Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, Sarah V Biedermann
{"title":"Borderline personality disorder and sexuality: causes and consequences of dissociative symptoms.","authors":"Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, Sarah V Biedermann","doi":"10.1186/s40479-024-00251-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sexual risk behavior in patients diagnosed with borderline personality disorder (BPD) is supposed to be associated with traumatic experiences and dissociative symptoms. Nevertheless, scientific research thereon is scarce which might be due to the high prevalence of sexual trauma and fear of overwhelming patients with explicit sexual content.</p><p><strong>Methods: </strong>We investigated a clinical sample of patients diagnosed with BPD (n = 114) and compared them to a sample of matched healthy controls (HC) (n = 114) concerning the dissociative symptoms derealization, depersonalization, and conversion in sexual situations. In a subgroup of patients with BPD (n = 41) and matched HC (n = 40) dissociative symptoms after exposure to an acoustically presented erotic narrative were assessed in the lab. Regression analyses were used to examine the associations between sexual trauma, post-traumatic stress disorder (PTSD), dissociation in sexual situations, and risky sexual behavior.</p><p><strong>Results: </strong>Patients diagnosed with BPD endorsed higher dissociative symptoms in sexual situations retrospectively and in the lab compared to HC. Regression analyses revealed that depersonalization and conversion symptoms in sexual situations were explained by severity of BPD, while derealization was explained by PTSD symptomatology. Impulsive and sexual behavior with an uncommitted partner were higher in the BPD group and explained by derealization, while conversion showed an inverse association.</p><p><strong>Conclusion: </strong>Our findings highlight the importance of addressing distinct dissociative symptoms in sexual situations when counselling and treating women with BPD. In the long term, this could contribute to a reduction in sexual risk behavior in patients with BPD.</p><p><strong>Trial registration: </strong>This analysis is part of a larger ongoing study and was registered prior to accessing the data (Registration trial DRKS00029716).</p>","PeriodicalId":48586,"journal":{"name":"Borderline Personality Disorder and Emotion Dysregulation","volume":null,"pages":null},"PeriodicalIF":4.0000,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949637/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Borderline Personality Disorder and Emotion Dysregulation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40479-024-00251-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Sexual risk behavior in patients diagnosed with borderline personality disorder (BPD) is supposed to be associated with traumatic experiences and dissociative symptoms. Nevertheless, scientific research thereon is scarce which might be due to the high prevalence of sexual trauma and fear of overwhelming patients with explicit sexual content.
Methods: We investigated a clinical sample of patients diagnosed with BPD (n = 114) and compared them to a sample of matched healthy controls (HC) (n = 114) concerning the dissociative symptoms derealization, depersonalization, and conversion in sexual situations. In a subgroup of patients with BPD (n = 41) and matched HC (n = 40) dissociative symptoms after exposure to an acoustically presented erotic narrative were assessed in the lab. Regression analyses were used to examine the associations between sexual trauma, post-traumatic stress disorder (PTSD), dissociation in sexual situations, and risky sexual behavior.
Results: Patients diagnosed with BPD endorsed higher dissociative symptoms in sexual situations retrospectively and in the lab compared to HC. Regression analyses revealed that depersonalization and conversion symptoms in sexual situations were explained by severity of BPD, while derealization was explained by PTSD symptomatology. Impulsive and sexual behavior with an uncommitted partner were higher in the BPD group and explained by derealization, while conversion showed an inverse association.
Conclusion: Our findings highlight the importance of addressing distinct dissociative symptoms in sexual situations when counselling and treating women with BPD. In the long term, this could contribute to a reduction in sexual risk behavior in patients with BPD.
Trial registration: This analysis is part of a larger ongoing study and was registered prior to accessing the data (Registration trial DRKS00029716).
期刊介绍:
Borderline Personality Disorder and Emotion Dysregulation provides a platform for researchers and clinicians interested in borderline personality disorder (BPD) as a currently highly challenging psychiatric disorder. Emotion dysregulation is at the core of BPD but also stands on its own as a major pathological component of the underlying neurobiology of various other psychiatric disorders. The journal focuses on the psychological, social and neurobiological aspects of emotion dysregulation as well as epidemiology, phenomenology, pathophysiology, treatment, neurobiology, genetics, and animal models of BPD.