The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder

Janina Naoum; Sarah Reitz; Annegret Krause-Utz; Nikolaus Kleindienst; Franziska Willis; Sarah Kuniss; Ulf Baumgärtner; Falk Mancke; Rolf-Detlef Treede; Christian Schmahl

doi:10.1016/j.psychres.2016.10.066

The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder

Psychiatry Res. 2016 Dec 30:246:676-682. doi: 10.1016/j.psychres.2016.10.066. Epub 2016 Nov 2.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. Electronic address: janina.naoum@zi-mannheim.de.
² Department of Neurology, Johann Wolfgang Goethe University, Frankfurt, Germany.
³ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Clinical Psychology, Institute of Psychology, Leiden University; Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands.
⁴ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
⁵ Department of Neurophysiology, Centre of Biomedicine and Medical Technology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁶ Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.
⁷ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

PMID: 27829508
DOI: 10.1016/j.psychres.2016.10.066

Abstract

Patients with Borderline Personality Disorder (BPD) often engage in non-suicidal self-injury (NSSI), to reduce arousal levels under stress. However, the importance of seeing blood for the effect of NSSI is yet unknown. The present pilot study examined 20 female BPD patients and 20 healthy controls (HC) to assess the role of seeing blood on arousal, pain, urge for NSSI (ratings) and heart rate (continuously measured). Participants completed two sessions consisting of stress induction (forced mental arithmetics with white noise), followed by a seven second non-invasive pain stimulus with a blade to the volar forearm. At one session, only the painful blade stimulus was applied, at the other, artificial blood was added. For arousal, a significantly stronger decrease was revealed in the BPD than in the HC group, however with no significant effects between blood and non-blood conditions. Concerning urge for NSSI, the BPD showed a significantly greater decrease in blood condition over time than the HC group. Interestingly, heart rate decreased stronger over time in the HC group during the blood condition than in BPD. For tension relief by non-damaging mechanical painful stimulus the addition of visible blood showed neither subjective (arousal, urge for NSSI), nor objective (heart rate) advantages.

Keywords: Arousal; BPD; Heart rate; NSSI; Pain; Skin-cutting; Urge for NSSI.

MeSH terms

Adolescent
Adult
Arousal / physiology*
Blood*
Borderline Personality Disorder / physiopathology*
Female
Heart Rate / physiology*
Humans
Middle Aged
Pain Perception / physiology*
Self-Injurious Behavior / physiopathology*
Visual Perception / physiology*
Young Adult