title: Elevated pain thresholds correlate with dissociation and aversive arousal in patients with borderline personality disorder.
abstract: In addition to reduced pain perception, patients with borderline personality disorder (BPD) show higher pain thresholds under subjective stress conditions as compared with non-stress conditions. However, the correlation between symptoms of stress and pain thresholds has not been investigated so far. Using a new and convenient methodology, electric stimulation, we expected higher pain and detection thresholds in patients with BPD than in to healthy controls as well as a positive correlation between pain thresholds and symptoms of stress (aversive arousal and dissociation) in BPD patients. Twelve female patients with BPD and twelve healthy controls were included in the study. Electric stimulation was applied on the right index finger, and detection and pain thresholds were assessed by gradually intensifying the stimuli. We found significantly elevated pain thresholds in patients with BPD as compared with healthy controls, but no difference between patients and controls in detection thresholds. In patients, a significant positive correlation was revealed between pain thresholds and dissociation as well as between pain thresholds and aversive arousal. Besides demonstrating a close correlation between pain thresholds and symptoms of stress in patients with BPD, this study replicated earlier findings of reduced pain perception in patients with BPD. Measuring electric pain thresholds is a valid and reasonable method for larger studies.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Freiburg Medical School, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Ludäscher
authors.forename: Martin
authors.initials: M
authors.lastname: Bohus
authors.forename: Klaus
authors.initials: K
authors.lastname: Lieb
authors.forename: Alexandra
authors.initials: A
authors.lastname: Philipsen
authors.forename: Anja
authors.initials: A
authors.lastname: Jochims
authors.forename: Christian
authors.initials: C
authors.lastname: Schmahl
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004924:Escape Reaction; D005260:Female; D006801:Humans; D010146:Pain / Q000175:diagnosis* / Q000453:epidemiology*; D010147:Pain Measurement; D017288:Pain Threshold; D011594:Psychometrics / Q000706:statistics & numerical data; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology