Longitudinal covariance of resting-state cardiac function and borderline personality disorder symptoms in adolescent non-suicidal self-injury

Abstract

Objectives: Cardiac function is altered in borderline personality disorder (BPD). In adolescents with non-suicidal self-injury (NSSI) resting heart rate (HR) and vagally mediated heart rate variability (vmHRV) are associated with BPD symptoms. The study aimed to investigate longitudinal covariance of BPD symptoms and cardiac function in adolescent NSSI.

Methods: HR and vmHRV were recorded in female adolescents with NSSI (n = 17) completing a baseline and 1-year follow-up assessment. Physiological data, structured clinical interviews and self-reports were obtained at both time points. Predictors of change in clinical outcomes and cardiac function were assessed.

Results: Patients showed a reduction of NSSI (z_(34;17) = –3.79, P < 0.0001), depressive symptoms (z_(34;17) = –3.74, P < 0.0001), and increases in the level of functioning (z_(34;17) = 2.87, P = 0.004). Symptoms of BPD and frequency of BPD diagnosis did not significantly change. No significant differences on HR or vmHRV were observed. Changes in BPD symptoms were associated with changes in HR (r₍₁₇₎= 0.532, P = 0.028) and vmHRV (r₍₁₇₎ = –0.516, P = 0.033).

Conclusions: Longitudinal changes in BPD symptomatology in adolescents engaging in NSSI are associated with changes in resting cardiac function. Clinical studies are needed to investigate the utility of cardiac markers to track treatment outcome in adolescents with BPD.

Keywords:

• Heart rate variability
• adolescents
• non-suicidal self-injury
• borderline personality disorder
• longitudinal

Acknowledgements

JK acknowledges the financial support of a Boehringer Ingelheim Fonds Travel Grant, a Travel Grant provided by the GlaxoSmithKline Healthcare GmbH, and a Society of Biological Psychiatry’s 2016 Early Career Investigator-International Travel Fellowship Award. JK is supported by a Physician-Scientist-Fellowship provided by the Medical Faculty of Heidelberg University. We acknowledge the valuable support by Tabea Hoppstädter and Maren Niederbäumer in conducting the study.

Statement of interest

The authors have no conflict of interest to declare. The study was funded by a private donation.