Abstract
BackgroundBorderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input. However, whether or not perceptual alterations are present for its positive counterpart, i.e. pleasant touch (PT), has not yet been examined.MethodsIn the present study, we applied standardized PT stimuli to the hands of 25 patients with BPD and 25 healthy controls (HC) and compared their perception. We used the affect-modulated acoustic startle response as a physiological correlate of affective processing. We further explored the effect of PT stimulation on dissociative experiences in BPD.ResultsCompared to HC, BPD perceived PT as less pleasant and less intense. The effect on perceived valence of touch was large even after controlling for the effect of reduced perceived intensity of touch (ƞ2 = .29). We further found qualitative alterations in touch perception in BPD, who rated the touch as significantly rougher and firmer compared to HC. There was a positive correlation between perceived valence of touch and changes in dissociative experiences in terms of body ownership of the stimulated body part from pre to post stimulation, suggesting that a more negative evaluation of touch is associated with an increase in body-related dissociative experiences, while a positive perception of touch might be related to a reduction of these dissociative experiences.ConclusionsOur results confirm BPD-associated disturbances in the processing of affective somatosensory stimuli and indicate that not only pain perception but also pleasant touch perception is diminished in BPD. We discuss the role of altered touch perception for BPD psychopathology and its potential role for new treatment approaches.
Highlights
Borderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input
The assumption of altered pleasant touch processing in BPD is supported by a previous study by Croy et al [24], who assessed pleasant touch perception in a heterogeneous sample of psychotherapy outpatients suffering from different disorders
Perception of pleasant touch and affect modulated acoustic startle response (ASR) in BPD and healthy controls (HC) participants Perceived valence of touch was significantly lower in participants with BPD (M = − 4.50, SD = 41.56) compared to HC (M = 56.85, SD = 39.78), t (48) = − 5.33, p < .001, d = 1.51
Summary
Borderline personality disorder (BPD) is characterized by altered perception of affective stimuli, including abnormal evaluation of nociceptive input. Whereas previous studies repeatedly demonstrated significant reductions in pain sensitivity [9,10,11,12,13,14,15], with the affective component of pain, compared to its sensorydiscriminative component, being affected [e.g. 16], they found no evidence for altered proprioception, exteroception, and two-point discrimination [17] or warmth perception thresholds [9, 10,c.f. 18], suggesting that somatosensory dysfunction is limited to affective stimuli. It remains unclearwhether altered somatosensory processing in BPD is specific for pain perception or affects positive affective somatosensation. Croy et al [24] did not report results for different types of personality disorders, so that BPD-associated alterations remain unknown
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