title: Effects of serotonin-2A receptor binding and gender on personality traits and suicidal behavior in borderline personality disorder.
abstract: Impulsivity and aggressiveness are personality traits associated with a vulnerability to suicidal behavior. Behavioral expression of these traits differs by gender and has been related to central serotonergic function. We assessed the relationships between serotonin-2A receptor function, gender, and personality traits in borderline personality disorder (BPD), a disorder characterized by impulsive-aggression and recurrent suicidal behavior. Participants, who included 33 BPD patients and 27 healthy controls (HC), were assessed for Axis I and II disorders with the Structured Clinical Interview for DSM-IV and the International Personality Disorders Examination, and with the Diagnostic Interview for Borderline Patients-Revised for BPD. Depressed mood, impulsivity, aggression, and temperament were assessed with standardized measures. Positron emission tomography with [(18)F]altanserin as ligand and arterial blood sampling was used to determine the binding potentials (BPND) of serotonin-2A receptors in 11 regions of interest. Data were analyzed using Logan graphical analysis, controlling for age and non-specific binding. Among BPD subjects, aggression, Cluster B co-morbidity, antisocial PD, and childhood abuse were each related to altanserin binding. BPND values predicted impulsivity and aggression in BPD females (but not BPD males), and in HC males (but not HC females.) Altanserin binding was greater in BPD females than males in every contrast, but it did not discriminate suicide attempters from non-attempters. Region-specific differences in serotonin-2A receptor binding related to diagnosis and gender predicted clinical expression of aggression and impulsivity. Vulnerability to suicidal behavior in BPD may be related to serotonin-2A binding through expression of personality risk factors.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: soloffph@upmc.edu.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Soloff
authors.affiliation: Department of Statistics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Laurel
authors.initials: L
authors.lastname: Chiappetta
authors.affiliation: Department of Radiology and the PET Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Neale Scott
authors.initials: NS
authors.lastname: Mason
authors.affiliation: Department of Radiology and the PET Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Becker
authors.affiliation: Department of Radiology and the PET Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Price
mesh_terms: D000328:Adult; D000374:Aggression; D001883:Borderline Personality Disorder / Q000378:metabolism* / Q000523:psychology*; D003287:Contrast Media / Q000378:metabolism; D003863:Depression; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007175:Impulsive Behavior; D007650:Ketanserin / Q000031:analogs & derivatives / Q000378:metabolism; D008297:Male; D010551:Personality; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D044402:Receptor, Serotonin, 5-HT2A / Q000378:metabolism*; D012702:Serotonin Antagonists / Q000378:metabolism; D012737:Sex Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted; D013694:Temperament
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D044402:Receptor, Serotonin, 5-HT2A; D012702:Serotonin Antagonists; D019788:Fluorodeoxyglucose F18; C071983:altanserin; D007650:Ketanserin
keywords: Aggression; Harm avoidance; Impulsivity; Novelty seeking; Positron emission tomography (PET); Suicidal behavior
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