边缘型人格障碍的切口和应激调节：自伤行为的神经生物学机制。
Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour.
机构信息
Sarah Reitz, MD, Rosemarie Kluetsch, Inga Niedtfeld, PhD, Teresa Knorz, MD, Stefanie Lis, PhD, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Christian Paret, Department Neuroimaging, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Peter Kirsch, PhD, Department of Clinical Psychology, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Andreas Meyer-Lindenberg, MD, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Rolf-Detlef Treede, MD, Ulf Baumgärtner, MD, Department of Neurophysiology, Center for Biomedicine and Medical Technology, Medical Faculty Mannheim/Heidelberg University, Mannheim; Martin Bohus, MD, Christian Schmahl, MD, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
Sarah Reitz, MD, Rosemarie Kluetsch, Inga Niedtfeld, PhD, Teresa Knorz, MD, Stefanie Lis, PhD, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Christian Paret, Department Neuroimaging, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Peter Kirsch, PhD, Department of Clinical Psychology, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Andreas Meyer-Lindenberg, MD, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim; Rolf-Detlef Treede, MD, Ulf Baumgärtner, MD, Department of Neurophysiology, Center for Biomedicine and Medical Technology, Medical Faculty Mannheim/Heidelberg University, Mannheim; Martin Bohus, MD, Christian Schmahl, MD, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
出版信息
Br J Psychiatry. 2015 Aug;207(2):165-72. doi: 10.1192/bjp.bp.114.153379. Epub 2015 Apr 23.
BACKGROUND
Patients with borderline personality disorder frequently show non-suicidal self-injury (NSSI). In these patients, NSSI often serves to reduce high levels of stress.
AIMS
Investigation of neurobiological mechanisms of NSSI in borderline personality disorder.
METHOD
In 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.
RESULTS
We 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.
CONCLUSIONS
Decreased 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.
背景
边缘型人格障碍患者经常出现非自杀性自伤（NSSI）。在这些患者中，NSSI 通常用于减轻高度的压力。
目的
探究边缘型人格障碍中 NSSI 的神经生物学机制。
方法
共纳入 21 名边缘型人格障碍女性患者和 17 名健康对照者，进行应激诱导，随后进行前臂切口或假手术。之后，参与者在静息状态下进行功能磁共振成像，同时评估厌恶张力、心率和心率变异性。
结果
我们发现切口对主观和客观应激水平有显著影响，与假手术相比，边缘型人格障碍组在切口后厌恶张力下降更明显。在边缘型人格障碍组中，杏仁核活动减少，与额上回的功能连接正常化。
结论
切口后应激水平和杏仁核活动的降低支持 NSSI 对边缘型人格障碍个体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伤来减轻内心紧张。
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