Psychophysiological stress response and memory in borderline personality disorder

Area of Science:

• Neuroscience
• Psychiatry
• Endocrinology

Background:

• Previous research indicated hydrocortisone enhances memory retrieval in borderline personality disorder (BPD) patients, but not healthy controls (HC).
• The current study investigates the impact of endogenous cortisol release following psychosocial stress on memory in BPD and HC.

Purpose of the Study:

• To determine if endogenous cortisol increases after psychosocial stress correlate with memory function in BPD patients and HC.
• To compare the HPA axis and sympathetic nervous system responses to stress between BPD patients and HC.

Main Methods:

• 49 female BPD patients and 49 female HC underwent the Trier Social Stress Test (TSST) and a placebo control.
• Salivary cortisol, alpha-amylase (sAA), and blood pressure were measured.
• Free recall, autobiographical, and working memory were assessed post-stress.

Main Results:

• A stress*time*group interaction was observed for cortisol and sAA responses, with BPD patients showing a slightly different cortisol increase.
• BPD patients exhibited a less pronounced increase in diastolic blood pressure post-stress compared to HC.
• No significant effect of stress on memory performance was found in either group.

Conclusions:

• BPD patients demonstrated a potentially blunted HPA axis and sympathetic nervous system response to psychosocial stress compared to healthy women.
• Unlike exogenous hydrocortisone, endogenous cortisol release after stress did not enhance memory retrieval in BPD patients.
• This difference may be attributed to lower cortisol levels and increased norepinephrine and negative affect following stress in BPD individuals.