The possible existence of diminished pain sensitivity in borderline personality disorder (BPD) is of major theoretical interest given the well-known proclivity of some patients with BPD for frequent self-mutilating behaviors, such as repeated cutting and burning of the skin. Schmahl et al1 recently reported that, relative to healthy controls, patients with BPD exhibited higher pain thresholds, which the authors claim is linked to diminished activation in several brain areas, as reflected in functional magnetic resonance imaging (fMRI) measures. Unfortunately, the psychophysical task used by Schmahl et al1 to assess pain sensitivity may reflect across-group differences in either sensory-discriminative or affective-motivational factors, with aspects of the reported results actually favoring the latter, response criterion,2- 4 type of difference. In addition, their interpretation of the neuroimaging data hinges on an assumed equality, but an actual inequality, in the pain measures.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 6
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.