Borderline personality disorder and sexuality: causes and consequences of dissociative symptoms.

Rose Gholami Mazinan, Christina Dudek, Hannah Warkentin, Maja Finkenstaedt, Johanna Schröder, Richard Musil, Leonhard Kratzer, Johannes Fuss, Sarah V Biedermann
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Abstract

Background: Sexual risk behavior in patients diagnosed with borderline personality disorder (BPD) is supposed to be associated with traumatic experiences and dissociative symptoms. Nevertheless, scientific research thereon is scarce which might be due to the high prevalence of sexual trauma and fear of overwhelming patients with explicit sexual content.

Methods: We investigated a clinical sample of patients diagnosed with BPD (n = 114) and compared them to a sample of matched healthy controls (HC) (n = 114) concerning the dissociative symptoms derealization, depersonalization, and conversion in sexual situations. In a subgroup of patients with BPD (n = 41) and matched HC (n = 40) dissociative symptoms after exposure to an acoustically presented erotic narrative were assessed in the lab. Regression analyses were used to examine the associations between sexual trauma, post-traumatic stress disorder (PTSD), dissociation in sexual situations, and risky sexual behavior.

Results: Patients diagnosed with BPD endorsed higher dissociative symptoms in sexual situations retrospectively and in the lab compared to HC. Regression analyses revealed that depersonalization and conversion symptoms in sexual situations were explained by severity of BPD, while derealization was explained by PTSD symptomatology. Impulsive and sexual behavior with an uncommitted partner were higher in the BPD group and explained by derealization, while conversion showed an inverse association.

Conclusion: Our findings highlight the importance of addressing distinct dissociative symptoms in sexual situations when counselling and treating women with BPD. In the long term, this could contribute to a reduction in sexual risk behavior in patients with BPD.

Trial registration: This analysis is part of a larger ongoing study and was registered prior to accessing the data (Registration trial DRKS00029716).

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边缘型人格障碍与性:分离症状的原因和后果。
背景:被诊断为边缘型人格障碍(BPD)的患者的性行为风险应该与创伤经历和分离症状有关。然而,这方面的科学研究却很少,这可能是由于性创伤的高发率以及害怕向患者灌输露骨的性内容所致:我们调查了被诊断为 BPD 患者的临床样本(114 人),并将他们与相匹配的健康对照组样本(114 人)进行了比较,比较内容涉及解离症状的去个性化、去人格化以及在性情境中的转换。在实验室中,对一个子组的 BPD 患者(n = 41)和匹配的 HC 患者(n = 40)暴露于声学情色叙述后的分离症状进行了评估。回归分析用于研究性创伤、创伤后应激障碍(PTSD)、性情境中的分离症状和危险性行为之间的关联:结果:被诊断为 BPD 的患者与 HC 相比,在回顾性研究和实验室研究中均表现出更高的性解离症状。回归分析表明,BPD 的严重程度可以解释性情境中的人格解体和转换症状,而创伤后应激障碍症状则可以解释人格解体。在 BPD 组中,冲动性行为和与非承诺性伴侣发生性行为的比例较高,其原因是人格解体,而转换症状则与之呈反向关系:我们的研究结果凸显了在为患有 BPD 的女性提供咨询和治疗时,解决她们在性方面的分离症状的重要性。从长远来看,这将有助于减少 BPD 患者的性风险行为:本分析是一项正在进行的大型研究的一部分,已在获取数据之前进行了注册(注册试验 DRKS00029716)。
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来源期刊
CiteScore
6.00
自引率
9.80%
发文量
30
审稿时长
28 weeks
期刊介绍: Borderline Personality Disorder and Emotion Dysregulation provides a platform for researchers and clinicians interested in borderline personality disorder (BPD) as a currently highly challenging psychiatric disorder. Emotion dysregulation is at the core of BPD but also stands on its own as a major pathological component of the underlying neurobiology of various other psychiatric disorders. The journal focuses on the psychological, social and neurobiological aspects of emotion dysregulation as well as epidemiology, phenomenology, pathophysiology, treatment, neurobiology, genetics, and animal models of BPD.
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