Reactivity of Patients With Borderline Personality Disorder to an Ecological Interpersonal Stress
Condition: Female; Borderline Personality Disorder
MeSH terms: Personality Disorders; Borderline Personality Disorder
Study type: Interventional

Summary: 
      Use lay language.

      According to the World Health Organization 1 death by suicide occurs every 40 seconds,
      leading suicide prevention to one of the public health priority.

      BPD (Borderline Personality Disorder) is a common condition affecting 6% of the population.

      This disorder is characterized by unstable emotions, unstable mood, difficulties with
      relationship and feer of abandonment.

      Borderline Personality Disorder is also the psychopathology the most related to suicidal
      attempts.

      Indeed, up to 50% of the patients admitted to hospital after a suicide attempt are diagnosis
      with a Borderline Personality Disorder

      Negative interpersonal events (events occurring between two people) are known as the main
      stressor that trigger a suicidal attempt.

      People with a Borderline Personality Disorder are highly sensitive to it.

      Moreover, neuropeptides such as oxytocin (OXT), vasopressin and opioid are known to be
      involved in the regulation of the emotions, especially those linked to relationship.

      The purpose of this study is to improve knowledge in suicidal behaviors.

      After simulating an interpersonal stress, the evolution of plasma neuropeptides level (OXT,
      vasopressin and opioid) of patients with a BPD will be compared to healthy controls (HC).

      Clinical data reflecting how the participant is feeling will be collected as well.
    

Detailed description: 
      A dysregulation of the neuropeptides (OXT, vasopressin and opioid) could explain the
      dysregulation of the emotions of people with Borderline Personality Disorder.

      Up to this date there is no other study measuring neuropeptides kinetics of patient with
      Borderline Personality Disorder after an interpersonal stress.

      This task of stress is meant to reproduce what people with Borderline Personality Disorder
      suffer in their everyday life (ecological).

      To reach this point, an imaginary interpersonal stress will be asked to be reproduced by the
      participants.

      Neuropeptides concentrations and clinical data (fear, shame, anger, moral pain, compelling
      needs (suicidal and non-suicidal)) will be collected at different times (pre stress, post
      stress immediat, 5 minutes post stress,15 minutes post stress and 40 minutes post stress)

      As copeptin ( fragment C terminal of the vasopressin) and vasopressin are found in
      stoichiometric concentration in the plasma as copeptin is more stable than vasopressin,
      plasma copeptin level will be used to reflect the one of vasopressin.

      The hypothesis is that both the neuropeptide variation and clinical data before and after the
      interpersonal stress will be higher for the patient with Borderline Personality Disorder than
      healthy controls.

      A correlation between clinical assessments and neuropeptides kinetics is expected. This study
      will help to identify inter-individual and contextual factors impacting neuropeptide's
      kinetics
    

Intervention name(s): Interpersonal stress
Intervention type(s): Other
Intervention description(s): Through an interview the evaluator will make a 1 to 2 pages script, written in first-person and in present tense. It will involve an interpersonal conflict between the participants and the person who once trigger their feeling of abandonment.
After reading the script the participants will have to close their eyes and imagine the event as if was happening to them, now, in real time, and think about it during 3 minutes.
To evaluate the stress efficiency, the evaluator will ask 2 questions :
1) "from 0 (no distress at all) to 10 (maximal unimaginable distress), to wich point this script bring distress to you?"
2) "from 0 (I can not at all) to 10 (I can completely), to wich point are you able to imagine the scenario in real time, as if you were living it?"
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Psychiatry; Suicidal Behavior; Borderline Personality Disorder; Interpersonal Relations; Social Stress; Oxytocin; Neuropeptide