The Interpersonal Dimension of Borderline Personality Disorder: Toward a Neuropeptide Model

Abstract

Borderline personality disorder is characterized by affective instability, impulsivity, identity diffusion, and interpersonal dysfunction. Perceived rejection and loss often serve as triggers to impulsive, suicidal, and self-injurious behavior, affective reactivity, and angry outbursts, suggesting that the attachment and affiliative system may be implicated in the disorder. Neuropeptides, including the opioids, oxytocin, and vasopressin, serve a crucial role in the regulation of affiliative behaviors and thus may be altered in borderline personality disorder. While clinical data are limited, the authors propose alternative neuropeptide models of borderline personality disorder and review relevant preclinical research supporting the role of altered neuropeptide function in this disorder in the hope of stimulating more basic research and the development of new treatment approaches.

Impulsivity: current and future trends in pharmacological treatment

“…Neuropeptides, including opioids, oxytocin and vasopressin, serve a crucial role in the regulation of affiliative behaviors and, thus, could contribute to undesirable rapid responses to interpersonal conflicts [19].…”

“…However, new findings regarding the role of the endo cannabinoid system [17,18], and other neuromodulators, such as opioids, oxytocin and vasopresine [12,19], should encourage more basic and translational studies in order to develop novel pharmacological treatments for impulsive behaviors.…”

Using Functional Neuroimaging to Refine the Diagnostic Construct of Borderline Personality Disorder

“…It is readily apparent than an individual's sensitivity to emotion will likely impact their potential for emotion dysregulation, which certainly impacts their interpersonal relationships and their behavioral constraint. As has been highlighted, evidence suggests that emotion dysregulation may underlie behavioral impulsivity and interpersonal sensitivity [141,134], yet we also find suggestive evidence that interpersonal sensitivity (and rejection sensitivity) may underlie many of the other BPD symptoms [38,184]. The goal of this project, therefore, was not to determine, what is, once and for all the chicken and what is the egg in the BPD diagnosis, because that is a futile endeavor.…”

Borderline personality disorder: current drug treatments and future prospects

“…Dysregulation of the endogenous opioid system has been implicated in nonsuicidal self-harm [Tiefenbacher et al 2005;Schmahl et al 2002], interpersonal vulnerabilities and social attachments [Panksepp et al 1978], all of which are implicated to some degree in the clinical spectrum of BPD. Evidence for this has been demonstrated in human studies, revealing altered opioid neurotransmission associated with negative affect [Zubieta et al 2003[Zubieta et al , 2002, altered opioid levels in patients with a history of self-harm [Stanley et al 2009;Sandman et al 1997;Coid et al 1983], and genetic single nucleotide polymorphisms in the m-opioid receptor gene associated with identity disturbance [Stanley and Siever, 2010].…”