Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory.

Signal detection theory measures of thermal responsivity were examined to determine whether differences in reported pain experienced during self-injurious behavior in female patients with borderline personality disorder (BPD) are explained by neurosensory factors and/or attitudinal factors (response bias). Female patients with BPD who do not experience pain during self-injury (BPD-NP group) were found to discriminate more poorly between noxious thermal stimuli of similar intensity, low P(A), than female patients with BPD who experience pain during self-injury (BPD-P group), female patients with BPD who do not have a history of self-injury (BPD-C group), and age-matched normal women. The BPD-NP group also had a higher response criterion, B (more stoical) than the BPD-C group. These findings suggest that 'analgesia' during self-injury in patients with BPD is related to both neurosensory and attitudinal/psychological abnormalities.

Pain and self-injury in borderline patients: sensory decision theory, coping strategies, and locus of control.

Fifteen women with borderline personality disorder who do not experience pain during self-injury were found to discriminate more poorly between imaginary painful and mildly painful situations, to reinterpret painful sensations (a pain-coping strategy related to dissociation), and to have higher scores on the Dissociative Experiences Scale than 24 similar female patients who experience pain during self-injury and 22 age-matched normal women. "Analgesia' during self-injury in borderline patients may be related to a cognitive impairment in the ability to distinguish between painful and mildly painful situations, as well as to dissociative mechanisms.

Effects of nortriptyline on memory self-assessment and performance in recovered elderly depressives.

The effects of nortriptyline (NTL) on memory were compared with those of placebo (PBO), in elderly subjects after recovery from a major depression. Subjective and objective memory was assessed using a repeated-measures discontinuation design. Average immediate, but not delayed, free recall, on a 20-item selective reminding test was adversely affected by medication. Free recall on placebo was stable over four learning trials and at delay. A different pattern of responses occurred on nortriptyline: Performance dropped off significantly on learning Trial 2, remained worse than placebo through Trial 4, but improved after a 15-min delay. Performance on measures of immediate and delayed recognition memory were comparable on nortriptyline and placebo. Discontinuation of nortriptyline resulted in significant improvement on a subset of nine memory self-assessment items. On questions addressing ability to retrieve recently learned information, subjects reported the greatest improvement while on placebo compared with nortriptyline.