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Self-Reported Gonadal Pubertal Timing Predicts Adolescent Borderline Personality Symptoms: Two Extended Replications With Prospective and Cross-Sectional Data. 自我报告性腺青春期时间预测青少年边缘性人格症状:前瞻性和横断面数据的两个扩展重复。
IF 2.1 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1521/pedi.2023.37.6.661
Kiran Boone, Diana J Whalen, Deanna M Barch, Joan L Luby, Katherine R Luking

The current study investigated the understudied relationship between pubertal timing and borderline personality disorder (BPD) symptoms in males and females. We conducted hierarchical linear regressions in a longitudinal Cohort 1 (N = 117) and a cross-sectional Cohort 2 (N = 127). Cohort 1: Pubertal timing was self-reported at age 10; BPD symptoms and covariates were assessed between ages 13 and 19. Cohort 2: All assessments were between ages 8 and 12. Covariates: race, age, internalizing and externalizing symptoms, and income-to-needs ratio. Sex differences were examined post hoc. In Cohort 1, early gonadal timing was associated with more BPD symptoms in females (beta = .46, p = .002), and late gonadal timing was associated with more BPD symptoms in males (beta = -.23, p = .035). In Cohort 2, early gonadal timing was associated with more BPD symptoms (beta = .21, p = .033) without sex moderation. Results indicate that early gonadal development could be a risk indicator for the emergence of BPD in adolescence, particularly in females, which could inform causal mechanisms and intervention targets.

本研究调查了青春期时间与男性和女性边缘性人格障碍(BPD)症状之间的关系。我们对纵向队列1 (N = 117)和横断面队列2 (N = 127)进行了分层线性回归。队列1:青春期时间在10岁时自我报告;在13岁至19岁之间评估BPD症状和协变量。队列2:所有的评估年龄在8到12岁之间。协变量:种族、年龄、内化和外化症状、收入需求比。性别差异在事后被检查。在队列1中,性腺时间提前与女性更多的BPD症状相关(β = 0.46, p = 0.002),性腺时间晚与男性更多的BPD症状相关(β = -)。23, p = .035)。在队列2中,性腺时间提前与更多的BPD症状相关(β = 0.21, p = 0.033),没有性别调节。结果表明,性腺发育早期可能是青春期(尤其是女性)出现BPD的危险指标,这可能为其因果机制和干预目标提供信息。
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引用次数: 0
Author Index to Volume 37 Journal of Personality Disorders. 作者索引卷37杂志人格障碍。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1521/pedi.2023.37.6.761
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引用次数: 0
The Role of Epistemic Trust in Mentalization-Based Treatment of Borderline Psychopathology 认知信任在边缘型精神病理心理化治疗中的作用
3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.633
Tobias Nolte, Joost Hutsebaut, Carla Sharp, Chloe Campbell, Peter Fonagy, Anthony Bateman
Building on the notion of epistemic trust as facilitating social learning, in this article we clarify how interventions from mentalization-based treatment (MBT) for borderline personality disorder generate this process. We suggest first that being mentalized is a critical cue in interactions to establish epistemic trust and second that epistemic mistrust may represent a final common pathway through which aversive relational experiences in the past may exert their influence on treatments—both as a disposition of the patient and as a characteristic of the therapist-patient encounter. By charting MBT interventions from the initial assessment and formulation, through individual and group therapy sessions, to re-engaging with the wider social environment, we examine how each of these can establish a “we-mode,” an interpersonal experience associated with being mentalized that unlocks the barrier posed by epistemic vigilance. In addition, implications for relational mentalizing and rupture and repair within the therapeutic relationship are discussed.
基于认知信任作为促进社会学习的概念,在本文中,我们阐明了基于心理治疗(MBT)的边缘型人格障碍干预是如何产生这一过程的。我们认为,首先,心理化是建立认知信任的关键线索,其次,认知不信任可能代表了一个最终的共同途径,通过这个途径,过去的厌恶关系经历可能会对治疗产生影响——既作为患者的性格,也作为治疗师-患者接触的特征。通过绘制MBT干预的图表,从最初的评估和制定,到个人和团体治疗,再到重新融入更广泛的社会环境,我们研究了这些干预是如何建立一个“我们模式”的,这是一种与心智化相关的人际体验,可以解除认知警惕带来的障碍。此外,还讨论了关系心理化和治疗关系破裂与修复的含义。
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引用次数: 1
Interpersonal Trust and Borderline Personality Disorder: Insights From Clinical Practice and Research: Introduction. 人际信任与边缘型人格障碍:临床实践与研究的启示:导论。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.469
Eric A Fertuck, Emanuele Preti

Individuals suffering from borderline personality disorder (BPD) show a pervasive sense that others cannot be trusted, are vulnerable to negative therapeutic reactions, and can oscillate between idealized and persecutory interactions with others. These trust processing impairments impact both the immediate and wider social milieu of individuals with BPD, including therapist-patient interactions. Recently, research started unraveling the social-cognitive mechanisms of these impairments in BPD. In this Special Issue, we attempt to close the gap between research findings and clinical theories on trust processing impairment in BPD. The first section includes five original studies on trust processing in BPD. The second section includes five articulations of trust processing impairment as a treatment target in evidence-based treatments for BPD and as an indispensable "common factor" in the treatment of BPD. These cutting-edge research and clinical contributions advance a potential integrative, clinical science framework for conceptualizing and intervening effectively with those who struggle with BPD.

患有边缘型人格障碍(BPD)的个体表现出一种普遍的感觉,即他人不可信任,容易受到负面治疗反应的影响,并且可能在与他人的理想化和迫害性互动之间摇摆不定。这些信任处理障碍影响BPD患者的直接和更广泛的社会环境,包括治疗师与患者的互动。最近,研究开始揭示BPD中这些障碍的社会认知机制。在本期特刊中,我们试图缩小BPD中信任处理障碍的研究结果与临床理论之间的差距。第一部分包括五个关于BPD中信任处理的原始研究。第二部分包括信任处理障碍作为BPD循证治疗的治疗目标和BPD治疗中不可或缺的“共同因素”的五个方面。这些前沿的研究和临床贡献为BPD患者的概念化和有效干预提供了一个潜在的综合临床科学框架。
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引用次数: 0
Atypical Neural Plasticity and Behavioral Effects of Trustworthiness Learning in Borderline Personality Disorder Features. 边缘型人格障碍特征中的非典型神经可塑性和可信学习行为效应。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.542
Eric A Fertuck, Stephanie A Fischer, Robert D Melara

This study distinguishes interpersonal trust learning with a novel trust learning paradigm in participants high (H-BPD) and low (L-BPD) in BPD features. Neutral faces were paired with trust-relevant behaviors in four conditions: trustworthy, untrustworthy, ambiguously trustworthy, and mixed trustworthiness. After training, participants rated faces on untrustworthiness as electroencephalographic measures were recorded. H-BPD rated neutral faces as significantly more untrustworthy than L-BPD at both time periods. Negative and ambiguous trustworthiness pairing conditions led to higher ratings of untrustworthiness, whereas trustworthy and mixed descriptors led to lower ratings of untrustworthiness. Learning enhanced the amplitude of an early sensory event-related potential (ERP) component (i.e., P1) for both groups. The slow-wave ERP, an index of sustained attention, revealed greater focus after learning to trustworthy descriptors in H-BPD and to untrustworthy descriptors in L-BPD. H-BPD utilized greater effort to overcome an inherent mistrust bias and L-BPD to overcome unexpected untrustworthy information.

本研究用一种新的信任学习范式区分了参与者在BPD特征中的高(H-BPD)和低(L-BPD)。中性面孔在四个条件下与信任相关行为配对:可信、不可信、模糊可信和混合可信。训练结束后,参与者在记录脑电图测量结果时,对人脸进行不可信评级。在这两个时期,H-BPD都认为中性面孔明显比L-BPD更不可信。负面和模糊的可信度配对条件导致不可信评级更高,而可信和混合描述符导致不可信评分更低。学习增强了两组早期感觉事件相关电位(ERP)成分(即P1)的振幅。慢波ERP是一种持续注意力的指标,在学习了H-BPD中值得信赖的描述符和L-BPD中不值得信赖的描述之后,它显示出更大的关注度。H-BPD更努力地克服了固有的不信任偏见,L-BPD克服了意外的不可信信息。
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引用次数: 1
Transference-Focused Psychotherapy and Trust Processing in BPD: Exploring Possible Mechanisms of Change. BPD中以转移为中心的心理治疗和信任处理:探索可能的变化机制。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.620
Eric A Fertuck, Emanuele Preti, John F Clarkin

Individuals with borderline personality disorder (BPD) struggle to identify whom they can safely trust, and this struggle contributes to profound emotional turmoil in their close relationships. Transference-focused psychotherapy (TFP) is an application of object relations theory (ORT) that posits that polarized mental representations of self and other define the personality organization of BPD. TFP aims to utilize a clear treatment frame coupled with an analysis of the therapeutic relationship (i.e., the transference) to help individuals with BPD integrate their polarized mental representations. Improvement in the capacity to trust others is inherent in the mechanisms of change in TFP. In this article, a social cognitive model of trust processing provides a new lens through which we formulate how TFP may enhance trust processing in BPD. Recent evidence from randomized clinical trials supports the argument that TFP may intervene with BPD in a way that is concordant with uniquely improved trust processing.

患有边缘型人格障碍(BPD)的人很难确定他们可以安全地信任谁,这种斗争导致了他们亲密关系中的深刻情感混乱。以转移为中心的心理治疗(TFP)是客体关系理论(ORT)的一种应用,该理论认为自我和他人的两极分化的心理表征定义了BPD的人格组织。TFP旨在利用一个明确的治疗框架,结合对治疗关系的分析(即转移),帮助BPD患者整合他们两极分化的心理表征。信任他人的能力的提高是TFP变革机制所固有的。在本文中,信任处理的社会认知模型提供了一个新的视角,我们可以通过这个视角来制定TFP如何增强BPD中的信任处理。最近来自随机临床试验的证据支持这样一种论点,即TFP可能以一种与独特改进的信任处理相一致的方式干预BPD。
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引用次数: 1
Accuracy and Bias in Facial Trustworthiness Appraisals in Borderline Personality Disorder. 边缘型人格障碍患者面部可信度评估的准确性和偏倚。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.525
Annemarie Miano, Sophia Lustig, Luca Meyerding, Sven Barnow

Individuals with borderline personality disorder (BPD) have shown a negativity bias, whereas the general population has shown a positivity bias in their trustworthiness appraisal of others. We tested if individuals with BPD are more negative but also more realistic with their appraisals. Trustworthiness was objectified on an external criterion. The influence of childhood trauma was investigated. Facial photographs of peace prize laureates and sentenced murderers were presented. Participants with BPD and healthy controls (HC) rated the trustworthiness of the targets. Bias and sensitivity were measured using signal detection theory. The BPD group was more negatively biased compared to HC, but not more sensitive in discriminating between the two groups. When correcting for experienced childhood abuse and neglect, the authors found that group differences in bias disappeared. Individuals with BPD might not be more sensitive in discriminating between, on average, more or less trustworthy targets, but they have developed a negativity bias to ensure the detection of untrustworthiness.

边缘型人格障碍(BPD)患者表现出消极偏见,而普通人群在对他人的可信度评估中表现出积极偏见。我们测试了患有BPD的人是否更消极,但他们的评估也更现实。可信度是在一个外部标准上被客观化的。调查了儿童创伤的影响。和平奖获得者和被判刑的杀人犯的面部照片被出示。患有BPD和健康对照组(HC)的参与者对目标的可信度进行了评级。使用信号检测理论测量偏差和灵敏度。与HC相比,BPD组的负偏性更强,但在区分两组方面并不更敏感。在纠正童年时期遭受的虐待和忽视时,作者发现偏见的群体差异消失了。平均而言,患有BPD的个体在区分或多或少值得信赖的目标方面可能并不更敏感,但他们已经形成了消极偏见,以确保检测到不可信。
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引用次数: 0
Corrective Experiences to Enhance Trust: Clinical Wisdom From Good (Enough) Psychiatric Management. 增强信任的矫正经验:来自良好(足够)精神病管理的临床智慧。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.559
Lois W Choi-Kain, Sara R Masland, Ellen F Finch

Unstable trust within social interchange underlies the symptom constellation of borderline personality disorder (BPD), resulting in preoccupation with intense dyadic relationships, limited capacity for social collaboration, and constricted social networks. Good Psychiatric Management (GPM) provides a distilled formulation of how interpersonal hypersensitivities drive the engine of BPD's symptomatic oscillations in both affect and attachment. The authors summarize clinically relevant conclusions from the empirical literature on trust in BPD, synthesize it with selected ideas from other empirically supported interventions, and distill a formulation of how the GPM approach can address problems of trust in BPD with strategies most clinicians can use to improve their work with patients. GPM's clinical management approach utilizes common factors in psychotherapy to structure collaboration with patients to be accountable partners in treatment, rely on themselves more to diminish unrealistic demands on others, and function more effectively in arenas that expand and stabilize their social network.

社会交往中不稳定的信任是边缘型人格障碍(BPD)症状群的基础,导致人们专注于紧张的二元关系,社交协作能力有限,社交网络受限。良好的精神病管理(GPM)提供了一个提炼的公式,说明人际超敏行为如何驱动BPD在情感和依恋方面的症状振荡引擎。作者总结了有关BPD信任的经验文献中的临床相关结论,将其与其他经验支持的干预措施中的选定想法进行了综合,并提炼出GPM方法如何通过大多数临床医生可以用来改善患者工作的策略来解决BPD信任问题的公式。GPM的临床管理方法利用心理治疗中的共同因素,将与患者的合作构建为负责任的治疗伙伴,更多地依靠自己来减少对他人不切实际的要求,并在扩大和稳定其社交网络的领域中更有效地发挥作用。
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引用次数: 1
Modulation of Trust in Borderline Personality Disorder by Script-Based Imaginal Exposure to Betrayal. 基于脚本的想象暴露于背叛对边缘型人格障碍信任的调节。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.508
Rosa Shapiro-Thompson, Tanya V Shah, Caroline Yi, Nasir Jackson, Daniel Trujillo Diaz, Sarah K Fineberg

Interpersonal and trust-related difficulties are central features of borderline personality disorder (BPD). In this study, we applied script-driven betrayal imagery to evoke mistrustful behavior in a social reinforcement learning task. In 21 BPD and 20 healthy control (HC) participants, we compared this approach to the standard confederate paradigm used in research studies. The script-driven imagery evoked a transient increase in negative affect and also decreased trusting behavior to a similar degree in both groups. Across conditions, we also replicated previously reported between-group differences in negative affect (increased in BPD) and task behavior (more sensitive to social cues in BPD). These results support the validity of script-driven imagery as an alternative social task stimulus. This script-driven imagery approach is appealing for clinical research studies on reinforcement learning because it eliminates deception, scales easily, and evokes disorder-specific states of social difficulty.

人际关系和信任相关的困难是边缘型人格障碍(BPD)的核心特征。在这项研究中,我们应用脚本驱动的背叛意象来唤起社会强化学习任务中的不信任行为。在21名BPD和20名健康对照(HC)参与者中,我们将这种方法与研究中使用的标准联盟范式进行了比较。脚本驱动的图像在两组中都引发了负面情绪的短暂增加,并在相似程度上降低了信任行为。在不同的条件下,我们还复制了先前报道的负面影响(BPD增加)和任务行为(对BPD中的社会线索更敏感)的组间差异。这些结果支持了脚本驱动的图像作为替代社会任务刺激的有效性。这种脚本驱动的图像方法对强化学习的临床研究很有吸引力,因为它消除了欺骗,易于扩展,并唤起了特定于障碍的社会困难状态。
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引用次数: 0
Interpersonal Trust in Adolescents With Borderline Personality Disorder: Comparisons With Healthy and Psychiatric Controls. 边缘型人格障碍青少年的人际信任:与健康和精神控制的比较。
IF 2.3 3区 医学 Q3 PSYCHIATRY Pub Date : 2023-10-01 DOI: 10.1521/pedi.2023.37.5.475
Carla Sharp, Amanda Venta, Veronica McLaren

The aim of the current study was to utilize a well-known trust versus lottery paradigm to evaluate interpersonal trust in adolescents with borderline personality disorder (BPD). The study included 126 healthy controls, 59 inpatient adolescents with a diagnosis of BPD, and 137 inpatient adolescents without BPD. Alongside diagnostic measures, a questionnaire-based measure for assessing trust beliefs was administered to probe group differences in trust beliefs and associations between game behavior and trust beliefs. No main effect for group or condition was found. A significant interaction of trial and group was noted, suggesting that across games, psychiatric controls demonstrated the steepest increase in trust over time, followed by the BPD and healthy control groups. Healthy controls evidenced significantly higher levels of trust beliefs compared to BPD and psychiatric controls. Reasons for nonreplication of previously demonstrated anomalous game behavior in adults in this adolescent sample are discussed.

本研究的目的是利用众所周知的信任与彩票范式来评估边缘型人格障碍(BPD)青少年的人际信任。该研究包括126名健康对照、59名诊断为BPD的住院青少年和137名未诊断为BPD的住院青少年。除了诊断措施外,还实施了一项基于问卷的信任信念评估措施,以调查信任信念的群体差异以及游戏行为和信任信念之间的关联。未发现对组或条件的主要影响。试验和小组之间存在显著的相互作用,这表明在整个游戏中,精神病对照组的信任度随着时间的推移增长最快,其次是BPD和健康对照组。与BPD和精神病对照组相比,健康对照组的信任信念水平明显更高。讨论了在这个青少年样本中,先前证明的异常游戏行为在成年人中没有重复的原因。
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引用次数: 0
期刊
Journal of Personality Disorders
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