SS-06-01

E. Seifritz. Department of Clinical Psychia, Bern, Switzerland

SS-06-02

Dissociative experiences in borderline personality disorder and other trauma disorders

E. Vermetten. C. Schmahl, J. D. Bremner, R. Loewenstein. Department Psychiatry Central, CX Utrecht, Netherlands

Objective: Borderline personality disorder (BPD) patients have a wide range of dissociative experiences, including experiences of absorption, amnesia, and experiences of depersonalization. These phenomena are understood to be components of high hypnotic susceptibility. An empirical relation has been demonstrated between trauma-related psychopathology and hypnotizability, with a strong link between the phenomenology of hypnosis and symptoms of trauma-related psychopathology, e.g. analgesia, memory problems, time distortion. Symptom patterns of BPD may also be linked to a relative inability to engage in cognitive inhibition and may be a factor related to suggestibility; levels of trauma-related stress can be warded off by virtue of high dissociative capacity.

Methods: We used the the Dissociative Experience Scale (DES) and the Clinician Administered Dissociative Symptoms Scale (CADDS) to assess trait and state dissociation, the Tellegen Absorption Scale (TAS) to assess absorption, and the Guddjonsson Suggestibility Scale (GSS) to assess suggestibility. In addition we assessed hypnotic susceptibility with the Hypnotic Induction Profile (HIP) in a female population of trauma controls (n=17), post traumatic stress disorder (n=15), BPD (n=10) and DID (n=16).

Results: As a group, BPD patients were highly hypnotizable, showed high levels of absorption and trait dissociation, with low state dissociation scores. In addition, BPD patients were the among the highest suggestible in the study group.

Conclusion: These findings support the notion that BPD patients frequently engage in dissociative experiences, which may give them a sense of loss of agency since it points to a mechanism that coincides with high level of absorption, suggestibility and hypnotic susceptibility.

SS-06-03

Perception of facial affect in borderline personality disorder (BPD)

F. Domes, S. Herpertz, S. Herpertz. Department of Psychiatry & Psy, Rostock, Germany

Objective: It has been suggested that inadequate perception of social-affective cues is a basal factor in the psychpathology of psychiatric conditions. Impaired recognition of facial affect for example has been well documented in schizophrenia, affective disorders, autism and other psychiatric disorders. Since emotional hyperreactivity is one of the key symptoms in BPD, we expected the BPD patients to be more sensitive to facial affect in general.

Methods: Fifteen women with BPD were compared to 15 age and IQ matched healthy controls. Particpants were exposed to pictures of facial affect which displayed different emotions. In a computerized procedure the intenity of the displayed emotion was increased in a pseudo-continous manner. Particants were instructed to indicate by a button-press when they became aware of the particular basic emotion (sadness, fear, disgust, anger, happiness, surprise), and to label the emotion displayed. Mean detection intensity and mean error rate were recorded.

Results: Analyses of data is still in progress. The results so far show, that BPS patients tend to detected the disgusted faces at a lower mean intenity compared to normal subjects. So far no other differences in detection sensitivity and accuracy could be obeserved.

Conclusion: The results so far contradict the hypothesis, that in BPD patients sensitivity and accuracy in the perception of facial affect is generally enhanced. Preliminary data suggest that BPD subjects are more sensitive to subtle cues of social hostility. This specific effect might reflect a bias towards the perception of potentially self-treatening cues in the social environment.

SS-06-04

Biological and psychological aspects of self-injurious behavior in borderline personality disorder

C. Schmahl, P. Ludaescher, A. Jochims, K. Kuenkele, M. Bohus. Department of Psychosomatics C, Mannheim, Germany

Objective: Intentional, non-suicidal self-injurious behavior (SIB) is a characteristic feature of borderline personality disorder (BPD). A major hypothesis regarding SIB is that it serves to reduce aversive states of inner tension and dissociation. However, the underlying psychological and biological factors of SIB have not been well investigated.

Methods: We developed a questionnaire which assesses qualitative and quantitative aspects of self-injurious behavior together with motivational issues regarding SIB. This instrument was administered to 100 female patients with BPD. Using the widely used method of script-driven imagery, we investigated BPD patients with a script depicting a situation of self-injury. Patients were assessed with psychophysiological measures as well as with fMRI during presentation of the scripts.

Results: Preliminary results of these investigations will be presented.

Conclusion: Self-injurious behavior has various psychological and neurobiological aspects.