Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr University, Bochum, Germany.
Eur Arch Psychiatry Clin Neurosci. 2024 Feb;274(1):129-138. doi: 10.1007/s00406-023-01678-8. Epub 2023 Aug 31.
Stressful social situations like social exclusion are particularly challenging for patients with borderline personality disorder (BPD) and often lead to dysfunctional reactive behaviour of aggression and withdrawal. The autonomous signature of these core symptoms of BPD remains poorly understood. The present study investigated the parasympathetic response to social exclusion in women with BPD (n = 62) and healthy controls (HC; n = 87). In a between-subjects design, participants experienced objective social exclusion or overinclusion in the Cyberball task, a virtual ball-tossing game. Need threat scores served as individual measures of perceived exclusion and the resulting frustration of cognitive-emotional needs. Five-minute measurements of high-frequency heart rate variability (HF-HRV) at three time points (before, during, after Cyberball) indicated parasympathetic tone and regulation. We observed a trend towards lowered baseline HF-HRV in BPD vs. HC in line with previous findings. Interestingly, the parasympathetic response of patients with BPD to objective and perceived social exclusion fundamentally differed from HC: higher exclusion was associated with increased parasympathetic activation in HC, while this autonomic response was reversed and blunted in BPD. Our findings suggest that during social stress, the parasympathetic nervous system fails to display an adaptive regulation in patients with BPD, but not HC. Understanding the autonomous signature of the stress response in BPD allows the formulation of clinically relevant and biologically plausible interventions to counteract parasympathetic dysregulation in this clinical group.
应激性社会情境，如社会排斥，对边缘型人格障碍（BPD）患者极具挑战性，往往导致其产生功能失调的攻击和回避反应。BPD 的这些核心症状的自主特征仍未被充分理解。本研究调查了 BPD 女性（n=62）和健康对照组（HC；n=87）对社会排斥的副交感神经反应。在被试间设计中，参与者在 Cyberball 任务（一种虚拟抛球游戏）中经历了客观的社会排斥或过度包容。需要威胁评分作为感知排斥和认知情感需求受挫的个体衡量标准。在 Cyberball 之前、期间和之后的三个时间点进行了 5 分钟的高频心率变异性（HF-HRV）测量，以指示副交感神经张力和调节。我们观察到 BPD 组的基线 HF-HRV 低于 HC 组，这与之前的发现一致。有趣的是，BPD 患者对客观和感知社会排斥的副交感反应与 HC 有根本不同：在 HC 中，更高的排斥与副交感神经激活增加有关，而在 BPD 中，这种自主反应则相反并减弱。我们的研究结果表明，在社交压力下，BPD 患者的副交感神经系统无法表现出适应性调节，而 HC 则可以。了解 BPD 中应激反应的自主特征，可以为该临床群体的副交感神经失调提供临床相关且具有生物学合理性的干预措施。
