Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour
Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour
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DOI：
10.1192/bjp.bp.114.153379
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发表时间：
2015-08-01
影响因子：
10.5
通讯作者：
Schmahl, Christian
中科院分区：
文献类型：
--
作者：
Reitz, Sarah;Kluetsch, Rosemarie;Schmahl, Christian
边缘型人格障碍患者常表现为非自杀性自伤。在这些患者中，自伤通常是为了减轻高水平的压力。目的探讨边缘型人格障碍患者自伤的神经生物学机制方法共选取21名边缘型人格障碍患者和17名健康对照者进行应激诱导，然后进行前臂切口或假治疗。之后，参与者接受静息状态功能磁共振成像，同时评估厌恶张力、心率和心率变异性。结果发现边缘型人格障碍患者的主观和客观应激水平均受手术切口的显著影响，且手术后患者的厌恶紧张程度明显低于假手术组。边缘型人格障碍组在手术后杏仁核活动下降更多，与额上回的功能连接恢复正常。结论切口后应激水平和杏仁核活动的降低支持了自伤对边缘型人格障碍患者情绪调节的影响的假设，并有助于理解为什么这些患者使用自我造成的疼痛来减轻内心紧张。版权及用法(C)皇家精神科医学院2015。
BackgroundPatients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress.AimsInvestigation of neurobiological mechanisms of NSSI in borderline personality disorderMethodIn total, 21 women with borderline personality disorder and 17 healthy controls underwent a stress induction, followed by either an incision into the forearm or a sham treatment. Afterwards participants underwent resting-state functional magnetic resonance imaging while aversive tension, heart rate and heart rate variability were assessed.ResultsWe found a significant influence of incision on subjective and objective stress levels with a stronger decrease of aversive tension in the borderline personality disorder group following incision than sham. Amygdala activity decreased more and functional connectivity with superior frontal gyrus normalised after incision in the borderline personality disorder group.ConclusionsDecreased stress levels and amygdala activity after incision support the assumption of an influence of NSSI on emotion regulation in individuals with borderline personality disorder and aids in understanding why these patients use self-inflicted pain to reduce inner tension.Copyright and usage (C) The Royal College of Psychiatrists 2015.