Affective dysregulation and dissociative experience in female patients with borderline personality disorder: a startle response study
Affective dysregulation and dissociative experience in female patients with borderline personality disorder: a startle response study
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DOI：
10.1016/j.jpsychires.2004.05.001
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发表时间：
2005-01-01
影响因子：
4.8
通讯作者：
Bohus, M
中科院分区：
文献类型：
--
作者：
Ebner-Priemer, UW;Badeck, S;Bohus, M
情感调节障碍和分离是目前讨论的边缘性人格障碍(BPD)的核心特征。根据从塞拉和贝里奥斯分离的皮质边缘断开模型，假设情感调节失调与杏仁核功能增强有关，而分离与杏仁核上的处理抑制和自主神经输出抑制有关[生物精神病学44(1998)898]。我们评估了主要由杏仁核介导的惊吓反应，以调查情感调节失调和分离之间的关系。我们假设，患有BPD的患者会对令人震惊的音调表现出增强的反应，但这些反应会因状态分离经验的存在而减弱。21例女性BPD患者和21例健康女性对照组分别听15种惊厥音(95-分贝、500毫秒、1000-赫兹)，同时测量心率、皮肤电导和眼轮匝肌肌电反应。协方差分析显示，与对照组相比，BPD组在肌电中的惊吓反应明显更高。此外，当前状态的分离经历对惊吓反应有显著影响。低分离性经历的患者惊吓反应增强，而高分离性经历的患者反应减弱。我们的数据支持BPD的情感性失调，以及至少对肌电的皮质-边缘分离分离模型。此外，它强调了在基础研究和心理治疗中评估现状分离的重要性。(C)2004爱思唯尔有限公司。保留所有权利。
Affective dysregulation and dissociation are currently discussed as core features of borderline personality disorder (BPD). Affective dysregulation is hypothesized to be correlated with increased amygdala functioning and dissociation is linked to inhibited processing on the amygdala and dampened autonomic output, according to the corticolimbic disconnection model of dissociation from Sierra and Berrios [Biological Psychiatry 44 (1998) 898]. We assessed startle response, which is mainly mediated by the amygdala, to investigate the relationship between affective dysregulation and dissociation. We hypothesized that patients with BPD would reveal enhanced responses to startling tones, but that these would be lessened by the presence of state dissociative experiences. 21 unmedicated female patients with BPD and 21 healthy female controls listened to 15 startling tones (95-dB, 500-ms, 1000-Hz) while heart rate, skin conductance and orbicularis oculi electromyogram responses were measured. Covariance analysis showed that the BPD group had a significantly higher startle response in the electromyogram as compared to controls. Furthermore, present-state dissociative experiences significantly influenced the startle response. Patients with low dissociative experiences revealed enhanced startle responses whereas patients with high dissociative experiences showed reduced responses. Our data support affective dysregulation in BPD as well as the corticolimbic disconnection model of dissociation at least for EMG. Furthermore, it highlights the importance of assessing present-state dissociation in basic research as well as psychotherapy. (C) 2004 Elsevier Ltd. All rights reserved.