Psychophysiological reactivity to traumatic and abandonment scripts in borderline personality and posttraumatic stress disorders: a preliminary report
Open accessAbstract
Borderline personality disorder (BPD) is a highly prevalent and disabling condition linked to early stressors including traumatic abuse and abandonment. While much work has addressed traumatic events in childhood, little is known about the biological sequelae of BPD including how this disorder may be differentiated from other stress-related disorders such as posttraumatic stress disorder (PTSD). The purpose of this study was to investigate psychophysiological effects of different types of stressful reminders in BPD and in PTSD. Psychophysiological measures including heart rate, skin conductance responses, systolic and diastolic blood pressure in response to standardized neutral scripts, and personalized scripts of traumatic and abandonment situations were compared among subjects with BPD, PTSD and controls, all with a reported history of sexual and/or physical abuse before age 18. Significant script by diagnosis interactions were found for skin conductance and systolic blood pressure. No significant effects were found for diastolic blood pressure or heart rate. In the PTSD group the greatest systolic blood pressure responses were to traumatic scripts, whereas patients with BPD showed a tendency towards greater skin conductance responses to abandonment scripts. Our findings reveal only partially different psychophysiological responses to traumatic and abandonment scripts in PTSD and BPD. A divergence in pathophysiology in these two disorders is suggested that may be linked to childhood trauma. However, this interpretation must be tested in a larger population.
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No study utilizing personalized trauma stimuli found a relationship between skin conductance and trait dissociation.
“No study utilizing personalized trauma stimuli found a relationship between SC and trait dissociation (Bichescu-Burian et al., 2017; Rhudy et al., 2008; Schmahl et al., 2004; Vermes et al., 2020).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Schmahl et al., 2004
The Procedure and Analyses (§§2.4–2.5) show that the study used personalized trauma scripts and measured skin conductance; the Study groups section (§2.3) reports trait-dissociation scores. But the reported analyses compare responses by diagnosis and script type, and the Discussion (§4) only speculates that dissociative traits could influence reactivity. Our copy does not report a test finding no relationship between skin conductance and trait dissociation. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSchmahl et al. (2004) demonstrated a positive correlation between trait dissociation and systolic blood pressure (change score: r = .65, p = .032), but not diastolic blood pressure (r = .48, p = .137).
“Only one study examined blood pressure during trauma exposure (Schmahl et al., 2004), demonstrating a positive correlation between trait dissociation and SBP (change score: r = .65, p = .032), but not DBP (r = .48, p = .137).”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Schmahl et al. (2004)
Sections 2.5 (Analyses) and 3.3 (Systolic blood pressure) show that the study measured blood-pressure changes during traumatic scripts. The Discussion mentions dissociative traits as a possible influence on autonomic reactivity, but our copy does not report the claimed trait-dissociation correlations with systolic or diastolic blood pressure, or the stated r and p values. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTwo other studies demonstrated hyperactive autonomic responses to traumatic content.
“whereas two other studies (Hyer et al., 1993; Schmahl et al., 2004) demonstrated hyperactive autonomic responses to traumatic content.”
From Trauma-related dissociation and the autonomic nervous system: a systematic literature review of psychophysiological correlates of dissociative experiencing in PTSD patients (2022) · cites this paper as Schmahl et al., 2004
The Results (§3.3, p. not available) report greater systolic blood-pressure responses to traumatic than neutral scripts in the PTSD group, supporting an autonomic response to traumatic content. But the Discussion (§4, p. not available) says the study did not find the larger heart-rate responses reported in earlier studies, and the Results also report elevated trauma-script blood pressure in controls relative to the BPD group. Thus, describing the study as demonstrating generally hyperactive autonomic responses overstates its finding. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPsychophysiological reactivity to abandonment themes can be normal in BPD patients prone to dissociation.
“This could explain why psychophysiological reactivity to abandonment themes can be normal in BPD patients prone to dissociation (Schmahl et al., 2004).”
From A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder (2009) · cites this paper as Schmahl et al., 2004
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Development, reliability, and validity of a dissociation scale
BERNSTEIN, E. M., & PUTNAM, F. W. (1986) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198612000-00004 · Cited by 3,793 · cited 1× · see citing works
“Dissociative traits were assessed with the Dissociative Experience Scale (DES; Bernstein and Putnam, 1986).”
Bremner, J. D., Krystal, J. H., Putnam, F. W., Southwick, S. M., Marmar, C., Charney, D. S., & Mazure, C. M. (1998) · Journal of Traumatic Stress · doi:10.1023/a:1024465317902 · Cited by 817 · see citing works
Self-citationShin, L. M., McNally, R. J., Kosslyn, S. M., Thompson, W. L., Rauch, S. L., Alpert, N. M., Metzger, L. J., Lasko, N. B., Orr, S. P., & Pitman, R. K. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.4.575 · Cited by 647 · see citing works
McGlashan, T. H., Grilo, C. M., Skodol, A. E., Gunderson, J. G., Shea, M. T., Morey, L. C., Zanarini, M. C., & Stout, R. L. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.102004256.x · Cited by 542 · see citing works
Self-citationA psychophysiological study of Post Traumatic Stress Disorder in Vietnam veterans
Blanchard, E. B., Kolb, L. C., Pallmeyer, T. P., & Gerardi, R. J. (1982) · Psychiatric Quarterly · doi:10.1007/bf01064817 · Cited by 278 · see citing works
Autonomic responses to stress in Vietnam combat veterans with posttraumatic stress disorder
McFall, M. E., Murburg, M. M., Ko, G. N., & Veith, R. C. (1990) · Biological Psychiatry · doi:10.1016/0006-3223(90)90053-5 · Cited by 183 · see citing works
Carson, M. A., Paulus, L. A., Lasko, N. B., Metzger, L. J., Wolfe, J., Orr, S. P., & Pitman, R. K. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.890 · Cited by 119 · see citing works
Flagged first, then by citations
Research works printed but not linked: 18
- Benjamin, L.S., 1996. Interpersonal Diagnosis and Treatment of Personality Disorders. 2nd ed. Guilford Press, New York.
- Blanchard, E.B., Buckley, T.C., 1999. Psychophysiological assessment of posttraumatic stress disorder. In: Saigh, P.A., Bremner, J.D. (Eds.), Posttraumatic Stress Disorder: A Comprehensive Text. Allyn and Bacon, Boston, pp. 248-266.
- Boucsein, W., 1992. Electrodermal Activity. Plenum Press, New York.
- Bremner, J.D., 1999. Acute and chronic responses to stress: where do we go from here? wEditorialx. American Journal of Psychiatry 156, 349-351.
- Bremner, J.D., Narayan, M., Staib, L.H., Southwick, S.M., McGlashan, T., Charney, D.S., 1999. Neural correlates of childhood sexual abuse in women with and without post- traumatic stress disorder. American Journal of Psychiatry 156, 1787-1795.
- First, M.B., Spitzer, R.L., Gibbon, M., Williams, J.B.W., 1995. Structured Clinical Interview for Axis-I DSM-IV Disorders, Patient Edition (SCID-IyP). Biometrics Research Depart- ment, New York State Psychiatric Institute, New York.
- Gunderson, J.G., 1996. The borderline patient's intolerance of aloneness. Insecure attachments and therapist availability. American Journal of Psychiatry 153, 752-758.
- Herman, J.L., Perry, J.C., van der Kolk, B.A., 1989. Childhood trauma in borderline personality disorder. American Journal of Psychiatry 146, 490-495.
- Herpertz, S.C., Kunert, H.J., Schwenger, U.B., Sass, H., 1999. Affective responsiveness in borderline personality disorder: a psychophysiological approach. American Journal of Psy- chiatry 156, 1550-1556.
- Linehan, M.M., 1993. Cognitive Behavioral Treatment of Borderline Personality Disorder. Guilford Press, New York.
- Links, P.S., Steiner, M., Offord, D.R., Eppel, A., 1988. Char- acteristics of borderline personality disorder: a Canadian study. Canadian Journal of Psychiatry 33, 336-340.
- Ogata, S.N., Silk, K.R., Goodrich, S., Lohr, N.E., Westen, D., Hill, E.M., 1990. Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry 147, 1008-1013.
- Orr, S.P., Pitman, R.K., Lasko, N.B., Herz, L.R., 1993. Psy- chophysiological assessment of posttraumatic stress disorder imagery in World War II veterans. Journal of Abnormal Psychology 102, 152-159.
- Orr, S.P., Lasko, N.B., Metzger, L.J., Berry, N.J., Ahern, C.E., Pitman, R.K., 1998. Psychophysiologic assessment of wom- en with posttraumatic stress disorder resulting from child- hood sexual abuse. Journal of Consulting and Clinical Psychology 66, 906-913.
- Pitman, R., Orr, S., Forgue, D., Altman, B., de Jong, J., 1990. Psychophysiologic responses to combat imagery of Vietnam veterans with posttraumatic stress disorder vs. other anxiety disorders. Journal of Abnormal Psychology 99, 49-54.
- Prins, A., Kaloupek, D.G., Keane, T.M., 1995. Psychophysio- logical evidence for autonomic arousal and startle in trau- matized adult populations. In: Friedman, M.J., Charney, D.S., Deutch, A.Y. (Eds.), Neurobiological and Clinical Consequences of Stress: From Normal Adaptation to PTSD. Raven Press, New York.
- Westen, D., Ludolph, P., Misle, B., Ruffins, S., Block, J., 1990. Physical and sexual abuse in adolescent girls with borderline personality disorder. American Journal of Ortho- psychiatry 60, 55-66.
- Zanarini, M.C., 1997. Role of Sexual Abuse in the Etiology of Borderline Personality Disorder. American Psychiatric Press, Washington, DC.
Cited by
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Fonagy, P., & Luyten, P. (2009) · Development and Psychopathology · doi:10.1017/s0954579409990198 · Cited by 1,146 · see citing works
“This could explain why psychophysiological reactivity to abandonment themes can be normal in BPD patients prone to dissociation (Schmahl et al., 2004).”
BackgroundNeurobiology of Aggression and Violence
Siever, L. J. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07111774 · Cited by 984 · see citing works
The psychophysiology of posttraumatic stress disorder: a meta-analysis
Pole, N. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.5.725 · Cited by 582 · see citing works
Kuo, J. R., & Linehan, M. M. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0016392 · Cited by 288 · see citing works
Posttraumatic Stress Disorder, Cardiovascular, and Metabolic Disease: A Review of the Evidence
Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A., & Beckham, J. C. (2010) · Annals of Behavioral Medicine · doi:10.1007/s12160-010-9165-9 · Cited by 263 · see citing works
Borderline personality disorder and emotional responding: a review of the research literature
Rosenthal, M. Z., Gratz, K. L., Kosson, D. S., Cheavens, J. S., Lejuez, C. W., & Lynch, T. R. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.04.001 · Cited by 245 · see citing works
Complex PTSD, affect dysregulation, and borderline personality disorder
Ford, J. D., & Courtois, C. A. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-9 · Cited by 182 · see citing works
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Wingenfeld, K., Rullkoetter, N., Mensebach, C., Beblo, T., Mertens, M., Kreisel, S., Toepper, M., Driessen, M., & Woermann, F. G. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.10.024 · Cited by 124 · see citing works
Naismith, I., Zarate Guerrero, S., & Feigenbaum, J. (2019) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2357 · Cited by 80 · see citing works
Beutler, S., Mertens, Y. L., Ladner, L., Schellong, J., Croy, I., & Daniels, J. K. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008066.2022.2132599 · Cited by 64 · see citing works
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BackgroundResultInfluentialChung, B. Y., Hensel, S., Schmidinger, I., Bekrater‐Bodmann, R., & Flor, H. (2020) · European Journal of Pain · doi:10.1002/ejp.1567 · Cited by 36 · see citing works
Bichescu‐Burian, D., Steyer, J., Steinert, T., Grieb, B., & Tschöke, S. (2017) · Psychophysiology · doi:10.1111/psyp.12795 · Cited by 27 · see citing works
Rhudy, J. L., Davis, J. L., Williams, A. E., McCabe, K. M., & Byrd, P. M. (2008) · Behavioral Sleep Medicine · doi:10.1080/15402000802162539 · Cited by 19 · see citing works
- Authors
- Schmahl, C. G., Elzinga, B. M., Ebner, U. W., Simms, T., Sanislow, C., Vermetten, E., McGlashan, T. H., & Douglas Bremner, J.
- Affiliations
- Central Institute of Mental Health (DE)
- Leiden University (NL)
- University of Freiburg (DE)
- Yale University (US)
- University Medical Center Utrecht (NL)
- Corresponding author
- Schmahl, Christian G
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 126
- Issue
- 1
- Pages
- 33-42
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2119578546
- Cited by
- 132
- References
- 7
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 4 · 2022: 6 · 2021: 12 · 2020: 5 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 9 · 2015: 10 · 2014: 9 · 2013: 6 · 2012: 7
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- green
- works.bepress.com
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Wesleyan University Digital Collections (Wesleyan University) (submittedVersion)
- Wesleyan University Digital Collections (Wesleyan University) (submittedVersion, public-domain)
- WESLEYAN
- Funders
- National Institute of Mental Health (R01MH056120, R01MH56120, K05 MH1654, K05MH001654)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- borderline personality disorder, post-traumatic stress disorder, childhood trauma, child sexual abuse, child physical abuse, abandonment, psychophysiological reactivity, skin conductance, heart rate, blood pressure, differential diagnosis
- MeSH terms
- Adult, Blood Pressure, Borderline Personality Disorder, Child, Child, Abandoned, Female, Galvanic Skin Response, Heart Rate, Humans, Middle Aged, Stress Disorders, Post-Traumatic
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