Mittermeier Sabrina, Gregorova Klara, Goettfert Christopher, Merz Christian, Weiß Martin, Krauss Jana, Franke Sarah, Reiter Andrea, Wienrich Carolin, Buerger Arne
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Centre of Mental Health, University Hospital of Wuerzburg, Wuerzburg, Germany.
German Centre of Prevention Research in Mental Health, University of Wuerzburg, Wuerzburg, Germany.
Int J Clin Health Psychol. 2025 Apr-Jun;25(2):100583. doi: 10.1016/j.ijchp.2025.100583. Epub 2025 May 5.
High emotional arousal (EA) is a core feature of borderline personality disorder (BPD). While virtual reality (VR) has shown promise in treating emotion-based disorders, research on VR applications for BPD remains limited, especially in adolescence. This study aimed to validate a novel VR-based paradigm for assessing EA in adolescents and young adults with BPD symptoms.
In a multimodal study, we investigated the validity of aVeRsive tension: We surveyed 62 patients with BPD symptoms and 62 healthy controls (HC) aged 13-25 years who completed two VR sessions (stress/control condition). Each session included an adapted Trier Social Stress Test (TSST) followed by a cyberball paradigm. Subjective EA ratings and physiological measurements were taken during the sessions.
The BPD group showed significantly higher EA levels compared to HC across both conditions. While both groups exhibited peak EA after TSST, HC demonstrated EA reduction during Cyberball in both conditions. The BPD group maintained elevated EA levels in the stress condition. Physiological data partially supported these findings, with the BPD group showing higher heart rates, particularly during Cyberball in the stress condition.
The paradigm successfully discriminated between BPD and HC groups, capturing both subjective and physiological responses. The sustained EA in the BPD group during stress conditions aligns with characteristic emotion dysregulation patterns. While task-specific effects were observed, with TSST eliciting stronger responses than Cyberball, the paradigm effectively simulated real-life stressors in a controlled VR environment.
This study validates the protocol as a promising tool for assessing EA in adolescents and young adults with BPD symptoms. The VR-based approach offers advantages in experimental control and ecological validity, showing potential for both diagnostic assessment and therapeutic intervention in clinical settings.
高情绪唤起（EA）是边缘性人格障碍（BPD）的核心特征。虽然虚拟现实（VR）在治疗基于情绪的障碍方面已显示出前景，但针对BPD的VR应用研究仍然有限，尤其是在青少年中。本研究旨在验证一种基于VR的新型范式，用于评估有BPD症状的青少年和年轻人的EA。
在一项多模态研究中，我们调查了“厌恶紧张”的有效性：我们对62名有BPD症状的患者和62名年龄在13 - 25岁的健康对照者（HC）进行了调查，他们完成了两个VR环节（压力/对照条件）。每个环节包括一个改编的特里尔社会压力测试（TSST），随后是一个网络球范式。在环节过程中进行了主观EA评分和生理测量。
在两种条件下，BPD组的EA水平均显著高于HC组。虽然两组在TSST后均表现出EA峰值，但HC组在两种条件下的网络球环节中EA均有所降低。BPD组在压力条件下维持较高的EA水平。生理数据部分支持了这些发现，BPD组显示出更高的心率，尤其是在压力条件下的网络球环节中。
该范式成功区分了BPD组和HC组，捕捉了主观和生理反应。BPD组在压力条件下持续的EA与特征性的情绪调节障碍模式一致。虽然观察到了特定任务的效应，TSST引发的反应比网络球更强，但该范式在可控的VR环境中有效地模拟了现实生活中的应激源。
本研究验证了该方案作为评估有BPD症状的青少年和年轻人EA的一种有前景的工具。基于VR的方法在实验控制和生态效度方面具有优势，在临床环境中的诊断评估和治疗干预方面均显示出潜力。
Zotero 插件