Abstract
Interpersonal problems and affective dysregulation are core characteristics of borderline personality disorder (BPD). BPD patients predominantly show unresolved attachment representations. The oxytocin (OT) system is associated with human social attachment and affiliative behavior, and OT dysregulation may be related to distinct attachment characteristics. Here, we investigated whether attachment representations are related to peripheral OT levels in BPD patients. Twenty-one female BPD patients and 20 age-, gender-, and education-matched healthy controls (HCs) were assessed with clinical scales and measures of interpersonal and attachment-related characteristics, including the Adult Attachment Projective Picture System (AAP). Plasma OT concentrations were measured prior to and during social exclusion in a virtual ball tossing game (Cyberball). The majority of BPD patients (63.2%) but no HCs showed unresolved (disorganized) attachment representations. In this subgroup of patients, baseline OT plasma levels were significantly lower than in BPD patients with organized attachment representations. This pilot study extends previous findings of altered OT regulation in BPD as a putative key mechanism underlying interpersonal dysregulation. Our results provide first evidence that altered OT plasma levels are related to disorganized attachment representations in BPD patients.
Highlights
Borderline personality disorder is characterized by a pervasive pattern of emotional instability, impulsivity, severe problems in social interactions, and disturbed self-image (Bohus et al, 2009; Leichsenring et al, 2011)
Fertuck et al (2009) reported an enhanced mental state discrimination based on the eye region of the face in borderline personality disorder (BPD) patients compared to healthy controls (HC) and considered this enhanced sensitivity as a potential basis for social impairment in BPD
On the basis of Childhood Trauma Questionnaire (CTQ) cut-off values defined by Bernstein and Fink (1998), the BPD patients in our sample reported moderate to severe traumatization
Summary
Borderline personality disorder is characterized by a pervasive pattern of emotional instability, impulsivity, severe problems in social interactions, and disturbed self-image (Bohus et al, 2009; Leichsenring et al, 2011). Oxytocin in Borderline Patients increasing aversive tension in BPD, which may lead to selfinjurious behavior or dissociation (Herpertz, 1995; Stiglmayr et al, 2005; Gunderson and Lyons-Ruth, 2008). BPD patients demonstrate significant impairments in making social judgments about others from their faces by judging them as less trustworthy and approachable than controls (Nicol et al, 2013). Fertuck et al (2009) reported an enhanced mental state discrimination based on the eye region of the face in BPD patients compared to HCs and considered this enhanced sensitivity as a potential basis for social impairment in BPD. Gunderson and Lyons-Ruth (2008) describe a genetically based hypersensitivity to interpersonal stressors in BPD patients: An interpersonal hypersensitivity phenotype may lead to characteristic interpersonal strategies and contradictory interpersonal features observed in adult BPD patients Fertuck et al (2009) reported an enhanced mental state discrimination based on the eye region of the face in BPD patients compared to HCs and considered this enhanced sensitivity as a potential basis for social impairment in BPD. Gunderson and Lyons-Ruth (2008) describe a genetically based hypersensitivity to interpersonal stressors in BPD patients: An interpersonal hypersensitivity phenotype may lead to characteristic interpersonal strategies and contradictory interpersonal features observed in adult BPD patients
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