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Selective interoception impairments and treatment effects in borderline personality disorder.

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Τίτλος: Selective interoception impairments and treatment effects in borderline personality disorder.
Συγγραφείς: Voelter J; Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany. jella.voelter@uni-oldenburg.de.; Ambulatory Assessment in Psychology, Department of Psychology, University of Oldenburg, Oldenburg, Germany. jella.voelter@uni-oldenburg.de., Postin D; Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany., Müller C; Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany., Roheger M; Ambulatory Assessment in Psychology, Department of Psychology, University of Oldenburg, Oldenburg, Germany., Schulz A; Research Group 'Brain-Body Interaction', Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg., Bekrater-Bodmann R; Department of Psychiatry, Psychotherapy and Psychosomatics, Uniklinik RWTH Aachen, Aachen, Germany., Hurlemann R; Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany.; Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany., Scheele D; Department of Social Neuroscience, Center of Medical Psychology and Translational Neuroscience, Medical Faculty, Ruhr University Bochum, Bochum Süd, Germany. Dirk.Scheele@ruhr-uni-bochum.de.; Research Center One Health Ruhr of the University Alliance Ruhr, Ruhr University Bochum, Bochum Süd, Germany. Dirk.Scheele@ruhr-uni-bochum.de.
Πηγή: Translational psychiatry [Transl Psychiatry] 2026 Sep 10; Vol. 16 (1). Date of Electronic Publication: 2026 Sep 10.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Nature Pub. Group Country of Publication: United States NLM ID: 101562664 Publication Model: Electronic Cited Medium: Internet ISSN: 2158-3188 (Electronic) Linking ISSN: 21583188 NLM ISO Abbreviation: Transl Psychiatry Subsets: MEDLINE
Imprint Name(s): Original Publication: New York, NY : Nature Pub. Group
Ιατρικοί όροι (MeSH): Borderline Personality Disorder*/therapy , Borderline Personality Disorder*/physiopathology , Borderline Personality Disorder*/psychology , Borderline Personality Disorder*/diagnostic imaging , Interoception*/physiology , Dialectical Behavior Therapy*/methods, Attention/physiology ; Metacognition/physiology ; Gyrus Cinguli/physiopathology ; Gyrus Cinguli/diagnostic imaging ; Humans ; Female ; Adult ; Magnetic Resonance Imaging ; Male ; Young Adult ; Heart Rate ; Treatment Outcome
Περίληψη: Patients with borderline personality disorder (BPD) suffer from severe emotional dysregulation and disturbances in body image and self-perception. Interoception, the processing and perception of internal body signals, is closely linked to emotional processing, but it remains unclear whether BPD impairs specific interoceptive facets and how these deficits respond to treatment. We investigated two key interoceptive facets, accuracy and attention, in BPD patients and healthy controls (HC) using self-report and objective measures before (nBPD=55,nHC = 31) and after (nBPD=37,nHC = 31) four-week residential Dialectical Behavior Therapy (DBT)/a waiting interval. Interoceptive accuracy and its metacognitive awareness were evaluated using a heartbeat discrimination task, while interoceptive attention was measured through questionnaires, intensity ratings, and uni- and multivariate neural responses during a functional magnetic resonance imaging (fMRI) interoceptive attention task. Before DBT, BPD patients showed reduced self-reported interoceptive attention, which was associated with more interpersonal problems. Patients further exhibited higher similarity in activity patterns evoked by cardiac interoceptive and exteroceptive attention in the insular and dorsal anterior cingulate cortex. There were no significant group differences in behavioral or self-reported interoceptive accuracy or metacognitive awareness. However, behavioral interoceptive accuracy was impaired in BPD patients with more severe symptoms. After four-week residential DBT, self-reported interoceptive attention significantly improved, while other interoceptive facets showed no significant changes. Our findings indicate that BPD involves selective interoceptive attention disturbances, with only self-reported measures responding to treatment. These results support multifaceted assessments of interoception and the potential benefit of interoceptive attention training for all BPD patients, with additional accuracy training in more severe cases.
(© 2026. The Author(s).)
Competing Interests: Competing interests: The authors declare no competing interests.
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Entry Date(s): Date Created: 20260910 Date Completed: 20260910 Latest Revision: 20260914
Update Code: 20260914
PubMed Central ID: PMC13562582
DOI: 10.1038/s41398-026-04414-7
PMID: 42722661
Βάση Δεδομένων: MEDLINE
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