Body connection mediates the relationship between traumatic childhood experiences and impaired emotion regulation in borderline personality disorder

Abstract

Background Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describing the awareness of the relationship of bodily and mental states, for the association between a history of traumatic childhood experiences and BPD core symptomatology. Methods One-hundred-twelve adult female individuals with BPD and 96 healthy female controls (HC) were included. Impaired emotion regulation, traumatic childhood experiences, and BPD symptomatology were assessed with self-report questionnaires. The Scale of Body Connection was used to assess two dimensions of body connection, that is body awareness, describing attendance to bodily information in daily life and noticing bodily responses to emotions and/or environment and body dissociation, describing a sense of separation from one’s own body, due to avoidance or emotional disconnection. Mann-Whitney U tests were employed to test for group differences (BPD vs. HC) on the two SBC subscales and associations with clinical symptoms were analyzed with Spearman correlations. We performed mediation analyses in the BPD group to test the assumption that body connection could act as a mediator between a history of traumatic childhood experiences and emotion dysregulation. Results Individuals with BPD reported significantly lower levels of body awareness and significantly higher levels of body dissociation compared to HC. Body dissociation, traumatic childhood experiences, and emotion dysregulation were significantly positively associated. Further analyses revealed that body dissociation, but not body awareness, significantly and fully mediated the positive relationship between traumatic childhood experiences and impaired emotion regulation in the BPD sample. This mediation survived when trait dissociation, i.e., general dissociative experiences not necessarily related to the body, was statistically controlled for. Conclusion Certain dimensions of body connection seem to be disturbed in BPD patients, with body dissociation being an important feature linking a history of traumatic childhood experiences to current deficits in emotion regulation.

Neuroscience and personality disorders.

“…Their generators are located in the anterior insula and dorsal anterior cingulate cortex (Pollatos et al, 2005)-and thus, in regions important for the integration and awareness of bodily signals (Critchley et al, 2004). Two independent studies have reported reduced resting-state heartbeat-evoked potentials in patients with BPD compared with healthy volunteers (Müller et al, 2015;Schmitz et al, 2020), in line with the reduced self-reported body awareness (Schmitz et al, 2021). Interestingly, no significant difference in the amplitude of heartbeat-evoked potentials could be found between patients with a former diagnosis of BPD and healthy volunteers (Müller et al, 2015), which may suggest plasticity in self-awareness related to symptom amelioration.…”

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

“…[46,47] Social/Emotional Impairment This can range from mild social interaction issues to trauma-associated body disassociation. [48,49] Elevated risk of suicide This often co-occurs with major depressive disorder. [50,51] HPA axis dysregulation This recent review describes a neuroimmune regulation model for the resulting HPA hyperactivity.…”

Dissociation, trauma, and borderline personality disorder

“…In a recent study, female patients with BPD reported significantly lower levels of body awareness and significantly higher levels of body dissociation compared to healthy women. Significant positive correlations between body dissociation, traumatic childhood experiences, and emotion regulation were found [ 67 ].…”