Psychopathology and the autonomic nervous system in borderline personality disorder. Part 1. The Influence of Early Adversities, Dissociation, Self-stigma, Parenting and Attachment on Disorder Severity.

Abstract

Background: Borderline Personality Disorder (BPD) is a complex psychiatric condition characterized by significant emotional instability, impulsivity, and intense interpersonal difficulties. This study examines the relationship between early traumatic experiences, attachment, dissociation, self-stigmatization, autonomic nervous system activity, specifically heart rate variability (HRV), and the severity of BPD symptoms.

Objective: To explore the associations between psychosocial and physiological factors and the severity of BPD symptoms, with a focus on early adverse experiences, adult attachment styles, HRV, and self-stigmatization.

Methods: The study sample consisted of 75 hospitalized BPD patients. HRV was measured, and self-report questionnaires were used to assess early traumas (Childhood Trauma Questionnaire), parenting style (Parental Bonding Instrument), adult attachment style (Experiences in Close Relationships Scale), and dissociation (Dissociative Experience Scale). Self-stigmatization was evaluated using the Internalized Stigma of Mental Illness (ISMI) scale, while symptom severity was assessed using self-report and clinician-administered scales, including the CGI-BPD, Beck Depression Inventory-II, and Beck Anxiety Inventory.

Results: Significant correlations were found between early traumas, attachment, and the severity of BPD symptomatology. Higher levels of emotional abuse in childhood correlated with earlier onset and greater symptom severity. HRV analysis indicated a link between sympathetic nervous system activation and specific BPD symptoms, particularly in patients with high levels of attachment anxiety. Self-stigmatization was associated with increased symptom severity and reduced treatment response.

Conclusion: The findings confirm that early traumatic experiences, adult attachment, and self-stigmatization are key factors in understanding symptom severity and emotional dysregulation in BPD. Targeted interventions addressing these areas may significantly improve treatment outcomes for BPD patients.