The present study aimed to expand on previous findings that pre-treatment autonomic nervous system (ANS) functioning serves as a predictor of clinical outcome in adolescent borderline personality disorder (BPD), while examining whether the relationship between ANS functioning and treatment outcome may vary as a function of early life maltreatment (ELM). ANS stress response was examined considering changes in heart rate (HR) and vagally-mediated heart rate variability (vmHRV) over different conditions of the Montreal Imaging Stress Task (MIST) in a clinical sample of N = 27 adolescents across the spectrum of BPD severity. Participants received in- and/or outpatient treatment, while clinical data was assessed at routine follow-ups. Clinical outcome was defined by change in the number of fulfilled BPD criteria (as measured using the SCID-II), severity of psychopathology (CGI-S), and global level of functioning (GAF), measured 12 and 24 months after baseline assessments. Mixed-effects (random-intercept/random slope) linear regression models were calculated to examine markers of ANS function as potential predictors of clinical outcome. Irrespective of the presence of ELM exposure, both vmHRV resting-state and stress recovery measures were identified as significant predictors of clinical outcome over time. This study adds to the existing literature by replicating and expanding on preliminary findings, considering also physiological reactivity and recovery in addition to resting-state measures of ANS functioning. The present results further highlight the potential of markers of ANS functioning to serve as objective measures in the process of monitoring patient progress and to make predictions regarding treatment outcome in psychiatry research.

本研究旨在扩展先前的研究结果，即治疗前自主神经系统 (ANS) 功能可作为青少年边缘型人格障碍 (BPD) 临床结果的预测因子，同时检查 ANS 功能与治疗结果之间的关系是否可能因早期生活虐待 (ELM) 的一种功能。考虑到心率 (HR) 和迷走神经介导的心率变异性 (vmHRV) 在蒙特利尔影像应激任务 (MIST) 的不同条件下的N临床样本中的变化，检查 ANS 应激反应 = 27 名 BPD 严重程度范围内的青少年。参与者接受住院和/或门诊治疗，同时在常规随访中评估临床数据。临床结果的定义是在基线评估后 12 个月和 24 个月测量的满足的 BPD 标准数量（使用 SCID-II 测量）、精神病理学严重程度 (CGI-S) 和整体功能水平 (GAF) 的变化。计算混合效应（随机截距/随机斜率）线性回归模型以检查 ANS 功能的标志物作为临床结果的潜在预测因子。无论是否存在 ELM 暴露，vmHRV 静息状态和压力恢复措施都被确定为随时间推移临床结果的重要预测因素。这项研究通过复制和扩展初步发现，增加了现有文献，除了 ANS 功能的静息状态测量之外，还考虑生理反应和恢复。目前的结果进一步强调了 ANS 功能标志物的潜力，可作为监测患者进展过程中的客观指标，并预测精神病学研究中的治疗结果。