title: Emotion avoidance and fear bradycardia in patients with borderline personality disorder and healthy controls.
abstract: OBJECTIVE
  Exaggerated emotional reactivity is supposed to be essential in the etiology of borderline personality disorder (BPD). More specifically, models of defensive behavior would predict reduced freezing behavior -indicated by fear bradycardia-in response to threat. This study examined automatic fear bradycardia responses in BPD versus healthy controls and the role of emotion dysregulation, more specifically tendencies to avoid emotions.
  
  
  METHODS
  Patients with BPD (n = 23) and healthy controls (n = 18) completed questionnaires and then watched neutral, pleasant and unpleasant pictures while heart rate was assessed.
  
  
  RESULTS
  Emotion avoidance interacted with group: it was associated with distinct autonomic responses in healthy controls but not in BPD patients. Controls with lower emotion avoidance tendencies showed bradycardia in response to unpleasant pictures, while controls with higher emotion avoidance tendencies did not. BPD patients showed no bradycardia, irrespective of their emotion avoidance tendencies.
  
  
  CONCLUSIONS
  This study is limited by a small sample size. Comorbidity or medication intake were not controlled for.
  
  
  CONCLUSIONS
  The results may suggest impaired automatic defense responses in BPD. Further understanding of the regulation of distress and defense responses might improve BPD treatment.
authors.affiliation: Amstel Academy, VU Medical Centre, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Malou
authors.initials: M
authors.lastname: Stoffels
authors.affiliation: Netherlands Psychiatric Association, Mercatorlaan 1200, 3528 BL Utrecht, The Netherlands.
authors.forename: Maurits
authors.initials: M
authors.lastname: Nijs
authors.affiliation: Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: Spinhoven
authors.affiliation: Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands; PsyQ, Lijnbaan 4, 2512 VA Den Haag, The Netherlands.
authors.forename: Rahele
authors.initials: R
authors.lastname: Mesbah
authors.affiliation: Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands; Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands. Electronic address: m.a.hagenaars@uu.nl.
authors.forename: Muriel A
authors.initials: MA
authors.lastname: Hagenaars
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology*; D000704:Analysis of Variance; D001143:Arousal / Q000502:physiology; D001883:Borderline Personality Disorder / Q000150:complications* / Q000523:psychology*; D001919:Bradycardia / Q000209:etiology*; D005239:Fear / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D010775:Photic Stimulation; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
keywords: Avoidance; Borderline personality disorder; Bradycardia; Emotion regulation; Freezing; Stress