Borderline personality disorder and emotion regulation: Insights from the Polyvagal Theory

Abstract

The current study provides the first published evidence that the parasympathetic component of the autonomic nervous system differentiates the response profiles between individuals diagnosed with borderline personality disorder (BPD) and controls. Respiratory sinus arrhythmia (RSA), a non-invasive marker of the influence of the myelinated vagal fibers on the heart, and heart period were collected during the presentation of film clips of varying emotional content. The BPD and control groups had similar initial levels of RSA and heart period. However, during the experiment the groups exhibited contrasting trajectories, with the BPD group decreasing RSA and heart period and the control group increasing RSA and heart period. By the end of the experiment, the groups differ significantly on both RSA and heart period. The correlation between the changes in RSA and heart period was significant only for the control group, suggesting that vagal mechanisms mediated the heart period responses only in the control group. The findings were consistent with the Polyvagal Theory [Porges, S. W. (1995). Orienting in a defensive world: Mammalian modifications of our evolutionary heritage: A Polyvagal Theory. Psychophysiology, 32, 301-318; Porges, S. W. (2001). The Polyvagal Theory: Phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42, 123-146; Porges, S. W. (2003). Social engagement and attachment: A phylogenetic perspective. Annals of the New York Academy of Sciences, 1008, 31-47.], illustrating different adaptive shifts in autonomic state throughout the course of the experiment. The BPD group ended in a physiological state that supports the mobilization behaviors of fight and flight, while the control group ended in a physiological state that supports social engagement behaviors. These finding are consistent with other published studies demonstrating atypical vagal regulation of the heart with other psychiatric disorders.

Attachment and its Vicissitudes in Borderline Personality Disorder

“…This work is consistent with other findings using heart rate measures [66], which found that individuals with BPD demonstrate less parasympathetic activity in response to emotional films. Greater parasympathetic activity promotes social engagement, whereas less is more indicative of preparedness for fight/flight.…”

Stability of resting frontal electroencephalogram (EEG) asymmetry and cardiac vagal tone in adolescent females exposed to child maltreatment

“…Low vagal tone has also been reported in patients with various psychiatric disorders (Austin, Riniolo, & Porges, 2007;Friedman, 2007;McCraty, Atkinson, Tomasino, & Stuppy, 2001;Rechlin, Weis, Spitzer, & Kaschka, 1994;Thayer, Friedman, & Borkovec, 1996).…”

Self-Esteem and Autonomic Physiology: Parallels Between Self-Esteem and Cardiac Vagal Tone as Buffers of Threat

“…Some research examining psychological variables that moderate these differences in vagal tone reactivity is consistent with this possibility. For example, in response to negatively valenced film clips, people with borderline personality disorder showed no change in vagal tone whereas control participants showed an increase in vagal tone (Austin, Riniolo, & Porges, 2007). In response to a mental arithmetic task, people with PTSD showed no change in vagal tone relative to control participants who showed an increase in vagal tone (Sahar, Shalev, & Porges, 2001).…”