缓解期边缘型人格障碍患者的应激反应和疼痛介导的应激调节。
Stress reactivity and pain-mediated stress regulation in remitted patients with borderline personality disorder.
机构信息
Department of Psychosomatic Medicine and Psychotherapy Medical Faculty Mannheim Central Institute of Mental Health University of Heidelberg Mannheim Germany.
Department of General, Visceral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany.
出版信息
Brain Behav. 2018 Jan 26;8(2):e00909. doi: 10.1002/brb3.909. eCollection 2018 Feb.
OBJECTIVE
Patients with borderline personality disorder (BPD) use nonsuicidal self-injury (NSSI) to cope with states of elevated inner tension. It is unclear to what extent remitted BPD patients experience these states and whether the experience of pain still regulates emotion. The purpose of this study was the investigation of baseline stress levels, stress reactivity, and pain-mediated stress regulation in remitted BPD patients.
METHOD
Subjective and objective stress parameters were assessed in 30 remitted BPD patients, 30 current BPD patients, and 30 healthy controls. After stress induction, a non-nociceptive tactile stimulus, a tissue-injuring, or a noninvasive pain stimulus was applied to the right volar forearm.
RESULTS
Baseline stress levels of remitted BPD patients lie in between the stress levels of current BPD patients and healthy controls. Urge for NSSI increased significantly more in current than remitted BPD patients. The experience of pain led to a greater decrease of arousal in current compared to remitted BPD patients and healthy controls.
CONCLUSIONS
States of increased tension still seem to appear in remitted BPD patients. The role of pain-mediated stress regulation appears to be reduced in remitted patients.
目的
患有边缘型人格障碍（BPD）的患者会使用非自杀性自我伤害（NSSI）来应对内心紧张加剧的状态。尚不清楚缓解期 BPD 患者会经历这些状态到何种程度，以及疼痛是否仍然可以调节情绪。本研究旨在调查缓解期 BPD 患者的基线压力水平、压力反应性和疼痛介导的压力调节。
方法
评估了 30 名缓解期 BPD 患者、30 名当前 BPD 患者和 30 名健康对照者的主观和客观压力参数。在应激诱导后，将非伤害性触觉刺激、组织损伤性刺激或非侵入性疼痛刺激施加到右掌侧前臂。
结果
缓解期 BPD 患者的基线压力水平处于当前 BPD 患者和健康对照组之间。当前 BPD 患者的 NSSI 冲动明显高于缓解期 BPD 患者。与缓解期 BPD 患者和健康对照组相比，当前 BPD 患者经历疼痛时的唤醒度降低更为显著。
结论
在缓解期 BPD 患者中，紧张加剧的状态似乎仍然存在。疼痛介导的压力调节作用在缓解期患者中似乎有所减弱。
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