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Dissociation and emotion regulation in borderline personality disorder

Published online by Cambridge University Press:  09 November 2011

S. Barnow ,
A. Limberg ,
M. Stopsack ,
C. Spitzer ,
H. J. Grabe ,
H. J. Freyberger  and
A. Hamm
S. Barnow*
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
A. Limberg
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
M. Stopsack
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
C. Spitzer
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Clinic Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek, Hamburg, Germany
H. J. Grabe
Affiliation:
Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
H. J. Freyberger
Affiliation:
Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
A. Hamm
Affiliation:
Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
*
*Address for correspondence: S. Barnow, Prof., Ph.D., Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Hauptstrasse 47-51, 69117 Heidelberg, Germany. (Email: [email protected])
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Abstract

Background

Although some evidence suggests that borderline personality disorder (BPD) is primarily a disorder of the emotion regulation system, findings remain inconsistent. One potential explanation for this is the moderating role of dissociation.

Method

In this study, 33 female subjects with BPD and 26 healthy controls (HC; matched by education level and nicotine intake) were presented idiographic aversive, standard unpleasant and neutral scripts. Modulation of startle reflex and electrodermal responses (skin conductance level; SCL) were measured during imagery of emotional and neutral scripts. Additionally, self-reports of emotional experience (valence and arousal) and present-state dissociation were assessed.

Results

Patients with BPD showed elevated levels of dissociative experiences during testing. Present-state dissociation mediated group differences in SCL and startle response between the HC and BPD groups.

Conclusions

These results suggest that careful attention must be paid to the moderating effect of dissociative symptoms on the psychophysiological responses of BPD patients. Furthermore, the findings have important implications for the assessment and treatment of BPD, including the need to carefully assess BPD patients for dissociative symptoms and to incorporate the treatment of dissociation.

Keywords

Borderline personality disorderdissociationemotional hyper-reactivityskin conductance levelstartle
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 783 - 794
Copyright
Copyright © Cambridge University Press 2011

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