Psychophysiological stress response and memory in borderline personality disorder

Abstract

Background: Previously, we found that patients with borderline personality disorder (BPD) but not healthy controls (HC) showed improved memory retrieval after hydrocortisone administration.Objective: In this study, we examined whether increases in endogenous cortisol after psychosocial stress are associated with memory function in patients with BPD and in healthy individuals.Methods: We recruited 49 female patients with BPD and 49 female HC. All participants were exposed to a psychosocial stressor, the Trier Social Stress Test (TSST) and a control condition (Placebo (P-)TSST) in randomized order. Salivary cortisol, alpha amylase (sAA) and blood pressure were measured in response to stress. Subsequently, we examined free recall of a previously learned word list, autobiographical memory, and working memory.Results: We found a stress*time*group interaction effect for the cortisol response and for sAA to stress, which is mainly triggered by a slightly different increase in cortisol between groups from pre to post TSST. Furthermore, BPD patients showed a less pronounced increase in diastolic blood pressure compared to HC after stress. There was no effect of stress on memory performance in any tests, either in healthy controls or in patients with BPD.Conclusion: Our results suggest a slightly blunted response of the HPA axis and the sympathetic nervous system to stress in BPD compared to healthy women. In contrast to hydrocortisone administration, psychosocial stress did not improve memory retrieval in BPD patients. This might be explained by lower cortisol concentrations and parallel increases in norepinephrine and negative affect after stress.

Effects of hydrocortisone on autobiographical memory retrieval in patients with posttraumatic stress disorder and borderline personality disorder: the role of childhood trauma

“…Activation of hippocampal GRs decreases HPA axis activity, so an increase in pituitary ACTH, which reflects central activation of the HPA axis, in responses to stress in participants with childhood trauma is in line with these results [46]. However, reduced cortisol reactivity in response to stress [47,48] has also been shown in participants with childhood trauma and in patients with BPD [49]. Abnormal stress responses might be linked to GR expression and resemble a dysregulation of the HPA axis with adverse health outcomes [47,48].…”

Childhood Adversities and Salivary Cortisol Responses to the Trier Social Stress Test: A Systematic Review of Studies Using the Children Trauma Questionnaire (CTQ)

“…Dividing 41 female anorexic patients into two groups with and without CA using composites of cut-offs of the 5 subscales, Monteleone et al [46] reported that patients with CA exhibited a lower AUC i than patients without CA. However, the significant association observed in patients with personality disorders [42] was not replicated in two other studies with female patients diagnosed with personality disorders [43,44]. In a similar vein, the significant association between CA and cortisol response in patients with eating disorders reported by Monteleone et al [46] was not observed in Monteleone et al [40].…”

“…A brief description of each study is also provided. Healthy participants were examined in 4 studies [34,[37][38][39] and the remaining 8 studies focused either on patients with specific psychiatric or medical conditions (n = 3, [33,40,41]) or both patients and healthy controls (n = 5, [42][43][44][45][46]). The 12 studies used either the standard TSST (n = 9) or an adapted version (n = 3) as the social stressor.…”

“…For the 4 studies that provided information on race or ethnicity of participants, 2 studies used a predominantly American-African youth sample [34,39] whereas the other two used a predominantly White/Caucasian adult sample [37,44]. In studies with psychiatric samples, the diagnoses were based on either the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) [42][43][44][45] or the Fifth Edition (DSM-5) criteria [40,46]. [38].…”

The Association between Noise Exposure and Metabolic Syndrome: A Longitudinal Cohort Study in Taiwan

“…Although the strength of the associations varies significantly across studies, chronic exposure to noise is associated with elevated blood pressure and other metabolic outcomes. In response to noise, stress hormones are released [ 29 ]. Psychophysiological stress reaction to noise is associated with metabolic and cardiovascular outcomes [ 30 , 31 ].…”