Psychophysiological stress response and memory in borderline personality disorder
Psychophysiological stress response and memory in borderline personality disorder
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DOI：
10.1080/20008198.2019.1568134
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发表时间：
2019-01-01
影响因子：
5
通讯作者：
Wingenfeld, Katja
中科院分区：
文献类型：
--
作者：
Duesenberg, Moritz;Wolf, Oliver T.;Wingenfeld, Katja
背景：此前，我们发现边缘性人格障碍（BPD）患者在给予氢化可的松后记忆恢复有所改善，而健康对照组（HC）则不然。目的：在这项研究中，我们检查了心理社会压力后内源性皮质醇的增加是否与 BPD 患者和健康个体的记忆功能相关。方法：我们招募了 49 名 BPD 女性患者和 49 名 HC 女性患者。所有参与者均按随机顺序接受心理社会压力源、特里尔社会压力测试 (TSST) 和对照条件（安慰剂 (P-)TSST）。测量唾液皮质醇、α淀粉酶（sAA）和血压以应对压力。随后，我们检查了对先前学过的单词列表、自传体记忆和工作记忆的自由回忆。结果：我们发现皮质醇反应和 sAA 对压力的压力*时间*组交互作用，这主要是由于 TSST 前后各组之间皮质醇的增加略有不同而引发的。此外，与 HC 相比，BPD 患者在应激后表现出舒张压升高不太明显。在任何测试中，无论是健康对照组还是边缘性人格障碍患者，压力都没有对记忆表现产生影响。结论：我们的结果表明，与健康女性相比，BPD 患者的 HPA 轴和交感神经系统对压力的反应稍微迟钝。与氢化可的松给药相反，社会心理压力并不能改善 BPD 患者的记忆检索。这可能是由于皮质醇浓度较低、去甲肾上腺素平行增加以及压力后的负面影响所致。
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.