Exaggerated affect-modulated startle during unpleasant stimuli in borderline personality disorder.
BACKGROUND
Excessive emotional responding is considered to be a hallmark of borderline personality disorder (BPD). The affect-modulated startle response is a reliable indicator of emotional processing of stimuli. The aim of this study was to examine emotional processing in BPD patients (n = 27) and healthy control subjects (n = 21).


METHODS
Participants viewed an intermixed series of unpleasant, borderline-salient (e.g., "hate"), and neutral (e.g., "view") words and were instructed to think about the meaning of the word for them personally while eyeblink responses were assessed.


RESULTS
The BPD patients exhibited larger startle eyeblink during unpleasant but not neutral words, indicating exaggerated physiological affect. This finding remained significant when we controlled for comorbid diagnoses, including generalized anxiety disorder and post-traumatic stress disorder. Greater symptom severity was associated with greater affective-startle difference scores (unpleasant-neutral).


CONCLUSIONS
Consistent with the symptom of affective dysregulation, these results suggest an abnormality in the processing of unpleasant emotional stimuli by BPD patients.
Hazlett
Erin A
EA
Department of Psychiatry, Mount Sinai School of Medicine, New York, New York 10029, USA. erin.hazlett@mssm.edu
Speiser
Lisa J
LJ
Goodman
Marianne
M
Roy
Marcela
M
Carrizal
Michael
M
Wynn
Jonathan K
JK
Williams
William C
WC
Romero
Michelle
M
Minzenberg
Michael J
MJ
Siever
Larry J
LJ
New
Antonia S
AS
D000161:Acoustic Stimulation; D000328:Adult; D000339:Affect / Q000502:physiology*; D000704:Analysis of Variance; D001143:Arousal / Q000502:physiology*; D001883:Borderline Personality Disorder / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D011601:Psychophysics; D012016:Reference Values; D013216:Reflex, Startle / Q000502:physiology*; D012720:Severity of Illness Index; D014936:Word Association Tests