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Impressum
Contents
De Psycho-lo
Letter from the Editor
BULLETIN RÉGULIER DE L`ASSOCIATION LUXEMBOURGEOISE DES ETUDIANTS EN
4
Borderline Personality Disorder and Somatoform Disorders
5
PSYCHOLOGIE (ALEP)
References
7
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Psycholo
Letter from the Editor
ALEP
teur war,
sich die Mühe gemacht haben und
interessante Hallo alle zusammen, dies ist leider die vorläu g letzte Ausgabe des Psycholo, die unter mir als Chefredakteur herausgegeben wird. Leider ist diese Ausgabe ziemlich dünn geworden, da die Endphase der Vorlesungszeit des Wintersemesters anstand. Daher gibt es zum Inhalt dieser Ausgabe auch nicht so viel zu sagen, im Sommer hatten wir ein verregnetes Fussballturnier, das wir nächstes Jahr gerne wiederholen werden. Photos dazu am Heftende. War auf jeden Fall sehr amüsant gewesen, ein gelungener Abschluss des Semesters und für manche Mitspieler auch des Bachelors an der Université du Luxembourg. Weiterhin
gibt
es
einen
Artikel
geschrieben
haben.
Ich
werde mich zukünftig auf mein Amt als EFPSA Member Representative of Luxembourg konzentrieren. 27.
Hier möchte ich besonders auf den
EFPSA
Congress
2013
Türkei aufmerksam machen.
in
Izmir
in
der
Dieser Kongress
ist dem Thema interkulturelle Psychologie gewidmet, einem Thema das besonders hier in Luxemburg eine wichtige Rolle spielt und in Zukunft mit Sicherheit eine noch gewichtigere Rolle spielen wird. Die Bewerbungen werden noch bis zum 20. Januar auf
congress2013.efpsa.org
entge-
gengenommen. Im Deckel auf der vorletzten Seite ndet ihr auch den Flyer zum Kongress. Falls ihr irgendwelche Fragen zum Kongress oder zu EFPSA habt, dann sendet sie einfach an mich, am
kurzen
Artikel
über
Borderline und Somatoforme Störungen, obwohl beiden Störungen anscheinend eine Fehlregulation der Emotionen zu Grunde liegt, wurde die möglichen Zusammenhänge zwischen diesen zwei Störungen bislang kaum thematisiert. Es wird auf jeden Fall spannend sein, die weitere Forschung dazu zu beobachten. Zu guter Letzt möchte ich mich an dieser Stelle als Chefredakteur des Psycholo verabschieden, es war eine sehr nette Zeit als Chefredakteur. Besonders bedanken möchte ich mich bei all denen, die in den zwei Jahren, die ich Chefredak-
besten per Email unter
L.R.Volkert@web.de.
In diesem Sinne: don't say goodbye, say ciao! Lucien Rasmus Volkert - Rédacteur en Chef -
ALEP
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Borderline Personality Disor-
commonly found in comorbid Somatoform and
der and Somatoform Disorders
Borderline Personality Disorder.
Abstract This written assigment aims at investigating the association between Borderline Personality Disorder (BDP) and Somatoform Disorder (SoD). First, the theoretical model drawn up by van Dijke (2012) is presented which explains typical di culties of patients with SoD and BDP as well as SoD+BDP taking into account attachment theory as well as under- and over-regulation of a ect and positive and negative psychoform and somatoform dissociative symptoms. Secondly, studies investigating the role of over-regulation of a ect and psychoform dissociation come to the conclusion that over-regulation of a ect and negative psychoform dissociation (SoD) were associated with inhibitory experiencing states whereas underregulation of a ect and positive psychoform dissociation (BDP) are associated with excitatory experiencing states. The combination of inhibitory and excitatory experiencing states was associated with the comorbid BDP+SoD. The empirical basis is very small and the presented studies present considerable shortcomings.
If inhibitory regulation is activated because of biased (negative-avoidant) cognitive-emotional information processing, it contains overregulation of a ect, negative psychoform and somotoform dissociation, fear of closeness in adult relationships, inhibited mentalization, narrowed executive functioning, immobilizing action tendencies and dominance of symapathetic system.
This
leads to a vicious circle since (among others) interpersonal misunderstandings and disappointments (which in turn result of fear of closeness and the inhibited mentalization) condition and maintain the insecure attachment representations and working models. If excitatory regulation is activated because of biased (negative-anxious) congitive-emotional information processing, it contains underregulation of a ect, positive psychoform and somatoform dissociation, fear of abandonment in adult relationships, pseudo mentalization, overly executive functioning, mobilizing action tendencies, and dominance of the dorsal vagal system. Just
Theoretical Background
like in the inhibitory regulation this leads to a vicious circle given that these factors condition and
According to van Dijke (2012) there is some evi-
maintain the insecure attachment representation
dence for the existence of inhibitory-, excitatory
and working models which results in a vicious cir-
and so-called combined inhibitory-excitatory reg-
cle.
ulation and that these regulations are associated with PDP and SoD in the following manner: (1) Inhibitory experiencing states, that is overregulation of a ect and negative psychoform dissociation, is most commonly found in Somatoform Disorders.
Concerning
the
third
case,
i.e.
inhibitory-
excitatory regulation, inhibitory and excitatory domains and symptoms can be present in alternation or combination (within the patients). This rationale is summarized in gure 1.
(2) Excitatory experiencing states,
that is overregulation of a ect and negative psy-
Empirical evidence
choform dissociation, are most commonly found in Somatoform Disorders. (3) Combination of in-
There are several studies which investigate the as-
hibitory and excitatory experiencing states most
sociation between inhibitory and excitatory regu-
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Psycholo
lation and Somotoform Disorders and Borderline Personality Disorders.
ALEP
Discussion
Unfortunetaly, all these
studies have been conducted by research groups around Annemiek van Dijke in the Netherlands which limits the general conclusions that can be drawn from these studies.
The model provided by van Dijke (2012) is an interesting theoretical framework taking into account developmental aspects as well as all major aspects of the Borderline Personality Disorder and the Somatoform Disorder. On the other
van Dijke et al. (2010) found that over-regulation
hand, there is very little empirical evidence be-
of a ect and negative psychoform dissociation
sides the studies conducted by Annemiek van Di-
(usually occuring in SoD) were associated with
jke.
inhibitory experiencing states whereas underreg-
van Dijke et al. (2010) was quite large (N
ulation of a ect and positive psychoform disso-
but there is no healthy control group (the control
ciation (usually occuring in BPD) are associated
group was other psychiatric patients ). This lim-
with excitatory experiencing states. Finally, the
its the conclusions that can be drawn from this
combination of inhibitory and excitatory experi-
study.
encing states was associated with the comorbid BDP+SoD.
the association between BDP and SoD and Alexithymia but only studies dealing with the association between SoD and Alexithymia and studies dealing with the association between BDP and New et al. (2012) found that pa-
tients with a BDP had more di culty in identifying emotions than a healthy control group.
= 472)
Secondly the men/women ratio was not comparable between the control groups.
Sadly, there are no further studies investigating
Alexithymia.
Although the sample size in the study of
In the psy-
chiatric control group the ratio men/women was
28 36
7.7 10 whereas the ratio in the BDP group 4,1 40 5 was 80 = 10 or even worse in the SoD ( 10 ) and
=
SoD+BDP (
3 10 ) groups.
Given that exclusively
self-reports were used the social desireability or gender-related steorotypes might have biased the results. van Dijke (2012) points out that in order to reduce participants' burden, the role of posttraumatic stress (especially PTS induced by pri-
Further, there is a study conducted by Waller
mary caretakers) was not assessed in this study.
and Scheidt (2004) which investigated the association between alexithymia and somatoform disorders. Similarly, they found that patients with SoD showed more alexithymia than healthy controls.
It should be highlighted that New et al.
(2012) and Waller and Scheidt (2004) used two di erent outcomes, the former group used a computerized task whereas the latter group used the TAS-20 and the ACI. Although the results are converging and in line with the theoretical framework of van Dijke (2012) the two outcomes measures do not necessarily present high convergent validity.
Furthermore, the model is based on Bowlby's attachment theory which goes along with the known di culties of operationalizing and testing the different attachment styles especially in adult age. Nevertheless, it is worthwhile to conduct more research on the subject of similarities between BDP and SoD. Especially longitudinal studies would be very suitable to shed light on the genesis of BDP and SoD as a function of the attachment style. In order to make the results as generalizable as possible the studies should be conducted in di erent countries (other than the Netherlands).
Lucien Rasmus Volkert
ALEP
Psycholo
Page 7
Dysfunctional regulation operating in vicious circles. (Note: A=a ect; S=soma; C=cognition; I=interaction; R=re ective function; ED=exec dysfunction; B=behavior; PF=psycho-physiological.) Taken from van Dijke (2012) Figure 1:
References
M.
(2010, January).
A ect dysregulation
and dissociation in borderline personality New, A. S., aan het Rot, M., Ripoll, L. H., Perez-
disorder and somatoform disorder:
di er-
Rodriguez, M. M., Lazarus, S., Zipursky,
entiating inhibitory and excitatory experi-
E.,
encing states.
ber).
...
Siever,
L.
J.
(2012,
Octo-
Empathy and alexithymia in bor-
derline personality disorder: laboratory
sonality disorders 26 ,
clinical and
Journal of per-
measures.
(5),
660 75.
doi:
(2012, January).
,
(4),
Dysfunctional
424 43.
doi:
10.1080/15299732.2010.496140 Waller, E., & Scheidt, C. E.
10.1521/pedi.2012.26.5.660 van Dijke, A.
Journal of trauma & dissociation : the o cial journal of the International Society for the Study of Dissociation (ISSD) 11 (2004, Septem-
ber). Somatoform disorders as disorders of
a ect regulation in borderline personality
a ect regulation:
disorder and in somatoform disorder.
TAS-20 with non-self-report measures of
European journal of psychotraumatology 3 ,
. doi:
10.3402/ejpt.v3i0.19566 van Dijke, A., van der Hart, O., Ford, J. D., van Son, M., van der Heijden, P., & BĂźhring,
alexithymia.
search 57 ,
a study comparing the
Journal of psychosomatic re-
(3), 239 47. doi: 10.1016/S0022-
3999(03)00613-5
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