Cardiac autonomic functioning and clinical outcome in adolescent borderline personality disorder over two years

Sigrist, Christine; Reichl, Corinna; Schmidt, Stefanie; Brunner, Romuald; Kaess, Michael; Koenig, Julian

doi:10.1016/j.pnpbp.2021.110336

Cited by 13 publications

(14 citation statements)

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“…To further resolve the high level of heterogeneity in resting-state HRV activity within BPD women and across studies, we examined (2) the moderating role of adult attachment insecurity in the association between childhood trauma and RMSSD. However, we expect a smaller or no moderation effect within the sample of healthy women, in line with recent meta-analytic results showing a lack of relationship between CT and HRV in the absence of a concomitant psychopathological status (Sigrist et al 2021 ). Lastly, we investigated (3) potential modulatory effects of oxytocin on RMSSD in women with BPD and healthy controls (HC) and (4) explored interactive effects of childhood trauma, attachment and clinical group with oxytocin on RMSSD.…”

Section: Introductionsupporting

confidence: 89%

“…With regard to the aetiology of BPD, various results on reduced HRV point to a chronic reduction of the vagal ANS component, potentially reflecting a lack for efficient self-regulation (Thayer et al 2009 ; Koenig et al 2017 ; Weise et al 2020a , b ). Longitudinal studies suggest that changes in adolescent resting-state HRV are associated with changes in BPD symptomatology (Koenig et al 2018 ; Sigrist et al 2021 ), and even predicted clinical symptom reduction in adolescent BPD patients receiving dialectical behavioural therapy (Weise et al 2020b ).…”

Section: Introductionmentioning

confidence: 99%

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Reduced vagal activity in borderline personality disorder is unaffected by intranasal oxytocin administration, but predicted by the interaction between childhood trauma and attachment insecurity

et al. 2022

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Individuals with borderline personality disorder (BPD) show self-regulatory deficits, associated with reduced heart-rate variability (HRV). However, results on reduced HRV in BPD remain heterogeneous, thus encouraging the search for developmental constructs explaining this heterogeneity. The present study first examined predictors of reduced resting-state HRV in BPD, namely the interaction between self-reported adult attachment insecurity and childhood trauma. Second, we investigated if alterations in resting-state HRV are modified by intranasal oxytocin administration, as oxytocin may enhance HRV and is implicated in the interaction between childhood trauma and disturbed attachment for the pathogenesis of BPD. In a randomized, placebo-controlled trial, 53 unmedicated women with BPD and 60 healthy controls (HC) self-administered either 24 I.U. of oxytocin or placebo and underwent a 4-min electrocardiogram. Our results replicate significantly reduced HRV in women with BPD, explained up to 16% by variations in childhood trauma and attachment insecurity. At high levels of acute attachment insecurity, higher levels of childhood trauma significantly predicted reduced HRV in BPD. However, our results do not support a significant effect of oxytocin on mean HRV, and no interaction effect emerged including childhood trauma and attachment insecurity. Our findings highlight a complex interaction between reduced vagal activity and developmental factors in BPD.

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Section: Introductionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Reduced vagal activity in borderline personality disorder is unaffected by intranasal oxytocin administration, but predicted by the interaction between childhood trauma and attachment insecurity

et al. 2022

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“…These studies have linked autonomic nervous system functioning (i.e. heart rate and heart rate variability) to clinical outcomes [61 ▪ ,62 ▪ ,63] and future studies may influence early identification and preventive efforts.…”

Section: Advances In Treatment and Future Directionsmentioning

confidence: 99%

Improving treatment outcomes for borderline personality disorder: what can we learn from biomarker studies of psychotherapy?

Marceau

Ruocco

Grenyer

2022

Current Opinion in Psychiatry

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Purpose of reviewBorderline personality disorder (BPD) is a severe and common psychiatric disorder and though evidence-based psychotherapies are effective, rates of treatment nonresponse are as high as 50%. Treatment studies may benefit from interdisciplinary approaches from neuroscience and genetics research that could generate novel insights into treatment mechanisms and tailoring interventions to the individual.Recent findingsWe provide a timely update to the small but growing body of literature investigating neurobiological and epigenetic changes and using biomarkers to predict outcomes from evidence-based psychotherapies for BPD. Using a rapid review methodology, we identified eight new studies, updating our earlier 2018 systematic review. Across all studies, neuroimaging (n = 18) and genetics studies (n = 4) provide data from 735 participants diagnosed with BPD (mean sample size across studies = 33.4, range 2–115).SummaryWe report further evidence for psychotherapy-related alterations of neural activation and connectivity in regions and networks relating to executive control, emotion regulation, and self/interpersonal functioning in BPD. Emerging evidence also shows epigenetic changes following treatment. Future large-scale multisite studies may help to delineate multilevel treatment targets to inform intervention design, selection, and monitoring for the individual patient via integration of knowledge generated through clinical, neuroscience, and genetics research.

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“…Latest empirical evidence has demonstrated associations between the presence of BPD (or symptoms) and higher rates of cardiovascular diseases, liver diseases, hypertension, venereal, and gastrointestinal diseases (El-Gabalawy et al, 2010;Benjamin et al, 2019;Virani et al, 2020;Cavicchioli et al, 2021). However, studies exploring the direct association between the presence of symptoms of BPD and cardiovascular diseases in medical samples are still scarce, and present empirical inquiry was conducted to add to the body of literature in this regard (Sher, 2005;Powers and Oltmanns, 2013;Gale et al, 2014;Maiß et al, 2021;Sigrist et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…About the association between physical health issues/conditions and borderline personality disorder (BPD), earlier studies showed a relationship between BPD and various deleterious physiological outcomes such as the enhanced risk of severe chronic illnesses, including heart disease, arthritis, and diabetes (Maiß et al, 2021;Sigrist et al, 2021). Nevertheless, few studies have explored the relationship between BPD, health care utilization, and medical comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Validity and Reliability of the Urdu Version of the McLean Screening Instrument for Borderline Personality Disorder

et al. 2021

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Introduction: Although the translation and the validation of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) are performed in various languages and samples, no study has established the validity and reliability of the Urdu version of MSI-BPD in individuals with cardiac problems.Materials and Methods: The Urdu version of the MSI-BPD was prepared through the standard back-translation method. The translation and adaption were completed in four steps: forward translation, adaption and translation, back translation and committee approach, and cross-language validation. The sample, selected through the purposive sampling method, comprised of 150 adults with cardiac problems (men = 75 and women = 75), with an age range of 23–78 years (M = 55, SD = 10.6). The Cronbach alpha reliability and factorial validity of the MSI-BPD were assessed through confirmatory factor analysis (CFA) and Pearson correlation analyses. Internal consistency and test–retest reliability (at 2 weeks' interval) were used to evaluate the reliability. Statistical analyses were performed, using SPSS (version 22) and Structural Equation Modeling (SEM) software.Results: Preliminary analysis revealed that the overall instrument had good internal consistency (Urdu MSI-BPD α = 0.79; English MSI-BPD α = 0.77) as well as test–retest correlation coefficients for 15 days (r = 0.94).Conclusions: Findings suggested that the MSI-BPD, with important limitations, can be used as an effective preliminary screening tool to measure BPD in Urdu-speaking adults with cardiac problems. Further validations should be conducted to make the translated version of the MSI-BPD an appropriate tool to screen BPD in hospitals and mental health care settings.

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Cardiac autonomic functioning and clinical outcome in adolescent borderline personality disorder over two years

Cited by 13 publications

References 91 publications

Reduced vagal activity in borderline personality disorder is unaffected by intranasal oxytocin administration, but predicted by the interaction between childhood trauma and attachment insecurity

Reduced vagal activity in borderline personality disorder is unaffected by intranasal oxytocin administration, but predicted by the interaction between childhood trauma and attachment insecurity

Improving treatment outcomes for borderline personality disorder: what can we learn from biomarker studies of psychotherapy?

Validity and Reliability of the Urdu Version of the McLean Screening Instrument for Borderline Personality Disorder

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