Background: In adolescent Borderline Personality Disorder (BPD), interactions with caregivers often provoke dysregulation. Vagally-mediated heart rate variability (HRV), a physiological marker of regulatory capacities, shows alterations in BPD. Studies on individual and dyadic HRV in adolescents with BPD (BPD-A) and their mothers (BPD-M) are lacking. We examined 1) individual resting state -, reactivity- and recovery- HRV, 2) intrapersonal concordance of interactional quality with HRV, 3) mother-adolescent interpersonal HRV-synchrony and 4) the association of interpersonal HRV-synchrony with behavioral synchrony in a case-control design.

Methods: Thirty-eight (sub)syndromal BPD-A and BPD-M were compared to 35 healthy control adolescents and their mothers (HC-A/-M). HRV was assessed during a positive interaction, a stress task and resting before and after interactions (recovery). Behavior during interactions was observed and coded using the "Coding Interactive Behavior"- Manual. Data were analyzed using multilevel modeling.

Results: BPD-A showed a lower resting HRV than HC-A, while no group differences were found for mothers. From resting to positive interaction, BPD-A/BPD-M/HC-M showed a significant increase in HRV; this increase was not significant for HC-A. HRV-reactivity to stress was not significant in either group but influenced by general emotional and behavioral problems within both adolescent samples. Significant intrapersonal concordance of HRV and behavior could only be found for HC-M during the positive interaction (positive association). For BPD-M, a complete disconnect between behavior and HRV was observed. BPD-dyads and dyads lower in behavioral synchrony displayed HRV-synchrony during stress, in HC-dyads and dyads higher in behavioral synchrony during rest after dyadic interactions.

Conclusions: Our study is the first investigating altered HRV-reactivity, behavior-HRV-concordance and HRV-synchrony in adolescents with BPD traits and their mothers, adding new insight to physiological regulation and co-regulation in adolescent BPD pathology. Limitations and implications of these results are discussed.

Keywords: Adolescents; BPD; Behavioral synchrony; HRV; Mother–child interaction; Physiological synchrony.

© 2025. The Author(s).

背景： 在青少年边缘型人格障碍（BPD）中，与照顾者的互动常常引发失调。迷走神经介导的心率变异性（HRV），作为调节能力的生理标志，在BPD中显示出改变。关于患有BPD的青少年及其母亲的个体和双人HRV的研究尚缺乏。我们研究了1) 休息状态下的、应激反应后的和恢复期的个体HRV，2) 互动质量与HRV之间的内在一致性，3) 母亲-青少年人际间的HRV同步性以及4) 在病例对照设计中人际间HRV同步性和行为同步性的关联。

方法： 将38名（亚）症状型BPD的青少年及其母亲与35名健康对照组青少年及其母亲进行了比较。在积极互动、应激任务以及互动前后休息状态下评估了HRV。使用"Coding Interactive Behavior"手册观察并记录了互动期间的行为，并进行编码。数据分析采用多水平模型。

结果： BPD的青少年在静息状态下的HRV低于健康对照组，而母亲之间没有发现组间差异。从休息到积极互动的过程中，BPD-A/BPD-M/HC-M显示了HRV显著增加，但HC-A中这种增加并不显著。对任何一组来说，HRV对于应激的反应性均不显著，但在两个青少年样本中，情绪和行为问题的一般水平影响着HRV-反应性。仅在健康对照母亲组（正向关联）中，在积极互动期间发现了显著的HRV与行为内在一致性。而对于BPD的母亲，则观察到行为和HRV之间完全脱节的现象。BPD双人组及行为同步度较低的双人组在应激状态下显示了HRV同步性，而健康对照组双人及其行为同步度较高的双人在互动后的休息期间表现出HRV同步性。

结论： 本研究首次调查了具有BPD特征的青少年及其母亲中改变的HRV反应性、行为与HRV的一致性和HRV同步性，为青春期BPD病理学中的生理调节和共调节提供了新的见解。讨论了这些结果的局限性和意义。

关键词： 青少年；BPD；行为同步性；HRV；母子互动；生理同步性。