Löffler Annette, Kleindienst Nikolaus, Neukel Corinne, Bekrater-Bodmann Robin, Flor Herta
Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159, Mannheim, Germany.
Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Borderline Personal Disord Emot Dysregul. 2022 Feb 1;9(1):3. doi: 10.1186/s40479-021-00176-4.
Borderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input. However, whether or not perceptual alterations are present for its positive counterpart, i.e. pleasant touch (PT), has not yet been examined.
In the present study, we applied standardized PT stimuli to the hands of 25 patients with BPD and 25 healthy controls (HC) and compared their perception. We used the affect-modulated acoustic startle response as a physiological correlate of affective processing. We further explored the effect of PT stimulation on dissociative experiences in BPD.
Compared to HC, BPD perceived PT as less pleasant and less intense. The effect on perceived valence of touch was large even after controlling for the effect of reduced perceived intensity of touch (ƞ = .29). We further found qualitative alterations in touch perception in BPD, who rated the touch as significantly rougher and firmer compared to HC. There was a positive correlation between perceived valence of touch and changes in dissociative experiences in terms of body ownership of the stimulated body part from pre to post stimulation, suggesting that a more negative evaluation of touch is associated with an increase in body-related dissociative experiences, while a positive perception of touch might be related to a reduction of these dissociative experiences.
Our results confirm BPD-associated disturbances in the processing of affective somatosensory stimuli and indicate that not only pain perception but also pleasant touch perception is diminished in BPD. We discuss the role of altered touch perception for BPD psychopathology and its potential role for new treatment approaches.
边缘型人格障碍（BPD）的特征是对情感刺激的感知改变，包括对伤害性输入的异常评估。然而，对于其积极对应物，即愉悦触觉（PT）是否存在感知改变尚未进行研究。
在本研究中，我们对25名BPD患者和25名健康对照者（HC）的手部施加标准化的PT刺激，并比较他们的感知。我们使用情感调节的听觉惊吓反应作为情感加工的生理相关指标。我们进一步探讨了PT刺激对BPD患者解离体验的影响。
与HC相比，BPD患者将PT感知为不那么愉悦且强度较低。即使在控制了触觉感知强度降低的影响后，对触觉感知效价的影响仍然很大（ƞ = 0.29）。我们进一步发现BPD患者在触觉感知上存在质性改变，与HC相比，他们将触觉评定为明显更粗糙、更坚实。从刺激前到刺激后，触觉感知效价与受刺激身体部位身体所有权方面的解离体验变化之间存在正相关，这表明对触觉的更负面评价与身体相关解离体验的增加有关，而对触觉的积极感知可能与这些解离体验的减少有关。
我们的结果证实了BPD患者在情感性躯体感觉刺激加工方面存在相关障碍，并表明BPD患者不仅疼痛感知，而且愉悦触觉感知也会减弱。我们讨论了触觉感知改变在BPD精神病理学中的作用及其在新治疗方法中的潜在作用。
