The role of nociceptive input and tissue injury on stress regulation in borderline personality disorder
The role of nociceptive input and tissue injury on stress regulation in borderline personality disorder
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伤害性输入和组织损伤对边缘性人格障碍压力调节的作用
DOI：
10.1097/j.pain.0000000000000787
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发表时间：
2017
期刊：
影响因子：
7.4
通讯作者：
. . . Schmahl
中科院分区：
文献类型：
--
作者：
Willis;Kuniss;Kleindienst;. . . Schmahl
摘要约60%~ 90%的边缘型人格障碍（BPD）患者存在非自杀性自伤行为（NSSI），切割是最常用的方法。NSSI的功能之一是减少令人厌恶的紧张。先前的研究已经发现了一个减少疼痛的组织损伤的切口的张力的效果。目前还不清楚这种效应是基于组织损伤的效应还是疼痛体验的效应，或者两者兼而有之。本研究的目的是确定组织损伤是否比BPD患者的单一疼痛刺激更能减轻压力。在应激诱导后，57名BPD患者和60名健康对照（HC）接受切口或非组织损伤性机械伤害性刺激（“刀片”），其通常被认为是疼痛的或非伤害性触觉假刺激（手术刀的钝端）。参与者不知道采用了哪种程序。对于压力评估，测量主观和客观参数。作为对刺激应用的即时反应，我们发现BPD患者在疼痛刺激（切口和刀片）后的应力降低更大，但组织损伤切口和非组织损伤疼痛刺激（刀片）之间的应力降低没有差异。与HCs相比，BPD患者中切口和刀片的觉醒立即减少更大。我们的研究结果证实，在BPD患者中，伤害性输入导致压力减轻。相比之下，组织损伤对应力降低的影响相对较小。此外，研究结果表明，疼痛刺激导致BPD患者的压力降低比HC更大。
Abstract Approximately 60% to 90% of patients with borderline personality disorder (BPD) show nonsuicidal self-injurious behavior (NSSI) with cutting being the most frequently applied method. One of NSSI’s functions is to reduce aversive tension. Previous studies have found a tension-reducing effect of painful tissue injury by an incision. It is still unclear whether this effect is based on the effect of tissue injury or the effect of pain experience, or both. The aim of this study was to determine whether tissue injury leads to a stronger stress reduction than a sole pain stimulus in patients with BPD. After stress induction, 57 BPD patients and 60 healthy controls (HCs) received either an incision or a non–tissue-injuring mechanical nociceptive stimulus (“blade”) typically perceived as painful or a nonnociceptive tactile sham stimulus (blunt end of scalpel). Participants were unaware of which procedure was applied. For stress assessment, subjective and objective parameters were measured. As immediate response to the stimulus application, we found greater stress reduction after both painful stimuli (incision and blade) in BPD patients but no difference in stress decrease between the tissue-injuring incision and the non–tissue-injuring pain stimulus (blade). Compared with HCs, incision and blade were followed by greater immediate decrease of arousal in BPD patients. Our findings confirm that among BPD patients, the nociceptive input leads to stress reduction. In contrast, the impact of tissue damage on stress reduction was relatively small. In addition, the results suggest that painful stimuli lead to a greater stress reduction in BPD patients compared with HCs.
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7.4
作者：
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通讯作者：
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影响因子：
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影响因子：
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