Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder

Abstract

This protocol offers a detailed description of a psychophysiological experiment using script-driven trauma-related imagery and standardized clinical instruments within a comparative design assessing physiological and psychopathological features of individuals with BPD. This method aims at studying the psychological and physiological effects of trauma-related dissociation. Since the psychodiagnostic classification of trauma-related disorders relies on the observation of evolutionarily determined responses to life-threat, an integrated assessment paradigm for the study of reactions to traumatic memories proposes a very appropriate methodological approach. The employed script-driven imagery paradigm uses individual recall instructions to activate trauma-related memory networks and prompt associated emotional and physiological responses. These responses are measured by means of self-rating scales and physiological assessments. During the individual recall, participants are asked to vividly imagine traumatic and everyday experiences and other situations triggered by short personalized verbal scripts they authored beforehand together with the experimenters. A wide range of affective reactions and different physiological parameters can be measured. We used this paradigm to investigate dissociative states in BPD and to find physiological and affective correlates of dissociative states. Some of the participants were having severe traumatic antecedents. To investigate different reaction patterns within the same diagnostic group, participants with different levels of traumatic histories, symptom severities, and co-morbidities should be included. By using short verbal scripts, the level of stress induced to participants is held as low as possible without affecting the validity of the object of investigation.

The brain-body disconnect: A somatic sensory basis for trauma-related disorders

“…When the latter result is coalesced with findings of diminished vestibular nuclei rsFC with cortical regions in PTSD + DS ( Harricharan et al, 2017 ), we converge on a hypothesis that dissociative symptomology is related to cortical-somatic sensory deafferentation, resulting in hypo-arousal and altered perceptual awareness of the body and its surroundings. Stress or trauma recall-induced dissociation has been linked to blunted psychophysiological arousal responses in traumatized individuals with high dissociative symptoms ( Griffin et al, 1997 ; Koopman et al, 2004 ; Sack et al, 2012 ; D’Andrea et al, 2013 ; for a review, see Boulet et al, 2022 ), as well as in individuals with psychiatric conditions highly associated with severe early life traumatization including dissociative disorder (DD) ( Schäflein et al, 2018 ), borderline personality disorder (BPD) ( Ebner-Priemer et al, 2005 ; Bichescu-Burian et al, 2018 ) and dissociative identity disorder (DID) ( Williams et al, 2003 ; see Putnam et al, 1986 for a review). Tendencies toward hyper-arousal and blunted arousal states in PTSD and PTSD + DS, respectively, point toward a psychophysiological manifestation of PTSD symptomology and different patterns of arousal-related neural circuitry in non-dissociative and dissociative trauma-related disorders.…”