Prefrontal cortex activation under stress as a function of borderline personality disorder in female adolescents engaging in non-suicidal self-injury.

IF 3.9 3区 医学 Q1 PSYCHIATRY BJPsych Open Pub Date : 2024-08-08 DOI:10.1192/bjo.2024.728
Saskia Höper, Felix Kröller, Anna-Lena Heinze, Kay Franziska Bardtke, Michael Kaess, Julian Koenig
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Abstract

Background: Neuroimaging studies suggest alterations in prefrontal cortex (PFC) activity in healthy adults under stress. Adolescents with non-suicidal self-injury (NSSI) report difficulties in stress and emotion regulation, which may be dependent on their level of borderline personality disorder (BPD).

Aims: The aim was to examine alterations in the PFC in adolescents with NSSI during stress.

Method: Adolescents (13-17 years) engaging in non-suicidal self-injury (n = 30) and matched healthy controls (n = 29) performed a task with low cognitive demand and the Trier Social Stress Test (TSST). Mean PFC oxygenation across the PFC was measured with an eight-channel near-infrared spectroscopy system. Alongside self-reports on affect, dissociation and stress, BPD pathology was assessed via clinical interviews.

Results: Mixed linear-effect models revealed a significant effect of time on PFC oxygenation and a significant time×group interaction, indicating increased PFC activity in patients engaging in NSSI at the beginning of the TSST compared with healthy controls. Greater BPD symptoms overall were associated with an increase in PFC oxygenation during stress. In exploratory analyses, mixed models addressing changes in PFC connectivity over time as a function of BPD symptoms were significant only for the left PFC.

Conclusions: Results indicate differences in the neural stress response in adolescents with NSSI in line with classic neuroimaging findings in adults with BPD. The link between PFC oxygenation and measures of BPD symptoms emphasises the need to further investigate adolescent risk-taking and self-harm across the spectrum of BPD, and maybe overall personality pathology, and could aid in the development of tailored therapeutic interventions.

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压力下前额叶皮层的激活与边缘型人格障碍在进行非自杀性自伤的女性青少年中的作用。
背景:神经影像学研究表明,健康成年人在压力下前额叶皮层(PFC)的活动会发生改变。非自杀性自伤(NSSI)青少年在压力和情绪调节方面存在困难,这可能与他们的边缘型人格障碍(BPD)程度有关:从事非自杀性自伤的青少年(13-17 岁)(n = 30)和匹配的健康对照组(n = 29)进行了一项认知需求较低的任务和特里尔社会压力测试(TSST)。使用八通道近红外光谱系统测量了整个前脑功能区的平均含氧量。除了对情感、分离和压力的自我报告外,还通过临床访谈对BPD病理进行了评估:混合线性效应模型显示,时间对PFC氧合有显著影响,且时间与组间有显著交互作用,表明与健康对照组相比,在TSST开始时进行NSSI的患者PFC活动增加。总体上,BPD症状的加重与应激时PFC氧合的增加有关。在探索性分析中,研究PFC连通性随时间的变化与BPD症状函数关系的混合模型仅对左侧PFC有显著意义:结论:研究结果表明,NSSI青少年的神经应激反应存在差异,这与BPD成人的经典神经影像学研究结果一致。PFC氧合与BPD症状测量之间的联系强调了进一步研究青少年在BPD范围内的冒险行为和自残行为以及整体人格病理学的必要性,并有助于制定有针对性的治疗干预措施。
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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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