest differential pathophysiology. However, these latter findings must be interpreted cautiously given the non-significant corrected results in the direct comparison between the disorders. Significant outcomes• This is the first FDG-PET study comparing patients with borderline personality disorder and patients with bipolar II disorder.• Several regions of decreased metabolism, including insula and frontotemporal white matter, were common for both disorders.• Reduced metabolism in the hypothalamus was shown in borderline patients only. This finding could potentially be linked to several previously suggested endocrinological disturbances in this disorder, involving HPA-axis, oxytocin, and testosterone.• Uncorrected analyses showed differences between the disorders regarding correlation with clinical variables. Limitations• Most participants were on psychotropic medication. • The number of participants was limited, although comparable with previous PET studies of these patient groups.

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“…Die letzte Literaturrecherche fand am 25.08.2018 statt und inkludierte die folgenden Suchwörter: "Cortisol" or "hpa" and "psychosocial stress" or "interpersonal stress" and "borderline". (15)(16)(17)(18)(19). Männliche BPS-Probanden zeigen eine erhöhte Kortisolreaktion auf den TSST im Vergleich zur gesunden Kontrollstichprobe (18).…”

Section: Methodenunclassified

“…In den vergangenen Jahrzehnten wurden zunehmend zugrunde liegende Mechanismen, speziell auf endokrinologischer, biologischer und neuronaler Ebene herausgearbeitet (10,11). Dabei kristallisierte sich unter anderem eine Dysregulation der Hypothalamus-Hypophysen-Achse (HPA) heraus (12), welche sowohl bei interpersonellen als auch zwischenmenschlich-evaluativ stressreichen Situationen eine große Rolle zu spielen scheint (13)(14)(15)(16). Um die Mechanismen der physiologischen Dysregulation in zwischenmenschlich-evaluativ und interpersonell stressreichen Situationen besser zu verstehen, wurden in den vergangenen 2 Jahrzehnten zunehmend Studien mit der Erfassung von endokrinologischen und physiologischen Parametern (z.…”

Section: Dieunclassified

Endokrinologische Korrelate der Borderline-Persönlichkeitsstörung

Kröner¹,

Schaitz²,

Maier³

et al. 2018

Nervenheilkunde

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ZusammenfassungDie Borderline-Persönlichkeitsstörung (BPS) ist eine schwerwiegende und im psychiatrischen sowie psychotherapeutischen Kontext die am häufigsten vorkommende Persönlichkeitsstörung. Sie zeichnet sich durch ein Muster von Instabilität im zwischenmenschlichen Kontakt und im Selbstbild sowie eine gesteigerte Impulsivität aus. Annahmen besagen, dass Personen mit einer BPS sehr stark auf emotionale Stimuli reagieren und Schwierigkeiten haben, ihre physiologischen Reaktionen zu kontrollieren. Die Übersichtsarbeit durchleutete die Datenbank PubMed systematisch auf Artikel zum Thema „Kortisol“ oder „Hpa“ und „psychosozialer Stress“ oder „interpersoneller Stress“ und „Borderline“. Hierbei konnten von 135 Artikeln 8 identifiziert werden, die den Suchkriterien entsprachen. Nach Evaluation der Studien können die Hypothesen bezüglich interpersoneller Stressoren teilweise bestätigt werden. Hierbei erlebten Personen mit BPS im Vergleich zu gesunden Kontrollprobanden eine erhöhte physiologische Stressreaktion, gemessen am Kortisol im Speichel, auf einen interpersonellen Konflikt. In Studien zu sozial-evaluativen Stressoren reagierten BPS-Probanden jedoch im Gegensatz zu diesen Ergebnissen auf Stress mit einer Hyporeagibilität des physiologischen und endokrinologischen Stresssystems. In Bezug auf ein Fazit bleiben die Befunde uneindeutig, was den geringen Stichprobengrößen, teilweise fehlenden Mediatorsowie Moderatorvariablen, unterschiedlichen Einschlusskriterien und Messzeitpunkten, aber auch der einseitigen Geschlechterverteilung geschuldet sein könnte.

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Borderline and cluster C personality disorders manifest distinct physiological responses to psychosocial stress

Cited by 38 publications

References 48 publications

Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls

Psychosocial stress differentially affects emotional empathy in women with borderline personality disorder and healthy controls

Patterns of altered regional brain glucose metabolism in borderline personality disorder and bipolar II disorder

Endokrinologische Korrelate der Borderline-Persönlichkeitsstörung

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