Poster #20 - Maternal Borderline Personality Disorder and Physiologic Stress Responding During the Third Trimester of Pregnancy

• In Event: 3-053 - Poster Session 10
  In Poster Session: PS 10 Section - Biological Processes: Psychophysiology

Integrative Statement

Introduction: Borderline personality disorder (BPD) is characterized by difficulties with emotion regulation, impulsivity, and unpredictable relationships (Sanislow et al., 2002; Brodsky et al., 2006). Regulating stress is particularly difficult for women with BPD (Kuo & Linehan, 2009). It may be that emotionally dysregulated pregnant women expose their unborn infants to heightened stress in various ways, which has implications for children’s neurobehavioral outcomes. However, the literature examining how women with BPD respond to stress during pregnancy is lacking. Examining maternal physiological reactivity to stress is important because research supporting Linehan’s biosocial developmental theory suggests maternal BPD and physiological stress responses of BPD during pregnancy may shape infant neurobehavior while in utero (Linehan, 1993; Crowell et al., 2009; Crandell, Patrick & Hobson, 2003; Lindsay et al., 2018).

Hypotheses: 1) Maternal BPD symptoms will be associated with heightened heart rate and reduced respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, during baseline; 2) HR will increase and RSA will decrease, from a baseline to the preparation phase, the stress (i.e. speech and math) phases, and recovery phase of the Trier Social Stress Test (TSST) for women with higher symptoms of BPD.

Study population: Participants were part of a NIMH-funded study examining the intergenerational transmission of emotion dysregulation. Participants included 147 pregnant women in their third trimester of pregnancy. Mean age was 28.80 yeas and 62.6% were Caucasian.

Method: Pregnant women completed the Borderline Symptom List—Short Form (BSL-23) to determine BPD symptom severity (Bohus et al., 2009). Each woman’s physiologic response was measured with a 10-minute baseline and the TSST, which elicits a stress response in adults with a preparation, stress (i.e. speech and math tasks), and a recovery phase (Kudielka, Hellhammer, & Kirschbaum, 2007).

Results: Women with high levels of BPD symptoms had significantly higher baseline HR and lower baseline RSA, compared to women with fewer BPD symptoms (table 1). Next, we examined associations between BPD and change scores measuring HR and RSA differences between baseline and each phase of the Trier Social Stress Task (i.e. Prep HR – Baseline HR; Prep RSA – Baseline RSA, etc.) As table 1 shows, HR and RSA change scores were not associated with BPD for any of the TSST phases (hypothesis 2).

We demonstrate preliminary evidence of baseline differences in physiological regulation for pregnant women with BPD symptoms. Our discussion will describe how our results compare to and contrast with physiological responding for women with BPD who are not pregnant.

Authors

• Ashley K. Allen, University of Utah
  Presenting Author

• Brendan Ostlund, University of Utah
  Non-Presenting Author

• Sarah Terrell, University of Utah
  Non-Presenting Author

• Mindy Brown, University of Utah
  Non-Presenting Author

• Parisa Kaliush, University of Utah
  Non-Presenting Author

• Robert Dennis Vlisides-Henry, University of Utah
  Non-Presenting Author

• Sheila Crowell, University of Utah
  Non-Presenting Author

• Elisabeth Conradt, University of Utah
  Non-Presenting Author