Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

Borderline Personality Disorder and Emotion Dysregulation

Martin Brüne¹  Andreas Ebert¹  Vera Flasbeck¹  Stoyan Popkirov² 

[1] LWL University Hospital, Department of Psychiatry, Psychotherapy and Preventive Medicine, Division of Social Neuropsychiatry and Evolutionary Medicine, Ruhr University Bochum, Alexandrinenstr. 1, D-44791, Bochum, Germany;University Hospital Knappschaftskrankenhaus Bochum, Department of Neurology, Ruhr University Bochum, In der Schornau 23-25, 44892, Bochum, Germany;

关键词: Interoception;    Heartbeat-evoked potentials;    Autonomic nervous system;    Borderline personality disorder;    Alexithymia;    Dissociation;   

DOI  :  10.1186/s40479-020-00139-1

来源: Springer

【 摘 要 】

BackgroundPatients with borderline personality disorder (BPD) experience difficulties in emotional awareness (alexithymia), and often develop dissociative symptoms, which may reflect broader deficits in interoceptive awareness. Whether this is associated with alterations in cortical processing of interoception is currently unknown.MethodsWe utilized an electrophysiological marker of interoception, i.e. heartbeat-evoked potentials (HEP), and examined its relationship with electrocardiographic correlates of autonomic nervous system (ANS) functioning (heart rate variability), and with self-report measures of alexithymia, dissociation and borderline symptom severity in patients with BPD.ResultsIndividuals with BPD had higher HEP amplitudes over frontal electrodes compared to healthy controls. Sympathetic ANS activity was greater in BPD patients than in controls. Across groups, HEP amplitudes were associated with parasympathetic activity over central electrodes and correlated with alexithymia over frontal electrodes.ConclusionsThese findings support the idea that difficulties in emotional awareness in BPD are reflected in altered frontal electrophysiological markers of interception. Therefore, emotional awareness can be understood as failures of modulation between interoceptive and exteroceptive attention. Future research may aim to investigate whether altered interoception and its electrophysiological correlates are malleable by therapeutic intervention.

【 授权许可】

CC BY