Individual patterns and synchrony of heart rate variability in adolescent patients with borderline personality psychopathology and their mothers: a case-control study.

Abstract

Background: In adolescent Borderline Personality Disorder (BPD), interactions with caregivers often provoke dysregulation. Vagally-mediated heart rate variability (HRV), a physiological marker of regulatory capacities, shows alterations in BPD. Studies on individual and dyadic HRV in adolescents with BPD (BPD-A) and their mothers (BPD-M) are lacking. We examined 1) individual resting state -, reactivity- and recovery- HRV, 2) intrapersonal concordance of interactional quality with HRV, 3) mother-adolescent interpersonal HRV-synchrony and 4) the association of interpersonal HRV-synchrony with behavioral synchrony in a case-control design.

Methods: Thirty-eight (sub)syndromal BPD-A and BPD-M were compared to 35 healthy control adolescents and their mothers (HC-A/-M). HRV was assessed during a positive interaction, a stress task and resting before and after interactions (recovery). Behavior during interactions was observed and coded using the "Coding Interactive Behavior"- Manual. Data were analyzed using multilevel modeling.

Results: BPD-A showed a lower resting HRV than HC-A, while no group differences were found for mothers. From resting to positive interaction, BPD-A/BPD-M/HC-M showed a significant increase in HRV; this increase was not significant for HC-A. HRV-reactivity to stress was not significant in either group but influenced by general emotional and behavioral problems within both adolescent samples. Significant intrapersonal concordance of HRV and behavior could only be found for HC-M during the positive interaction (positive association). For BPD-M, a complete disconnect between behavior and HRV was observed. BPD-dyads and dyads lower in behavioral synchrony displayed HRV-synchrony during stress, in HC-dyads and dyads higher in behavioral synchrony during rest after dyadic interactions.

Conclusions: Our study is the first investigating altered HRV-reactivity, behavior-HRV-concordance and HRV-synchrony in adolescents with BPD traits and their mothers, adding new insight to physiological regulation and co-regulation in adolescent BPD pathology. Limitations and implications of these results are discussed.