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Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion

It is well documented that borderline personality disorder (BPD) is characterized by reduced pain sensitivity, which might be related to nonsuicidal self-injury and dissociative experiences in patients with BPD. However, it remains an open question whether this insensitivity relies at least partly o...

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Autores principales: Bekrater-Bodmann, Robin, Chung, Boo Young, Richter, Ingmarie, Wicking, Manon, Foell, Jens, Mancke, Falk, Schmahl, Christian, Flor, Herta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770381/
https://www.ncbi.nlm.nih.gov/pubmed/26098439
http://dx.doi.org/10.1097/j.pain.0000000000000275
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author Bekrater-Bodmann, Robin
Chung, Boo Young
Richter, Ingmarie
Wicking, Manon
Foell, Jens
Mancke, Falk
Schmahl, Christian
Flor, Herta
author_facet Bekrater-Bodmann, Robin
Chung, Boo Young
Richter, Ingmarie
Wicking, Manon
Foell, Jens
Mancke, Falk
Schmahl, Christian
Flor, Herta
author_sort Bekrater-Bodmann, Robin
collection PubMed
description It is well documented that borderline personality disorder (BPD) is characterized by reduced pain sensitivity, which might be related to nonsuicidal self-injury and dissociative experiences in patients with BPD. However, it remains an open question whether this insensitivity relies at least partly on altered sensory integration or on an altered evaluation of pain or a combination of both. In this study, we used the thermal grill illusion (TGI), describing a painful sensation induced by the application of alternating cold and warm nonnoxious stimuli, in patients with either current or remitted BPD as well as matched healthy controls. Two additional conditions, applying warm or cold temperatures only, served as control. We further assessed thermal perception, discrimination, and pain thresholds. We found significantly reduced heat and cold pain thresholds for the current BPD group, as well as reduced cold pain thresholds for the remitted BPD group, as compared with the HC group. Current BPD patients perceived a less-intense TGI in terms of induced pain and unpleasantness, while their general ability to perceive this kind of illusion seemed to be unaffected. Thermal grill illusion magnitude was negatively correlated with dissociation and traumatization only in the current BPD patients. These results indicate that higher-order pain perception is altered in current BPD, which seems to normalize after remission. We discuss these findings against the background of neurophysiological evidence for the TGI in general and reduced pain sensitivity in BPD and suggest a relationship to alterations in N-methyl-D-aspartate neurotransmission.
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spelling pubmed-47703812016-06-28 Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion Bekrater-Bodmann, Robin Chung, Boo Young Richter, Ingmarie Wicking, Manon Foell, Jens Mancke, Falk Schmahl, Christian Flor, Herta Pain Research Paper It is well documented that borderline personality disorder (BPD) is characterized by reduced pain sensitivity, which might be related to nonsuicidal self-injury and dissociative experiences in patients with BPD. However, it remains an open question whether this insensitivity relies at least partly on altered sensory integration or on an altered evaluation of pain or a combination of both. In this study, we used the thermal grill illusion (TGI), describing a painful sensation induced by the application of alternating cold and warm nonnoxious stimuli, in patients with either current or remitted BPD as well as matched healthy controls. Two additional conditions, applying warm or cold temperatures only, served as control. We further assessed thermal perception, discrimination, and pain thresholds. We found significantly reduced heat and cold pain thresholds for the current BPD group, as well as reduced cold pain thresholds for the remitted BPD group, as compared with the HC group. Current BPD patients perceived a less-intense TGI in terms of induced pain and unpleasantness, while their general ability to perceive this kind of illusion seemed to be unaffected. Thermal grill illusion magnitude was negatively correlated with dissociation and traumatization only in the current BPD patients. These results indicate that higher-order pain perception is altered in current BPD, which seems to normalize after remission. We discuss these findings against the background of neurophysiological evidence for the TGI in general and reduced pain sensitivity in BPD and suggest a relationship to alterations in N-methyl-D-aspartate neurotransmission. Wolters Kluwer 2015-06-19 2015-10 /pmc/articles/PMC4770381/ /pubmed/26098439 http://dx.doi.org/10.1097/j.pain.0000000000000275 Text en © 2015 International Association for the Study of Pain
spellingShingle Research Paper
Bekrater-Bodmann, Robin
Chung, Boo Young
Richter, Ingmarie
Wicking, Manon
Foell, Jens
Mancke, Falk
Schmahl, Christian
Flor, Herta
Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title_full Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title_fullStr Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title_full_unstemmed Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title_short Deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
title_sort deficits in pain perception in borderline personality disorder: results from the thermal grill illusion
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770381/
https://www.ncbi.nlm.nih.gov/pubmed/26098439
http://dx.doi.org/10.1097/j.pain.0000000000000275
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