Cardiovascular Autonomic Modulation during Metronomic Breathing and Stress Exposure in Patients with Borderline Personality Disorder

2021 ◽  
pp. 1-15
Author(s):  
Lennard Geiss ◽  
Beate Beck ◽  
Wolfgang Hitzl ◽  
Thomas Hillemacher ◽  
Katharina M. Hösl
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Resting State ◽  
Borderline Personality ◽  
Stress Recovery ◽  
Autonomic Modulation ◽  
Stress Exposure

<b><i>Introduction:</i></b> Given the growing evidence of reduced heart rate variability in psychiatric diseases associated with emotional instability, we investigated cardiovascular autonomic modulation in patients with borderline personality disorder (BPD) during resting state, parasympathetic stimulation (metronomic breathing), and sympathetic stimulation (mental arithmetic stress test). <b><i>Methods:</i></b> In 29 BPD outpatients and 30 controls, we recorded RR-intervals (RRI), blood pressure, skin conductance levels, and respiratory frequency during resting state, metronomic breathing, stress anticipation, stress exposure, and stress recovery. We calculated baroreflex sensitivity (BRS) and parameters of heart rate variability, including the root mean square of successive differences (RMSSD), an index of cardiovagal modulation. <b><i>Results:</i></b> During resting state, BPD patients showed higher blood pressure and shorter RRI, as well as lower RMSSD and BRS than controls. Metronomic breathing increased RMSSD and BRS in BPD patients. During the stress exposure, BRS significantly decreased in controls, but not in BPD patients. Furthermore, BPD patients showed less cardioacceleration in response to stress exposure than controls. During stress recovery, we found increases in RMSSD and BRS in controls, but not in BPD patients. <b><i>Conclusion:</i></b> Our data show reduced cardiovascular autonomic modulation in BPD patients during resting state, psychophysiological relaxation, and stress exposure. The results indicate a vagal modulation deficit in this cohort. Breathing techniques, such as metronomic breathing, might be helpful to reduce stress and to increase vagal tone in BPD patients.

scholarly journals Heart rate variability in bipolar disorder and borderline personality disorder: a clinical review

2017 ◽  
Vol 21 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Oliver Carr ◽  
Maarten de Vos ◽  
Kate E A Saunders
Keyword(s):  
Bipolar Disorder ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Borderline Personality ◽  
Ongoing Research ◽  
Area Of Interest ◽  
Technological Advances

Heart rate variability (HRV) in psychiatric disorders has become an increasing area of interest in recent years following technological advances that enable non-invasive monitoring of autonomic nervous system regulation. However, the clinical interpretation of HRV features remain widely debated or unknown. Standardisation within studies of HRV in psychiatric disorders is poor, making it difficult to reproduce or build on previous work. Recently, a Guidelines for Reporting Articles on Psychiatry and Heart rate variability checklist has been proposed to address this issue. Here we assess studies of HRV in bipolar disorder and borderline personality disorder against this checklist and discuss the implication for ongoing research in this area.

scholarly journals Heart rate variability during a cognitive reappraisal task in female patients with borderline personality disorder: the role of comorbid posttraumatic stress disorder and dissociation

2018 ◽  
Vol 49 (11) ◽  
pp. 1810-1821 ◽  
Author(s):  
Annegret Krause-Utz ◽  
Julia-Caroline Walther ◽  
Stefanie Lis ◽  
Christian Schmahl ◽  
Martin Bohus
Keyword(s):  
Heart Rate ◽  
Posttraumatic Stress Disorder ◽  
Heart Rate Variability ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Cognitive Reappraisal ◽  
Borderline Personality ◽  
Subjective Arousal

AbstractBackgroundEmotion dysregulation is a core feature of borderline personality disorder (BPD), which often co-occurs with posttraumatic stress disorder (PTSD). Difficulties in emotion regulation (ER) have been linked to lower high-frequency heart rate variability (HF-HRV), a measure of autonomous nervous system functioning. However, previous research on vagally-mediated heart rate in BPD revealed heterogeneous findings and the effects of comorbid PTSD and dissociation on HF-HRV are not yet completely understood. This study aim to investigate HF-HRV during resting-state and an ER task in female BPD patients with comorbid PTSD (BPD + PTSD), patients without this comorbidity (BPD), and healthy controls (HC).Methods57 BPD patients (BPD: n = 37, BPD + PTSD: n = 20) and 27 HC performed an ER task with neutral, positive, and negative images. Participants were instructed to either attend these pictures or to down-regulate their upcoming emotions using cognitive reappraisal. Subjective arousal and wellbeing, self-reported dissociation, and electrocardiogram data were assessed.ResultsIndependent of ER instruction and picture valence, both patient groups (BPD and BPD + PTSD) reported higher subjective arousal and lower wellbeing; patients with BPD + PTSD further exhibited significantly lower HF-HRV compared with the other groups. Higher self-reported state dissociation predicted higher HF-HRV during down-regulating v. attending negative pictures in BPD + PTSD.ConclusionsFindings suggest increased emotional reactivity to negative, positive, and neutral pictures, but do not provide evidence for deficits in instructed ER in BPD. Reduced HF-HRV appears to be particularly linked to comorbid PTSD, while dissociation may underlie attempts to increase ER and HF-HRV in BPD patients with this comorbidity.

scholarly journals Cortisol Levels and Autonomic Control of Heart Rate in Healthy Subjects

2017 ◽  
Vol 17 (2) ◽  
pp. 5-14 ◽  
Author(s):  
Milana Drumond Ramos Santana ◽  
Eli Carlos Martiniano ◽  
Larissa Raylane Lucas Monteiro ◽  
Maria Do Socorro Santos De Oliveira ◽  
Vitor E. Valenti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Salivary Cortisol ◽  
Healthy Subjects ◽  
Autonomic Control ◽  
Autonomic Modulation ◽  
Cardiac Autonomic Modulation ◽  
Cortisol Levels ◽  
Modulation Methods

AbstractIntroduction: There is an increase in level of stress in the general population because of the social, personal and professional demands. Currently, there are only simple tools that can safely measure this stress such as levels of cortisol and heart rate variability (HRV). Objective: To analyze the relationship between salivary cortisol and the cardiac autonomic modulation. Methods: A total of fifty-one male and female subjects between 18 and 40 years old were evaluated. Saliva collection was achieved for the salivary cortisol dosage. The collection was performed through the SalivetteR tube. After this collection, the median cortisol levels (0.24 ug/dl) were analyzed and the volunteers were divided into two groups: i) cortisol below the mediane ii) cortisol above the median. After this division, each group consisted of 25 volunteers and then was verified the following information: age, gender, weight, height, body mass index (BMI), blood pressure. Shortly thereafter was assessment of cardiac autonomic modulation por meio da HRV. The Polar RS800cx heart rate receiver was placed on the chest of the volunteers, in the vicinity of the distal third of the sternum. The volunteers were instructed to remain in rest with spontaneous breathing in dorsal position for 20 minutes. HRV analysis included geometric, time and frequency domain indices. Results: There were no statistical differences for the two groups regarding systolic and diastolic blood pressure, heart rate, RR intervals or linear and frequency indices for the volunteers. In addition, also there was no correlation the cortisol with the analyzed variables (SAP, p=0.460; DAP, p = 0.270; HR, p = 0.360; RR, p = 0.380; SDNN, p = 0.510; rMSSD, p = 0.660; pNN50, p = 0.820; RRtri, p = 0.170; TINN, p = 0.470; SD1, p = 0.650; SD2, p = 0.500; LF [ms2], p = 0.880; LF [nu], p = 0.970; HF [ms2], p = 0.870; HF [nu], p = 0.960; LF/HF, p = 0.380 Conclusion: Heart rate variability autonomic control was unchanged in healthy subjects with physiological distribution of salivary cortisol levels. There was no association between normal salivary cortisol and resting autonomic regulation of heart rate.

Effects of a Painful Stimulus on Stress Regulation in Male Patients With Borderline Personality Disorder: A Pilot Study

2019 ◽  
Vol 33 (3) ◽  
pp. 394-412
Author(s):  
Janina Naoum ◽  
Nikolaus Kleindienst ◽  
Ulf Baumgärtner ◽  
Franziska Willis ◽  
Falk Mancke ◽  
...  
Keyword(s):  
Heart Rate ◽  
Borderline Personality Disorder ◽  
Pilot Study ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Pain Stimulus ◽  
Self Injury ◽  
Significant Difference ◽  
Pain Ratings ◽  
Male Patients

Pain processing in relation to stress has so far not been investigated in male patients with borderline personality disorder (BPD). This experimental pilot study examined 17 male BPD patients and 20 male healthy controls (HCs) to assess the effects of a pain stimulus on arousal, aggression, pain (ratings), and heart rate. At baseline, BPD patients showed significantly higher arousal and aggression; however, there was no significant difference in heart rate compared to the HC group. Following stress induction, a noninvasive mechanical pain stimulus was applied. No significant differences in pain ratings or heart rates were found between the groups. For arousal, a significantly stronger decrease was revealed in the BPD group compared to the HC group (t = 2.16, p = .038). Concerning aggression, the BPD group showed a significantly greater decrease after the pain stimulus than the HC group (t = 3.25, p = .002). This data showed that nonsuicidal self-injury can reduce arousal and aggression in male BPD.

scholarly journals Network analysis of functional brain connectivity in borderline personality disorder using resting-state fMRI

2016 ◽  
Vol 11 ◽  
pp. 302-315 ◽  
Author(s):  
Tingting Xu ◽  
Kathryn R. Cullen ◽  
Bryon Mueller ◽  
Mindy W. Schreiner ◽  
Kelvin O. Lim ◽  
...  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Network Analysis ◽  
Resting State ◽  
Brain Connectivity ◽  
Resting State Fmri ◽  
Borderline Personality ◽  
Functional Brain
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