Increased psychological and attenuated cortisol and alpha-amylase responses to acute psychosocial stress in female patients with borderline personality disorder

Nater, Urs M.; Bohus, Martin; Abbruzzese, Elvira; Ditzen, Beate; Gaab, Jens; Kleindienst, Nikolaus; Ebner‐Priemer, Ulrich W.; Mauchnik, Jana; Ehlert, Ulrike

doi:10.1016/j.psyneuen.2010.06.002

Cited by 86 publications

(68 citation statements)

References 41 publications

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“…Compared to healthy controls, those engaging in NSSI show an increased cortisol secretion following pain induction. Previous research on HPA axis response using standardized stressors (e.g., dexamethasone suppression test or the Trier Social Stress Test; TSST) found the HPA axis to be hyporesponsive to stress in adolescents with NSSI [22,23], consistent with findings from adults with BPD [24] and animal studies [25]. A blunted cortisol stress response has previously been linked to more aversive emotional reactions to stress [26].…”

Section: Introductionsupporting

confidence: 61%

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

et al. 2018

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Background: Nonsuicidal self-injury (NSSI), the intentional, self-directed act of injuring one’s own body tissue, is a behavioral phenomenon closely linked to stress and its maladaptive regulation. NSSI is associated with childhood adversity that may underlie altered hypothalamic-pituitary-adrenal axis and autonomic nervous system response to stress in adolescents engaging in NSSI. Adolescents engaging in NSSI show decreased pain sensitivity and increased psychophysiological response to pain that may underlie the maintenance of the behavior and its stress-regulating function. Sampling and Methods: In a secondary analysis of previously published data we aimed to address the relationship between childhood adversity and altered psychophysiological pain response in an outpatient sample of n = 30 adolescents engaging in repetitive NSSI. Results: Greater childhood adversity is associated with greater cortisol secretion and increased and prolonged autonomic arousal following pain induction. Conclusions: The findings illustrate a potential neurobiological pathway linking childhood adversity to hyporesponsiveness of endogenous stress response systems that in turn show increased reactivity to the experience of pain. This hyperreactivity may counterbalance an inadequate stress response and in turn help to cope with stressful experiences. Directions for future research are discussed.

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Section: Introductionsupporting

confidence: 61%

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

et al. 2018

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“…The most robust findings in experimental stress paradigms can be interpreted as attenuated peripheral cortisol release [92]. These findings have been confirmed in self-harming adolescents [93].…”

Section: Neurobiological Studiesmentioning

confidence: 62%

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

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Speranza

Luyten

et al. 2015

Eur Child Adolesc Psychiatry

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131

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Borderline personality disorder (BPD) has onset in adolescence, but is typically first diagnosed in young adulthood. This paper provides a narrative review of the current evidence on diagnosis, comorbidity, phenomenology and treatment of BPD in adolescence. Instruments available for diagnosis are reviewed and their strengths and limitations discussed. Having confirmed the robustness of the diagnosis and the potential for its reliable clinical assessment, we then explore current understandings of the mechanisms of the disorder and focus on neurobiological underpinnings and research on psychological mechanisms. Findings are accumulating to suggest that adolescent BPD has an underpinning biology that is similar in some ways to adult BPD but differs in some critical features. Evidence for interventions focuses on psychological therapies. Several encouraging research studies suggest that early effective treatment is possible. Treatment development has just begun, and while adolescent-specific interventions are still in the process of evolution, most existing therapies represent adaptations of adult models to this developmental phase. There is also a significant opportunity for prevention, albeit there are few data to date to support such initiatives. This review emphasizes that there can be no justification for failing to make an early diagnosis of this enduring and pervasive problem.

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“…57 A specific vulnerability to stress (higher emotional intensity in response to stressors and a delayed return to baseline affect) has been proposed for individuals with BPD, 58 which might be associated with the hypothalamic-pituitary-adrenal axis (HPAA). 59 Adults with BPD show an attenuated cortisol response to acute stress, 60 and this has also been found in adolescents engaging in repetitive NSSI. 61 More numerous self-harm behaviors in adolescents with BPD were associated with increased pituitary volumes, 62 suggesting greater basal activation of the HPAA.…”

Section: Neurobiological Findingsmentioning

confidence: 92%

Borderline Personality Disorder in Adolescence

2014

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This is the 4th in our series on Adolescent Health. abstract Borderline personality disorder (BPD) is a common and severe mental disorder that is associated with severe functional impairment and a high suicide rate. BPD is usually associated with other psychiatric and personality disorders, high burden on families and carers, continuing resource utilization, and high treatment costs. BPD has been a controversial diagnosis in adolescents, but this is no longer justified. Recent evidence demonstrates that BPD is as reliable and valid among adolescents as it is in adults and that adolescents with BPD can benefit from early intervention. Consequently, adolescent BPD is now recognized in psychiatric classification systems and in national treatment guidelines. This review aims to inform practitioners in the field of adolescent health about the nature of BPD in adolescence and the benefits of early detection and intervention. BPD diagnosis and treatment should be considered part of routine practice in adolescent mental health to improve these individuals' well-being and long-term prognosis.

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Increased psychological and attenuated cortisol and alpha-amylase responses to acute psychosocial stress in female patients with borderline personality disorder

Cited by 86 publications

References 41 publications

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

Childhood Adversity and Psychophysiological Reactivity to Pain in Adolescent Nonsuicidal Self-Injury

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

Borderline Personality Disorder in Adolescence

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