Gollan Jackie K, Lee Royce, Coccaro Emil F
University of Chicago, Clinical Neuroscience and Psychopharmacology Research Unit, Department of Psychiatry, IL 60637, USA.
Dev Psychopathol. 2005 Fall;17(4):1151-71. doi: 10.1017/s0954579405050546.
The aim of this paper is to clarify how neural mechanisms at the molecular level, specifically the serotonergic (5-HT) system and the hypothalamic-pituitary-adrenal axis system (HPA) in conjunction with early life stress may contribute to the emergence of aggression, self-directed and otherwise, in borderline personality disorder (BPD). Chronic dysregulation of these biological systems, which function to regulate stress and emotion, may potentiate the development of impulsive aggression in borderline personality conditions. Our central premise in this paper is that brain development, stress regulation, and early pathonomic experience are interactive and cumulative in their mutual influence on the development of impulsive aggression in BPD. We review the parameters of impulsive aggression in BPD, followed by a discussion of the neurobiological and neuroendocrine correlates of impulsive aggression with and without BPD. We then focus on the developmental continuities in BPD with attention to brain maturation of 5-HT and HPA axis function during the life span and the influence of early adverse experiences on these systems. Finally, we comment on the data of the relative stability of aggression in BPD, adolescence as a developmental stage of potential vulnerability, and the course of aggressive behavior during the life span.
本文旨在阐明分子水平的神经机制，特别是血清素能（5-羟色胺，5-HT）系统和下丘脑-垂体-肾上腺轴系统（HPA），连同早期生活压力，是如何促使边缘型人格障碍（BPD）中攻击行为（包括自我导向型及其他类型）的出现。这些负责调节压力和情绪的生物系统的慢性失调，可能会加剧边缘型人格状态下冲动攻击行为的发展。本文的核心前提是，大脑发育、压力调节和早期病理特征性经历在对BPD中冲动攻击行为发展的相互影响方面是相互作用且累积的。我们回顾了BPD中冲动攻击行为的参数，随后讨论了有和没有BPD情况下冲动攻击行为的神经生物学和神经内分泌相关性。接着，我们关注BPD中的发育连续性，留意5-HT和HPA轴功能在整个生命周期中的大脑成熟情况，以及早期不良经历对这些系统的影响。最后，我们对BPD中攻击行为的相对稳定性数据、青春期作为潜在易损性的发育阶段以及整个生命周期中攻击行为的进程发表评论。
