Sabine C Herpertz

Sabine C Herpertz
Universität Heidelberg · Department of General Psychiatry

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190
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Publications (190)
Article
Full-text available
Childhood maltreatment, specifically during sensitive developmental periods, is a major risk factor for poor physical and mental health. Despite its enormous clinical relevance, there is still a lack of scales measuring different types, timing, and duration of childhood maltreatment. The current study sought to validate and determine the psychometr...
Article
The first clinical applications of oxytocin (OT) were in obstetrics as a hormone to start and speed up labor and to control postpartum hemorrhage. Discoveries in the 1960s and 1970s revealed that the effects of OT are not limited to its peripheral actions around birth and milk ejection. Indeed, OT also acts as a neuromodulator in the brain affectin...
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At the time of publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition alternative model of personality disorders, skepticism regarding the clinical utility of a dimensional conceptualization of personality disorders was high including questions about its feasibility for clinicians, its reliability, predictive value,...
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Emotional dysregulation is a core feature of borderline personality disorder (BPD); it is, for example, known to influence one’s ability to read other people’s facial expressions. We investigated behavioral and neurophysiological foundations of emotional face processing in individuals with BPD and in healthy controls, taking participants’ sex into...
Article
Background Oxytocin, cortisol, and testosterone are involved in the processing of reward and stress and greatly influence mother-child interactions. Altered hormonal systems have been associated with borderline personality disorder (BPD), a disorder characterized by interpersonal deficits. Mothers with BPD tend to perceive interactions with the chi...
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Inappropriate aggression is a prominent and clinically relevant interpersonal dysfunction of individuals with borderline personality disorder (BPD). Previous studies have shown that individuals with BPD interpret interpersonal signals in a hostile manner, but it is uncertain how this negativity bias impacts decision-making during aggressive encount...
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Objective: Childhood trauma is highly prevalent and can have a negative impact on the development of socioemotional processes resulting in a higher vulnerability for mental disorders in adulthood. Previous studies have associated the severity of childhood trauma with deficits in social functioning, such as a negative attention bias, suggesting alt...
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Full-text available
Individuals with borderline personality disorder (BPD) show self-regulatory deficits, associated with reduced heart-rate variability (HRV). However, results on reduced HRV in BPD remain heterogeneous, thus encouraging the search for developmental constructs explaining this heterogeneity. The present study first examined predictors of reduced restin...
Preprint
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The hypothalamic neuropeptide, oxytocin (OT), exerts prominent analgesic effects via central and peripheral action. Here we discovered a novel subset of OT neurons whose projections preferentially terminate on OT receptor (OTR)-expressing neurons in the ventrolateral periaqueductal gray (vlPAG). Using a newly generated line of transgenic rats (OTR-...
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Objectives: Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdia...
Article
Background: Mothers with borderline personality disorder (BPD) often show altered emotional availability toward their own child and heightened stress vulnerability. The aims of the present study were (1) to examine total cortisol output in saliva during mother-child interaction in mothers with BPD and their children and (2) to test whether materna...
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Introduction To date, there are only few studies that compare the consequences of peripartum maternal depressive disorders (PD) versus depressive with comorbid anxiety disorders (PDCA) for infant and child development. As comorbidity is associated with greater impairment and symptom severity related to the primary diagnosis, comorbidity in mothers...
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Background: Patients with difficult personalities or personality disorders are a special challenge for primary care physicians. Their style of interpersonal interaction is often difficult. As the ICD-11 classification comes into use, a new systematic approach to diagnosis is being introduced that focuses on the patient's functional impairments in...
Article
When a family member becomes mentally or physically ill, the whole family is affected in a broader sense. So far the focus has been on the care of the sick index patient, although it has been proven that the inclusion of the social context, whether siblings, partners or parents, is not only beneficial for better compliance and better recovery rates...
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Aggression is highly prevalent in borderline personality disorder (BPD). Previous studies have identified specific biobehavioral mechanisms underlying aggression in BPD, threat sensitivity being among them. We composited the mechanism-based anti-aggression psychotherapy (MAAP) in order to target these specific mechanisms, and MAAP was found to be s...
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Background Parents’ mental illness (MI) and parental history of early life maltreatment (ELM) are known to be significant risk factors for poor parenting while poor parenting is a crucial mediator of the intergenerational continuity of child maltreatment. Hence, maltreatment prevention programs for families with an MI parent, which pay particular a...
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Schizophrenia is a severe mental illness associated with a heavy symptom burden and high relapse rates. Digital interventions are increasingly suggested as means to facilitate continuity of care, relapse prevention, and long-term disease management for schizophrenia spectrum disorders. In order to investigate the feasibility of a mobile and interne...
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Background Early life maltreatment is a risk factor for psychiatric disorders, including post-traumatic stress disorder (PTSD). Post-traumatic stress disorder is a severe and heterogeneous disorder with fluctuating states of emotional over- and undermodulation, including hypervigilance, dissociation, and emotion regulation deficits. The perception...
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Aim: Medical training is undergoing a dramatic shift toward alternative training methods due to the SARS-CoV-2 pandemic. This study is the first to examine medical students' expectations, experiences, and mental burden related to volunteering in COVID-19 patient support and treatment services using semi-structured interviews. Methods: In May 2020,...
Article
Empirical studies have identified deficits in cognitive and affective theory of mind (ToM) in patients with borderline personality disorder (BPD), but results remain heterogeneous and not much is known about the role of childhood trauma. The current study assessed cognitive and affective ToM in 80 patients with BPD and 41 healthy controls in a fals...
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Full-text available
Patients with borderline personality disorder (BPD) often display increased stress vulnerability, which may be linked to altered hypothalamus–pituitary–adrenal (HPA) axis functioning. Corresponding deviations of the cortisol awakening response (CAR) are presumed to mirror maladaptive neuroendocrine processes, which may explain why CARs are increase...
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Early life maltreatment (ELM) has an impact on brain functions involved in parenting and is associated with impaired maternal sensitivity. Here, we investigated the influence of ELM on intrinsic neural function and its associations with maternal sensitivity in mothers without a current episode of a mental disorder. Twenty-seven mothers with ELM and...
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Introduction: Aggressive behavior is highly prevalent in patients with borderline personality disorder (BPD) and represents a major burden for patients and their environment. Previous studies have hypothesized threat hypersensitivity, among other mechanisms, as a biobehavioral mechanism underlying aggressive behavior in patients with BPD. The effec...
Article
Major depressive disorder (MDD) has been linked to elevated inflammation markers. It remains unclear whether the elevation of C-reactive protein (CRP) and interleukin-6 (IL-6) levels are not only observable in acute MDD but also in patients after remission. MDD is a common sequela of early life maltreatment (ELM), which has also been associated wit...
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Background: Borderline personality disorder (BPD) is a severe mental disorder associated with far-reaching impairments in the self and interpersonal functioning. The broad database has contributed to the fact that BPD remains the only categorical personality diagnosis in ICD-11, even if coupled to the determination of the severity of impairments....
Article
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Background Previous studies revealed an association between traumatic childhood experiences and emotional dysregulation in patients with borderline personality disorder (BPD). However, possible mediating pathways are still not fully understood. The aim of the present study was to investigate the potential mediating role of body connection, describi...
Article
Full-text available
Aggression is a prominent interpersonal dysfunction of individuals with borderline personality disorder (BPD). In BPD aggression is predominantly reactive in nature, often triggered by frustration, provocation, or social threat and is associated with intense anger and an inability to regulate this strong, negative emotion. Building on previous rese...
Preprint
Introduction:To date, there are only few studies which compare the consequences of peripartum maternal depressive disorders (PD) versus depressive with comorbid anxiety disorders (PDCA) for infant and child development. As comorbidity is associated with greater impairment and symptom severity related to the primary diagnosis, comorbidity in mothers...
Article
Full-text available
Providing refugees with psychosocial support is particularly important considering the high level of mental health problems prevalent in this population. A psychosocial walk-in clinic operating within a state reception and registration center in Germany has been supporting mentally burdened refugees since 2016. This study focused on patients’ persp...
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The novel coronavirus disease 2019 (COVID-19) pandemic and its unprecedented social restrictions may have serious mental health implications, especially in individuals who have experienced childhood traumatic experiences (CTEs). This prospective study aimed to investigate whether general psychopathology and posttraumatic stress disorder (PTSD) symp...
Preprint
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Pathophysiological models are urgently needed for personalized treatments of mental disorders. However, most potential neural markers for psychopathology are limited by low interpretability, prohibiting reverse inference from brain measures to clinical symptoms and traits. Neural signatures (i.e. multivariate brain-patterns trained to be both sensi...
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Background Previous eye-tracking studies provide preliminary evidence for a hypersensitivity to negative, potentially threatening interpersonal cues in borderline personality disorder (BPD). From an etiological point of view, such interpersonal threat hypersensitivity might be explained by a biological vulnerability along with a history of early li...
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Purpose of Review To review the current literature on biobehavioral mechanisms involved in reactive aggression in a transdiagnostic approach. Recent Findings Aggressive reactions are closely related to activations in the brain’s threat circuitry. They occur in response to social threat that is experienced as inescapable, which, in turn, facilitate...
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Psychophysiological characteristics have been argued to tap the dynamic interface between psychological processes and physiological processes and to fit in the biopsychosocial models of the etiology of antisocial behavior. Low resting heart rate is thought to be the best‐replicated biological correlate of antisocial behavior in child and adolescent...
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The psychiatric assessment of “psychopathy” or antisocial personality is an especially delicate and complicated subject, regardless of whether clinical, forensic, or research issues are concerned. Current psychiatric classification of legally relevant personality disorders is far from homogeneous. The main text of Diagnostic and Statistical Manual...
Article
Empirical studies have identified deficits in cognitive and affective theory of mind (ToM) in patients with borderline personality disorder (BPD), but results remain heterogeneous and not much is known about the role of childhood trauma. The current study assessed cognitive and affective ToM in 80 patients with BPD and 41 healthy controls in a fals...
Article
Background: Early life maltreatment (ELM) has a high risk of transmission across generations, known as "the cycle of abuse." ELM is also an important risk factor for developing mental disorders, and having a mental disorder increases the risk of child abuse. Both the abuse potential in mothers with ELM and in mothers with a history of mental disor...
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Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, partic...
Article
Obstetric complications (OC) may have implications for later health outcomes. However, there is a lack of research examining the association between OC and behavior problems or quality of life (HRQoL). We aimed to close this gap and further investigate functioning of the hypothalamus-pituitary-adrenal (HPA)-axis as a potential physiological vulnera...
Article
Threat hypersensitivity is regarded as a central mechanism of deficient emotion regulation, a core feature of patients with borderline personality disorder (BPD). Here, we employed a classical fear-conditioning protocol in which interpersonally threatening, interpersonally non-threatening, and non-social (neutral) visual stimuli were predictive of...
Article
Early life maltreatment (ELM) has severe and lasting effects on the individual, which might also impact the next generation. On an endocrine level, the hypothalamus–pituitary–adrenal axis has been suggested to play an important role in the interplay between ELM and the development of mental disorders. Several studies have revealed that maternal pos...
Article
The neuropeptide oxytocin (OT) has been shown to play a modulatory role in nociception. However, analgesic effects of OT in chronic pain conditions remain elusive and the neural underpinnings have not yet been investigated in humans. Here, we conducted an exploratory, randomized, placebo-controlled, cross-over study to examine effects of intranasal...
Article
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Background: Interpersonal deficits are a core symptom of borderline personality disorder (BPD), which could be related to increased social threat sensitivity and a tendency to approach rather than avoid interpersonal threats. The neuropeptide oxytocin has been shown to reduce threat sensitivity in patients with BPD and to modify approach–avoidance...
Article
Development of an Online Intervention for Adolescents and Young Adults Engaging in Nonsuicidal Self-injury Nonsuicidal self-injury (NSSI) is a prevalent phenomenon in adolescence. Despite the existence of effective psychotherapeutic interventions, the majority of affected adolescents and young adults do not receive any treatment. Structural (e. g.,...
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Borderline Personality Disorders Abstract. Within the framework of the German task force "Transitional Psychiatry" (DGKJP and DGPPN), a group of experts discussed the significance of adolescence for the mental healthcare of Borderline Personality Disorder (BPD) in Germany. They identified particular gaps and problems within the following areas: ear...
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Background: Emotional dysregulation, a core feature of borderline personality disorder (BPD) has recently been linked to deficits in the cortical representation of bodily signals. Oxytocin modulates the salience of external social cues. However, its role in interoception is still not fully understood. The aim of the current study was to replicate...
Article
Introduction: Facial expressions and vocal intonation are key signals in the communication of emotions. Individuals with posttraumatic stress disorder (PTSD) are known to show an impaired perception of facial emotions. So far, research on multimodal emotional stimuli or the priming effects on emotion processing has been absent in PTSD. Therefore,...
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Criterion A of the alternative model for the classification of personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), introduced the Level of Personality Functioning Scale (LPFS), a dimensional model for the assessment of impairments in self and interpersonal functioning. The LPFS was developed ba...
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Introduction: Individualized treatment prediction is crucial for the development and selection of personalized psychiatric interventions. Here, we use random forest classification via pretreatment clinical and demographical (CD), functional, and structural magnetic resonance imaging (MRI) data from patients with borderline personality disorder (BP...
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Background: Non-suicidal self-injury (NSSI) is a clinically significant behavior affecting approximately 18% of adolescents and young adults worldwide. The importance of NSSI is supported by its association with a broad spectrum of mental disorders. Despite its high relevance, evidence-based, specific, time-, and cost-effective treatment approache...
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Previous research revealed experiences of childhood adversity (CA) to be related to less favorable parenting behavior. It can further be expected that maternal oxytocin receptor (OXTR) genes may influence parenting behavior and moderate relationships between CA and parenting behavior. Moreover, associations between the OXTR gene and plasma oxytocin...
Article
Oxytocin (OT) release by axonal terminals onto the central nucleus of the amygdala exerts anxiolysis. To investigate which subpopulation of OT neurons contributes to this effect, we developed a novel method: virus-delivered genetic activity-induced tagging of cell ensembles (vGATE). With the vGATE method, we identified and permanently tagged a smal...
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The study addresses the impact of maternal early life maltreatment (ELM) and maternal history of depression (HoD) on offspring’s mental health. Maternal sensitivity was examined as a potential mediator explaining the relationship between maternal ELM, maternal HoD and child psychopathology. Participants were 194 mothers with and without HoD and/or...
Article
There is an ongoing debate whether the neuropeptide oxytocin (OT) modulates pain processing in humans. This study differentiates behavioral and neuronal OT effects on pain perception and pain anticipation by using a Pavlovian conditioning paradigm. Forty-six males received intranasally administered OT in a randomized, double-blind, placebo-controll...
Article
Full-text available
Early life maltreatment (ELM) has long-lasting effects on social interaction. When interacting with their own child, women with ELM often report difficulties in parenting and show reduced maternal sensitivity. Sensitive maternal behavior requires the recognition of the child’s emotional state depicted in its facial emotions. Based on previous studi...
Article
Objective: Intense anger and anger-related aggression are frequently reported by patients with borderline personality disorders (BPD). Recent results suggest that anger-related aggression and its control is associated with a complex interplay of different neural systems in BPD. To further investigate this, we complement standard activation and see...
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Full-text available
Purpose of Review We review recent findings concerning the implications of borderline personality disorder (BPD) on parenting behaviors, the parent-child relationships, and parental and child outcomes. We focus on self-report and interview data characterizing parents with BPD and their children as well as on observational paradigms investigating pa...
Article
Background The “empathy hormone” oxytocin (OXT) is associated with social interaction and parent-child interaction. Mothers with mental stress factors, e.g., history of depression, borderline personality disorder or early life maltreatment in their own childhood often show distinct maternal behavior. The objectives of the study were (1) to examine...
Article
Background: Borderline Personality Disorder (BPD) is characterized by emotional instability, impulsivity, disturbed cognition, sleeplessness and states of high inner tension. Altered arousal regulation which is regarded as a higher domain of functioning according to the research domain criteria of the NIMH and which has previously been reported in...
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Strengthening Attachment Competencies in Parents with Mental Illness: Adaptation and Pilot Testing of the Mentalization-Based Lighthouse Parenting Program Mentalizing describes the imaginative ability to understand human behaviour in terms of mental states. Parents with mental illnesses and experiences of early maltreatment frequently show impairme...