659: Does Nociceptive Input Matter? Pain and Emotion Regulation in Borderline Personality Disorder

Topic: Experimental (Non-clinical) Human Studies
Subtopic: Non -specific to any diagnosis, Psychology

Background and Aims: Borderline personality disorder (BPD) is a severe psychiatric disorder characterized by reduced pain sensitivity (1) and non-suicidal self-injurious behavior (NSSI) as dysfunctional emotion-regulation strategy (2). While some individuals report no pain during NSSI, for others, the experience of pain during NSSI serves an emotion-regulatory function (3). This study examines whether the nociceptive input or rather the perception of pain contributes decisively to the soothing effect of NSSI in BPD. To this aim, we use the thermal grill illusion (TGI), an experimental paradigm to induce a painful heat sensation evoked by an alternating pattern of non-nociceptive warm and cold stimuli (4).

Methods: We apply non-painful warmth, heat, and TGI stimuli to the participant’s thenar eminence of the left hand in a sample of individuals with BPD and a non-clinical control sample. Simultaneously with the temperature stimulation, we present participants affective pictures of negative or neutral valence. After each trial, participants rate the valence of the picture. Affect-modulated startle response serves as additional physiological indicator of affective processing.

Results: Early results indicate that, in BPD, valence ratings vary with both, image category (negative vs. neutral) and temperature condition (warmth vs. heat vs. TGI), contrasting non-clinical controls where preliminary differences arise mainly from image category. Additionally, we report results of the affect-modulated startle response to complement the behavioral findings.

Conclusions: The results of this study contribute to a better understanding of the processes underlying the soothing effect of NSSI in BPD. A deeper insight into the interaction between nociceptive processing, pain perception, and emotion regulation in BPD is crucial for developing therapeutic approaches aimed at overcoming this dysfunctional behavior.

References: (1) Fales, J.L., Schmaling, K.B., & Culbertson, M.A. (2021). Acute pain sensitivity in individuals with borderline personality disorder: A systematic review and meta-analysis. Clinical Psychology: Science and Practice, 28(4), 341.

(2) Zanarini, M.C., Frankenburg, … & Gunderson, J.G. (2008). The 10‐year course of physically self‐destructive acts reported by borderline patients and axis II comparison subjects. Acta Psychiatrica Scandinavica, 117(3), 177-184.

(3) Selby, E.A., Kranzler, A.,... & Miller, A.L. (2019). The dynamics of pain during nonsuicidal self-injury. Clinical Psychological Science, 7(2), 302-320.

(4) Craig, A.D., & Bushnell, M.C. (1994). The thermal grill illusion: unmasking the burn of cold pain. Science, 265(5169), 252-255.

Presenting Author: Annette Löffler
Submitting Author: Annette Löffler

Senior Author: Robin Bekrater-Bodmann

IASP 2026 Global Year theme of Neuropathic Pain: No

• Jessica Nunes - Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
• Robin Bekrater-Bodmann - Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany