Resting state vagal tone in borderline personality disorder: A meta-analysis

Abstract

Borderline personality disorder (BPD) is the most common personality disorder in clinical settings. It is characterized by negative affectivity, emotional liability, anxiety, depression, as well as disinhibition (i.e., impulsivity and risk taking), all of which have been linked to lower resting state vagal tone, which may be indexed by vagally-mediated heart rate variability (vmHRV). Here, we aimed to quantify the current evidence on alterations in resting state vmHRV in individuals with BPD, relative to healthy controls. A rigorous search of the literature, according to the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses", revealed 5 studies suitable for meta-analysis, reporting vmHRV in individuals with BPD (n=95), relative to healthy controls (n=105). Short-term measures of resting state vmHRV were extracted and subjected to meta-analysis using both random- and fixed effect models in RevMan. BPD displayed lower resting state vmHRV relative to healthy controls in random- (Hedges' g=-0.59, 95% CI [-1.11; -0.06], k=5) and fixed-effect meta-analysis (Hedges' g=-0.56, 95% CI [-0.86; -0.27], k=5). Control for potential publication bias did not change observed findings. Lowered resting state vagal tone may be an important trait characteristic underlying BPD. As prior studies have observed lowered vmHRV in a variety of psychiatric disorders, we propose that lowered vmHRV may reflect a common psychophysiological mechanism underlying difficulties in emotion regulation and impulsivity, in particular.

Toward a social psychophysiology of vagally mediated heart rate variability: Concepts and methods in self‐regulation, emotion, and interpersonal processes

“…Associations with emotional adjustment are well documented. Higher resting vmHRV is associated with less negative affect and more constructive coping in response to daily stressors (Fabes & Eisenberg, ), whereas low resting vmHRV is associated with emotional symptoms and disorders, including depression (Kemp et al, ), anxiety (Chalmers, Quintana, Abbott, & Kemp, ), posttraumatic stress disorder (Campbell, Wisco, Silvia, & Gay, ), and borderline personality (Koenig, Kemp, Feeling, Thayer, & Kaess, ), suggesting a transdiagnostic marker of psychopathology and related vulnerabilities (Beauchaine & Thayer, ). Such associations are similar in children and adolescents (e.g., Koenig, Kemp, Beauchaine, Thayer, & Kaess, ).…”

A Meta‐analysis on Resting State High‐frequency Heart Rate Variability in Bulimia Nervosa

“…Bulimia nervosa (BN) is associated with various mental comorbidities, in particular depression and anxiety disorders as well as borderline personality disorder (Blinder, Cumella, & Sanathara, 2006;Cassin & von Ranson, 2005). Reduced vagally mediated HRV relative to controls is reported in both depressive disorders (Kemp et al, 2010) and anxiety disorders (Chalmers, Quintana, Maree, Abbott, & Kemp, 2014) including social anxiety as well as borderline personality disorder (Koenig, Feeling, Kemp, Thayer, & Kaess, 2016). It may be hypothesized that direct gastrointestinal effects brought about by bingeing and various compensating behaviours in BN exert a more prominent influence on the PNS than psychological symptoms and psychiatric comorbidities, respectively.…”

Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples

“…Chronic reductions in vagal activity indexed by HRV are associated with poor physiological, emotional, cognitive, behavioral regulation and self-rated heath (Alvares et al 2013; Beauchaine and Thayer 2015; Jarczok et al 2015; Thayer and Lane 2000; Thayer et al 2012; Thayer et al 2009a; Thayer and Lane 2009), as well as psychopathology (Kemp et al 2010; Koenig et al 2015, 2016; Clamor et al 2016). Functional neuroimaging studies and human lesion studies have shown several brain regions and networks involved in the neural control of HRV (Thayer et al 2012).…”