Serotonergic blunting to meta-chlorophenylpiperazine (m-CPP) highly correlates with sustained childhood abuse in impulsive and autoaggressive female borderline patients

Biol Psychiatry. 2000 Mar 15;47(6):548-56. doi: 10.1016/s0006-3223(99)00181-x.


Background: Disturbances of affect, impulse regulation, and autoaggressive behavior, which are all said to be related to an altered function of the central serotonergic (5-HT) system, are prominent features of borderline personality disorder (BPD). A high coincidence of childhood physical and sexual abuse is reported in these patients. Animal studies indicate that early, sustained stress correlates with a dysfunctional central 5-HT system. Therefore, we hypothesize that sustained traumatic stress in childhood affects the responsivity of the postsynaptic serotonergic system of traumatized BPD patients.

Methods: Following Axis I, Axis II, and trauma assessment, a neuroendocrine challenge test was performed with the postsynaptic serotonergic agonist meta-chlorophenylpiperazine (m-CPP) in 12 impulsive and autoaggressive female patients with BPD and 9 matched healthy volunteers.

Results: The cortisol and prolactin responses to the m-CPP challenge in BPD patients were significantly lower compared to those in controls. Within the group of patients with BPD, the net prolactin response showed a high inverse correlation with the frequency of the physical (r = -.77) and sexual abuse (r = -.60).

Conclusions: Our data suggest that severe and sustained traumatic stress in childhood affects the 5-HT system and especially 5-HT(1A) receptors. This finding confirms the data from animal research. The blunted prolactin response to m-CPP appears to be the result of severe traumatization and independent of the BPD diagnosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Borderline Personality Disorder / diagnosis
  • Borderline Personality Disorder / etiology*
  • Borderline Personality Disorder / metabolism*
  • Child
  • Child Abuse / psychology*
  • Child, Preschool
  • Female
  • Humans
  • Hydrocortisone / metabolism
  • Impulsive Behavior / etiology*
  • Middle Aged
  • Piperazines* / blood
  • Prolactin / metabolism
  • Psychiatric Status Rating Scales
  • Self-Injurious Behavior / etiology*
  • Serotonin / metabolism*
  • Serotonin Receptor Agonists* / blood
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / etiology*
  • Stress Disorders, Post-Traumatic / metabolism*


  • Piperazines
  • Serotonin Receptor Agonists
  • Serotonin
  • Prolactin
  • 1-(3-chlorophenyl)piperazine
  • Hydrocortisone