Altered interoception in patients with borderline personality disorder: a study using heartbeat-evoked potentials

Area of Science:

• Neuroscience
• Psychiatry
• Psychophysiology

Background:

• Borderline personality disorder (BPD) is associated with difficulties in emotional awareness (alexithymia) and dissociative symptoms.
• These symptoms may stem from broader deficits in interoceptive awareness.
• Cortical processing of interoception in BPD remains largely unexplored.

Purpose of the Study:

• To investigate the relationship between interoceptive awareness, autonomic nervous system (ANS) functioning, and self-reported symptoms in BPD.
• To examine electrophysiological markers of interoception in individuals with BPD.

Main Methods:

• Utilized heartbeat-evoked potentials (HEP) as an electrophysiological marker of interoception.
• Measured heart rate variability (HRV) as a correlate of ANS functioning.
• Administered self-report measures for alexithymia, dissociation, and BPD symptom severity.

Main Results:

• Patients with BPD exhibited significantly higher HEP amplitudes over frontal electrodes compared to healthy controls.
• Individuals with BPD displayed greater sympathetic ANS activity.
• Across all participants, HEP amplitudes correlated with parasympathetic activity over central electrodes and with alexithymia over frontal electrodes.

Conclusions:

• Altered frontal electrophysiological markers of interoception are evident in BPD, reflecting difficulties in emotional awareness.
• Emotional awareness in BPD may involve failures in modulating attention between interoceptive and exteroceptive information.
• Future research should explore the therapeutic potential for altering interoception and its neural correlates in BPD.