Dissociation proneness and pain hyposensitivity in current and remitted borderline personality disorder
Open accessAbstract
Background: Stress‐related dissociation has been shown to negatively co‐vary with pain perception in current borderline personality disorder (cBPD). While remission of the disorder (rBPD) is associated with normalized pain perception, it remains unclear whether dissociation proneness is still enhanced in this group and how this feature interacts with pain sensitivity. Methods: Twenty‐five cBPD patients, 20 rBPD patients and 24 healthy controls (HC) participated in an experiment using the script‐driven imagery approach. We presented a personalized stressful and neutral narrative. After listening to the scripts, dissociation and heat pain thresholds (HPT) were assessed. Results: Compared to HC, cBPD patients showed enhanced dissociation and exhibited significantly enhanced HPT in the neutral condition, whereas rBPD participants were in between. After listening to the stress script, both clinical groups exhibited enhanced dissociation scores. Current BPD participants responded with significantly higher HPT, whereas rBPD only showed a trend in the same direction. However, both BPD groups showed significantly increased HPT compared to the HC in the stress condition, but did not differ from each other. Dissociation proneness correlated significantly positively with pain hyposensitivity only in cBPD. Conclusion: Dissociation proneness is enhanced in both BPD groups. This feature is clearly positively related to pain hyposensitivity in cBPD, but not in rBPD. However, the data indicate that stress causes the pain perception in rBPD to drift away from that obtained in HC. These results highlight the volatile state of BPD remission and might have important implications for the care of BPD patients in the remitted stage. Significance: Both current (cBPD) and remitted borderline personality disorder (rBPD) patients show enhanced proneness to dissociation. This feature is significantly linked with pain hyposensitivity in cBPD in a paradigm that induces stress using a script‐driven imagery approach, whereas this connection cannot be observed in rBPD. However, in the stress compared to the neutral condition, rBPD participants also show pain hyposensitivity compared to healthy controls. This study provides new insights into the pain processing mechanisms of BPD and its remission.
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BPD often involves pain analgesia related to the use of dissociation, both in current and (when exposed to stressors) remitted BPD cases.
“BPD often involves pain analgesia related to the use of dissociation, both in current and (when exposed to stressors) remitted BPD cases [17].”
From Complex PTSD and borderline personality disorder (2021) · cites this paper as [17]
The Discussion reports reduced pain sensitivity in current BPD and in remitted BPD after a stressful script. It also says dissociation proneness was linked to pain hyposensitivity in current BPD, but not in remitted BPD; the claim overextends that relationship to remitted cases. (LLM, conf=0.93)
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Complex PTSD and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2021) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-021-00155-9 · Cited by 209 · see citing works
“BPD often involves pain analgesia related to the use of dissociation, both in current and (when exposed to stressors) remitted BPD cases [17].”
Background
- Authors
- Chung, B. Y., Hensel, S., Schmidinger, I., Bekrater‐Bodmann, R., & Flor, H.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Bekrater‐Bodmann, Robin
- Flor, Herta
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2020-04-15
- Volume
- 24
- Issue
- 7
- Pages
- 1257-1268
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W3013231812
- Cited by
- 36
- References
- 48
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 9 · 2023: 6 · 2022: 4 · 2021: 9 · 2020: 2
- FWCI
- 2.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Pain (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (publishedVersion, cc-by)
- Funders
- Deutsche Forschungsgemeinschaft (FL 156/35‐1, FL 156/35-2, BE 5723/1‐2)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- borderline personality disorder, pain perception, stress-induced pain, thermal pain threshold, script-driven imagery, pain processing
- MeSH terms
- Borderline Personality Disorder, Dissociative Disorders, Humans, Pain, Pain Threshold, Pain Perception
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