title: Borderline and cluster C personality disorders manifest distinct physiological responses to psychosocial stress.
abstract: Maladaptive emotional control is a defining feature of personality disorders. Yet little is known about the underlying physiological dynamics of emotional reactivity to psychosocial stress across distinct personality disorders. The current study compared subjective emotional responses with autonomic nervous system and HPA axis physiological responses to psychosocial stress in women with cluster C personality disorder (CPD) and borderline personality disorder (BPD).
  
  
  
  Subjective mood ratings, salivary cortisol, heart rate (HR), and skin conductance level (SCL) were assessed before, during, and after exposure to a standardized psychosocial stress paradigm (Trier Social Stress Test, TSST) in 26 women with BPD, 20 women with CPD, and 35 healthy female controls. Subjects were free of any medication including hormonal contraceptives, had a regular menstrual cycle, and were tested during the luteal phase of their menstrual cycle.
  
  
  
  Both CPD and BPD patients reported a similar burden of subjective mood disturbance. However, only BPD patients demonstrated reduced baseline cortisol levels with a blunted cortisol and HR reactivity to the TSST. In addition, BPD patients exhibited a generalized increase of SCL. No significant differences in baseline or TSST reactivity of cortisol, HR, or SCL were observed between CPD patients and healthy controls.
  
  
  
  These findings indicate that patients with BPD have significant alterations in their physiological stress reactivity, which is notably distinct from patients with CPD and those of healthy controls.
authors.affiliation: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.aleknaviciute@erasmusmc.nl.
authors.forename: Jurate
authors.initials: J
authors.lastname: Aleknaviciute
authors.affiliation: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.h.m.tulen@erasmusmc.nl.
authors.forename: Joke H M
authors.initials: JH
authors.lastname: Tulen
authors.affiliation: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands; Epidemiological and Social Psychiatric Research Institute, Rotterdam, The Netherlands. Electronic address: a.kamperman@erasmusmc.nl.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Kamperman
authors.affiliation: Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: y.derijke@erasmusmc.nl.
authors.forename: Yolanda B
authors.initials: YB
authors.lastname: de Rijke
authors.affiliation: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands; Rivierduinen, Institute of Mental Health Care, Zoetermeer, The Netherlands. Electronic address: kooiman@cgkooiman.nl.
authors.forename: Cornelis G
authors.initials: CG
authors.lastname: Kooiman
authors.affiliation: Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: s.kushner@erasmusmc.nl.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kushner
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000378:metabolism / Q000503:physiopathology*; D001883:Borderline Personality Disorder / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D010554:Personality Disorders / Q000378:metabolism / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology*; D013315:Stress, Psychological / Q000378:metabolism / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Autonomic nervous system; Borderline personality disorder; Cluster C personality disorder; Emotion dysregulation; Hypothalamus-pituitary-adrenal axis; Psychosocial stress