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Nervenheilkunde 2011; 30(08): 602-607
DOI: 10.1055/s-0038-1628400
Ulmer Heft
Schattauer GmbH

Transitionale Objekte und Schmerzwahrnehmung bei Patienten mit Borderline-Persönlichkeitsstörung

Transitional objects and pain in Borderline patients
M. M. Schmid
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
R. Freudenmann
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
I. Keterling
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
L. Cárdenas-Morales
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
B. J. Connemann
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
I. M. Gunst
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
C. Schönfeldt-Lecuona II
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
› Author Affiliations
Further Information

Publication History

Eingegangen am: 01 April 2011

angenommen am: 06 April 2011

Publication Date:
23 January 2018 (online)

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Zusammenfassung

Zum Verständnis der Entwicklung und Psychopathologie der emotional-instabilen Persönlichkeitsstörung vom Borderline-Typ (BPS) könnten phänomenologische Beobachtungen beitragen. In diesem Artikel werden Ergebnisse zweier Untersuchungen an Borderline-Patientinnen berichtet. Zum einen wurde eine größere Häufigkeit im Gebrauch von Übergangsobjekten bei BPS-Patientinnen im Vergleich zu ebenfalls stationär behandelten Patientinnen ohne diese Persönlichkeitsstörung nachgewiesen. Zum anderen war es mittels repetitiver peripherer Magnetstimulation (rPMS) möglich, eine veränderte Schmerzwahrnehmung mit erhöhter Schmerzschwelle bei BPS im Vergleich zu Kontrollen nachzuweisen.

Summary

Phenomenological observations play an important role in understanding Borderline Personality Disorder. In this article, we report results of two studies in female inpatient Borderline patients. Firstly, an increased use of transitional objects in Borderline patients was demonstrated. Secondly, differential patterns in emotional aspects of pain processing were observed in patients as compared to controls by means of repetitive peripheral magnet stimulation (rPMS). In Borderline patients, pain thresholds were consistently increased.

Schlüsselwörter

Borderline-Persönlichkeitsstörung - Schmerzwahrnehmung - Übergangsobjekte - Selbstverletzung

Keywords

Borderline personality disorder - pain perception - transitional objects - NSSI
 

  • Literatur

  • 1 Torgersen S, Kringlen E, Cramer V. The prevalence of personality disorders in a community sample. Archives of General Psychiatry 2001; 58: 590-6.
    CrossrefPubMedGoogle Scholar
  • 2 Grant BF. et al. Prevalence, correlates, disability, and comorbidity of DSM-IV Borderline personality disorder: Results from the wave 2 National Epidemiologic Survey on alcohol and related conditions. Journal of Clinical Psychiatry Research 2008; 69: 533-45.
    Google Scholar
  • 3 Gunderson JG. Borderline personality disorder: ontogeny of a diagnosis. Am J Psychiatry 2009; 166 (05) 530-9.
    CrossrefPubMedGoogle Scholar
  • 4 Bohus M, Schmahl C. Psychopathologie und Therapie der Borderline-Persönlichkeitsstörung. Nervenarzt 2007; 78: 1069-81.
    CrossrefPubMedGoogle Scholar
  • 5 Höschel K, Bohus M. An der Grenze zur Verzweiflung. Borderline-Persönlichkeitsstörungen in der Praxis. Der Neurologe und Psychiater 2005; 01: 20-8.
    Google Scholar
  • 6 Binks CA. et al. Psychological therapies for people with Borderline personality disorder. Cochrane Database of Systematic Reviews. 2006
    PubMedGoogle Scholar
  • 7 Holm Al. The emotional pain and distress of Borderline personality disorder: A review of the literature. International Journal of Mental Health Nursing 2008; 17: 27-35.
    CrossrefPubMedGoogle Scholar
  • 8 Paris J. Borderline personality disorder. Canadian Medical Association Journal 2005; 172: 1579-83.
    CrossrefPubMedGoogle Scholar
  • 9 Niedtfeld I. et al. Affect regulation and pain in borderline personality disorder: a possible link to the understanding of self-injury. Biol Psychiatry 2010; 68 (04) 383-91.
    CrossrefPubMedGoogle Scholar
  • 10 Fonagy P, Luyten P. A developmental, mentalization-based approach to the understanding and treatment of Borderline personality disorder. Development and Psychopathology 2009; 21: 1355-81.
    CrossrefPubMedGoogle Scholar
  • 11 Semiz UB, Basoglu C, Ebrinc S, Cetin M. Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder. Psychiatry Clin Neurosci 2008; 62 (01) 48-55.
    CrossrefPubMedGoogle Scholar
  • 12 Gunderson JG. et al. Predictors of 2-year outcome for patients with Borderline personality disorder. American Journal of Psychiatry 2006; 163: 822-6.
    CrossrefPubMedGoogle Scholar
  • 13 Kleindienst N. et al. Motives for nonsuicidal self-injury among women with Borderline personality disorder. Journal of Nervous and Mental Disease 2008; 196: 230-6.
    CrossrefPubMedGoogle Scholar
  • 14 Zittel CConklin, Westen D. Borderline personality disorder in clinical practice. American Journal of Psychiatry 2005; 162: 867-75.
    CrossrefPubMedGoogle Scholar
  • 15 Torgersen S. et al. A twin study of personality disorders. Compr Psychiatry 2000; 41 (06) 416-25.
    CrossrefPubMedGoogle Scholar
  • 16 Crowell SE, Beauchaine TP, Linehan MM. A biosocial developmental model of Borderline personality: Elaborating and extending Linehan´s theory. Psychological Bulletin 2009; 135: 495-510.
    CrossrefPubMedGoogle Scholar
  • 17 Zanarini MC. et al. Biparental failure in the childhood experiences of borderline patients. J Pers Disord 2000; 14 (03) 264-73.
    CrossrefPubMedGoogle Scholar
  • 18 Stanley B, Siever LJ. The interpersonal dimension of borderline personality disorder: toward a neuropeptide model. Am J Psychiatry 2010; 167 (01) 24-39.
    CrossrefPubMedGoogle Scholar
  • 19 Lis E, Greenfield B, Henry M, Guile JM, Dougherty G. Neuroimaging and genetics of borderline personality disorder: a review. J Psychiatry Neurosci 2007; 32 (03) 162-73.
    PubMedGoogle Scholar
  • 20 Rodrigues E. et al. Hippocampal volume in borderline personality disorder with and without comorbid posttraumatic stress disorder: A meta-analysis. Eur Psychiatry 2010; 67 (06) 608-13.
    Google Scholar
  • 21 Winnicott DW. Transitional objects and transitional phenomena; a study of the first not-me possession. Int J Psychoanal 1953; 34 (02) 89-97.
    PubMedGoogle Scholar
  • 22 Morris H, Gunderson JG, Zanarini MC. Transitional object use and borderline psychopathology. Am J Psychiatry 1986; 143 (12) 1534-8.
    CrossrefPubMedGoogle Scholar
  • 23 Cardasis W, Hochman JA, Silk KR. Transitional objects and borderline personality disorder. Am J Psychiatry 1997; 154 (02) 250-5.
    CrossrefPubMedGoogle Scholar
  • 24 Kernberg OF. [Psychotherapeutic treatment of borderline patients]. Psychother Psychosom Med Psychol 1995; 45 (3–4): 73-82.
    PubMedGoogle Scholar
  • 25 Clarkin JF. et al. An object relations model of borderline pathology. J Pers Disord 2007; 21 (05) 474-99.
    CrossrefPubMedGoogle Scholar
  • 26 Agrawal HR, Gunderson J, Holmes BM, Lyons-Ruth K. Attachment studies with borderline patients: a review. Harv Rev Psychiatry 2004; 12 (02) 94-104.
    CrossrefPubMedGoogle Scholar
  • 27 Russ MJ. et al. Pain perception in self-injurious patients with borderline personality disorder. Biol Psychiatry 1992; 32: 5001-11.
    Google Scholar
  • 28 Russ MJ. et al. Subtypes of self-injurious patients with borderline personality disorder. Am J Psychiatry 1993; 150 (12) 1869-71.
    CrossrefPubMedGoogle Scholar
  • 29 Bohus M. et al. Pain perception during self-reported distress and calmness in patients with borderline personality disorder and self-mutilating behavior. Psychiatry Research 2000; 95: 251-60.
    CrossrefPubMedGoogle Scholar
  • 30 Schmahl C. et al. Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli, and pain ratings. Pain 2004; 110 (1–2): 470-9.
    CrossrefPubMedGoogle Scholar
  • 31 Ludäscher P. et al. Elevated pain thresholds correlate with dissociation and aversive arousal in patients with borderline personality disorder. Psychiatry Research 2007; 149 (1–3): 291-6.
    CrossrefPubMedGoogle Scholar
  • 32 Schmahl C. et al. Neural correlates of antinociception in borderline personality disorder. Arch Gen Psychiatry 2006; 63 (06) 659-67.
    CrossrefPubMedGoogle Scholar
  • 33 Cárdenas-Morales L. et al. Exploring the affective component of pain perception during aversive stimulation in borderline personality disorder. Psychiatry Research 2010; 149: 291-6.
    Google Scholar
  • 34 Dahl AA. Controversies in diagnosis, classification and treatment of borderline personality disorder. Curr Opin Psychiatry 2008; 21 (01) 78-83.
    CrossrefPubMedGoogle Scholar
  • 35 Zanarini MC, Frankenburg FR, Hennen J, Silk KR. The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. Am J Psychiatry 2003; 160 (02) 274-83.
    CrossrefPubMedGoogle Scholar
  • 36 Paris J. The treatment of borderline personality disorder: implications of research on diagnosis, etiology, and outcome. Annu Rev Clin Psychol 2009; 05: 277-90.
    CrossrefPubMedGoogle Scholar
  • 37 Kernberg OF, Michels R. Borderline personality disorder. American Journal of Psychiatry Research 2009; 166 (Editorial): 5.
    Google Scholar