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Borderline Personality Disorder and Emotion Dysregulation最新文献

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Facial emotion processing in patients with borderline personality disorder as compared with healthy controls: an fMRI and ECG study. 边缘型人格障碍患者的面部情绪处理与健康对照组的比较:fMRI 和心电图研究。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-02-16 DOI: 10.1186/s40479-024-00245-4
Monika Radimecká, Adéla Látalová, Martin Lamoš, Martin Jáni, Patrik Bartys, Alena Damborská, Pavel Theiner, Pavla Linhartová

Background: Maladaptive behaviors and interpersonal difficulties in patients with borderline personality disorder (BPD) seem connected to biased facial emotion processing. This bias is often accompanied by heightened amygdala activity in patients with BPD as compared to healthy controls. However, functional magnetic resonance imaging (fMRI) studies exploring differences between patients and healthy controls in facial emotion processing have produced divergent results. The current study explored fMRI and heart rate variability (HRV) correlates of negative facial emotion processing in patients with BPD and healthy controls.

Methods: The study included 30 patients with BPD (29 females; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 females; M = 24.66, SD = 5.28). All participants underwent the "faces" task, an emotional face perception task, in an fMRI session simultaneously with ECG. In this task, participants are presented with emotional expressions of disgust, sadness, and fear (as a negative condition) and with the same pictures in a scrambled version (as a neutral condition).

Results: We found no differences in brain activity between patients with BPD and healthy controls when processing negative facial expressions as compared to neutral condition. We observed activation in large-scale brain areas in both groups when presented with negative facial expressions as compared to neutral condition. Patients with BPD displayed lower HRV than healthy controls in both conditions. However, there were no significant associations between HRV and amygdala activity and BPD symptoms.

Conclusion: The results of this study indicate no abnormal brain activity during emotional facial processing in patients with BPD. This result contrasts with previous studies and more studies are needed to clarify the relationship between facial emotion processing and brain activity in patients with BPD. Possible reasons for the absence of brain activity differences are discussed in the study. Consistent with previous findings, patients showed lower HRV than healthy controls. However, HRV was not associated with amygdala activity and BPD symptoms.

背景:边缘型人格障碍(BPD)患者的不适应行为和人际交往障碍似乎与面部情绪处理偏差有关。与健康对照组相比,边缘型人格障碍患者的杏仁核活动常常伴随着这种偏差。然而,功能性磁共振成像(fMRI)研究探索了患者与健康对照组在面部情绪处理方面的差异,却得出了不同的结果。本研究探讨了 BPD 患者和健康对照组面部负性情绪处理的 fMRI 和心率变异性(HRV)相关性:研究对象包括 30 名 BPD 患者(29 名女性;年龄:男 = 24.22,女 = 5.22)和 30 名健康对照者(29 名女性;男 = 24.66,女 = 5.28)。所有受试者在接受心电图检查的同时,还接受了一项名为 "面孔 "的情绪面孔感知任务。在这项任务中,参与者会看到恶心、悲伤和恐惧的情绪表达(作为负面条件),以及相同图片的乱码版本(作为中性条件):我们发现,与中性条件相比,在处理负面面部表情时,BPD 患者和健康对照组的大脑活动没有差异。我们观察到,与中性条件相比,当出现负面面部表情时,两组患者的大尺度脑区均出现激活。在这两种情况下,BPD 患者的心率变异均低于健康对照组。然而,心率变异和杏仁核活动与 BPD 症状之间并无明显关联:本研究结果表明,BPD 患者在情绪面部处理过程中的大脑活动没有异常。结论:本研究结果表明,BPD 患者在面部情绪处理过程中没有异常的大脑活动,这一结果与之前的研究形成了鲜明对比,因此需要更多的研究来阐明 BPD 患者面部情绪处理与大脑活动之间的关系。研究中讨论了大脑活动无差异的可能原因。与之前的研究结果一致,患者的心率变异低于健康对照组。然而,心率变异与杏仁核活动和 BPD 症状无关。
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引用次数: 0
The role of thyroid function in borderline personality disorder and schizophrenia: a Mendelian Randomisation study. 甲状腺功能在边缘型人格障碍和精神分裂症中的作用:孟德尔随机研究。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-02-15 DOI: 10.1186/s40479-024-00246-3
Oladapo Babajide, Alisa D Kjaergaard, Weichen Deng, Aleksander Kuś, Rosalie B T M Sterenborg, Bjørn Olav Åsvold, Stephen Burgess, Alexander Teumer, Marco Medici, Christina Ellervik, Bass Nick, Panos Deloukas, Eirini Marouli

Background: Genome-wide association studies have reported a genetic overlap between borderline personality disorder (BPD) and schizophrenia (SCZ). Epidemiologically, the direction and causality of the association between thyroid function and risk of BPD and SCZ are unclear. We aim to test whether genetically predicted variations in TSH and FT4 levels or hypothyroidism are associated with the risk of BPD and SCZ.

Methods: We employed Mendelian Randomisation (MR) analyses using genetic instruments associated with TSH and FT4 levels as well as hypothyroidism to examine the effects of genetically predicted thyroid function on BPD and SCZ risk. Bidirectional MR analyses were employed to investigate a potential reverse causal association.

Results: Genetically predicted higher FT4 was not associated with the risk of BPD (OR: 1.18; P = 0.60, IVW) or the risk of SCZ (OR: 0.93; P = 0.19, IVW). Genetically predicted higher TSH was not associated with the risk of BPD (OR: 1.11; P = 0.51, IVW) or SCZ (OR: 0.98, P = 0.55, IVW). Genetically predicted hypothyroidism was not associated with BPD or SCZ. We found no evidence for a reverse causal effect between BPD or SCZ on thyroid function.

Conclusions: We report evidence for a null association between genetically predicted FT4, TSH or hypothyroidism with BPD or SCZ risk. There was no evidence for reverse causality.

背景:全基因组关联研究报告称,边缘型人格障碍(BPD)和精神分裂症(SCZ)之间存在遗传重叠。在流行病学上,甲状腺功能与 BPD 和 SCZ 风险之间的关联方向和因果关系尚不清楚。我们旨在检验TSH和FT4水平的遗传预测变异或甲状腺功能减退是否与BPD和SCZ的风险有关:我们使用与TSH和FT4水平以及甲状腺功能减退症相关的遗传工具进行了孟德尔随机(MR)分析,以检验遗传预测的甲状腺功能对BPD和SCZ风险的影响。双向MR分析用于研究潜在的反向因果关系:遗传预测的较高 FT4 与 BPD 风险(OR:1.18;P = 0.60,IVW)或 SCZ 风险(OR:0.93;P = 0.19,IVW)无关。遗传预测的较高 TSH 与 BPD(OR:1.11;P = 0.51,IVW)或 SCZ(OR:0.98;P = 0.55,IVW)的风险无关。基因预测的甲状腺功能减退与 BPD 或 SCZ 无关。我们没有发现证据表明BPD或SCZ对甲状腺功能有反向因果效应:我们报告的证据表明,遗传预测的FT4、TSH或甲状腺功能减退与BPD或SCZ风险之间没有关联。没有证据表明存在反向因果关系。
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引用次数: 0
A case series of sage: a new couple-based intervention for borderline personality disorder. 鼠尾草案例系列:针对边缘型人格障碍的一种新型情侣干预方法。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-12 DOI: 10.1186/s40479-023-00244-x
Skye Fitzpatrick, Sonya Varma, David Chafe, Nikoo Norouzian, Jenna Traynor, Sophie Goss, Elizabeth Earle, Alyssa Di Bartolomeo, Ashley Siegel, Lindsay Fulham, Candice M Monson, Rachel E Liebman

Background: Research suggests that interpersonal dysfunction may be central to borderline personality disorder (BPD), and that the relationships of people with BPD are particularly impaired. Further, the significant others of people with BPD exhibit elevated psychological problems but little access to mental healthcare. Despite this, most BPD interventions are delivered individually and do not routinely incorporate significant others. This manuscript presents the first case series of Sage, a 12-session manualized intervention for people with borderline personality disorder (BPD) and their intimate partners with three targets: a) BPD severity, b) relationship conflict, and c) intimate partner mental health.

Findings: Five couples of people with BPD with frequent suicidal/self-injurious behavior or high suicidal ideation and their intimate partners received Sage. Measures of Sage targets as well as tertiary outcomes were administered at pre-, mid-, and post-intervention. Four out of five dyads completed Sage, with high intervention satisfaction ratings. Improvements were generally demonstrated in BPD severity, suicidal ideation, and suicidal behavior/self-injury. Half of dyads exhibited improvements in conflict, and additional improvements in mental health outcomes for dyad members were demonstrated. One dyad exhibited poor outcomes and speculations regarding this are offered.

Conclusions: Findings provide proof of concept of Sage as an intervention that can improve BPD and other mental health outcomes in those with BPD and their intimate partners. Incorporating intimate partners into BPD treatment may optimize and expedite its outcomes. However, further testing is needed.

Trial registration: This project was pre-registered at Clinicaltrials.gov (Identifier: [NCT04737252]).

背景:研究表明,人际关系功能障碍可能是边缘型人格障碍(BPD)的核心问题,而边缘型人格障碍患者的人际关系尤其受到损害。此外,边缘型人格障碍患者的重要他人表现出更严重的心理问题,但却很少获得心理保健服务。尽管如此,大多数 BPD 干预措施都是单独实施的,并没有将重要他人纳入其中。本手稿介绍了 Sage 的首个案例系列,这是一项针对边缘型人格障碍(BPD)患者及其亲密伴侣的 12 节手册化干预措施,有三个目标:a) BPD 严重程度;b) 关系冲突;c) 亲密伴侣心理健康:五对经常有自杀/自残行为或自杀意念强烈的边缘型人格障碍患者及其亲密伴侣接受了 "赛奇 "治疗。在干预前、干预中和干预后,对萨奇目标和三级结果进行了测量。五对伴侣中有四对完成了 "赛琪 "干预,并获得了较高的干预满意度。在 BPD 严重程度、自杀意念和自杀行为/自伤方面普遍有所改善。半数伴侣在冲突方面有所改善,伴侣成员的心理健康结果也有所改善。有一个组合的结果较差,我们对此进行了推测:研究结果证明了 "赛奇 "作为一种干预措施的概念,可以改善 BPD 患者及其亲密伴侣的 BPD 及其他心理健康结果。将亲密伴侣纳入 BPD 治疗可能会优化并加快治疗效果。不过,还需要进一步的测试:本项目已在 Clinicaltrials.gov 进行了预注册(标识符:[NCT04737252])。
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引用次数: 0
Transdiagnostic skills training group of dialectical behavior therapy: a long-term naturalistic study 辩证行为疗法的跨诊断技能培训小组:一项长期自然研究
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-12-21 DOI: 10.1186/s40479-023-00243-y
Amaury Durpoix, Enzo Lachaux, Luisa Weiner, Sébastien Weibel
Dialectical Behavior Therapy (DBT) has assembled a large body of evidence for the treatment of emotional dysregulation in borderline personality disorder (BPD), but also in other disorders characterized by emotional dysregulation (e.g., bipolar disorder (BD) and ADHD). Standalone skills learning groups address the problem of limited resources in several clinical settings. Furthermore, transdiagnostic skills groups facilitate the recruitment and decrease the scattering of resources in psychiatric settings. However, few studies have focused on the pertinence of transdiagnostic standalone skills groups in naturalistic settings as well as their long-term outcomes. The goal of this study is to assess the impact of participation in a transdiagnostic DBT skills group one year after its completion. Transdiagnostic DBT skills training groups were provided for BPD, BD and ADHD patients in a University Psychiatric Department (Strasbourg, France), between 2019 and 2020. They consisted of 16 group sessions of 2.5 h and 3 individual sessions. At 1-year follow-up, ad-hoc questionnaires were proposed to all participants to assess the perceived impacts, the changes in symptomatology, and the maintenance of skills learned. 22 of the 31 participants were interviewed at the one-year post-group session (64% BPD, 41% ADHD and 27% BD). 73% participants estimated that group impact was important or very important, 64% stated using the skills learned often or very often, mainly emotion regulation skills. An improvement in emotional instability, substance use, impulsivity and suicidal thoughts was reported by respectively 100%, 91%, 86% and 85% of participants. Quality of life improved according to 90% participants. All patients reported an improvement in suicidality during the post-group year, especially in suicide attempts. Psychotropic medication decreased in 59% of participants. Our one-year naturalistic study suggests that transdiagnostic DBT skills training groups are promising for the treatment of emotional dysregulation in people with BPD, BD and/or ADHD. The observational design and the lack of control group are the main limitations. Randomized controlled studies are required to confirm the long-term efficacy of transdiagnostic skills learning groups in naturalistic settings.
辩证行为疗法(DBT)在治疗边缘型人格障碍(BPD)以及其他以情绪失调为特征的疾病(如双相情感障碍(BD)和多动症)的情绪失调方面积累了大量证据。独立的技能学习小组可以解决一些临床环境中资源有限的问题。此外,跨诊断技能小组还有助于招募人员,减少精神病治疗机构资源的分散。然而,很少有研究关注跨诊断独立技能小组在自然环境中的相关性及其长期效果。本研究的目的是评估参加跨诊断 DBT 技能小组一年后的影响。跨诊断 DBT 技能培训小组于 2019 年至 2020 年期间在一所大学精神病学系(法国斯特拉斯堡)为 BPD、BD 和 ADHD 患者提供培训。这些小组包括 16 节 2.5 小时的小组课程和 3 节个人课程。在为期一年的随访中,对所有参与者进行了临时问卷调查,以评估感知到的影响、症状的变化以及所学技能的保持情况。31 名参与者中有 22 人(64% 患有 BPD、41% 患有 ADHD 和 27% 患有 BD)在小组活动一年后接受了访谈。73%的参与者认为小组的影响重要或非常重要,64%的参与者表示经常或非常经常使用所学技能,主要是情绪调节技能。分别有 100%、91%、86% 和 85% 的参与者表示情绪不稳定、药物使用、冲动和自杀念头有所改善。90%的参与者表示生活质量有所改善。在小组结束后的一年中,所有患者的自杀倾向都有所改善,尤其是自杀未遂。59%的参与者减少了精神药物治疗。我们为期一年的自然研究表明,跨诊断 DBT 技能训练小组有望治疗 BPD、BD 和/或 ADHD 患者的情绪失调。观察性设计和缺乏对照组是研究的主要局限性。需要进行随机对照研究,以确认在自然环境下跨诊断技能学习小组的长期疗效。
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引用次数: 0
ICD-11 complex posttraumatic stress disorder and subclasses of borderline personality disorder in a South Korean adult population with childhood abuse experiences: a latent class analysis 有童年受虐经历的韩国成年人群中的 ICD-11 复杂创伤后应激障碍和边缘型人格障碍亚类:潜类分析
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-12-15 DOI: 10.1186/s40479-023-00242-z
Jisu Lee, Hyunjung Choi
Complex posttraumatic stress disorder (CPTSD) and borderline personality disorder (BPD), which are distinctive diagnoses, share the common risk factor of childhood abuse experiences. However, additional evidence is needed to determine which factors contribute to the manifestation of different symptoms. Participants were 499 South Korean early and midlife adults with primarily college level education who reported experiences of childhood abuse. They were enrolled from an online panel using a stratified sampling considering gender, age, and residence information. A latent class analysis (LCA) was conducted to identify the patterns of CPTSD and BPD symptoms. We adopted a three-step LCA to compare types of childhood abuse, invalidating environments, attachment styles, and pathological personality traits among different classes. The LCA revealed four classes. Class 1 showed the highest scores in all symptoms and risk factors. Class 2 was distinguished from Class 3 by the externalizing versus internalizing associated pathological personality traits. Class 3 experienced high emotional neglect in addition to other types of abuse and it also showed an additional avoidant attachment style. Class 4 showed low symptomatology. Class 1 was named as a CPTSD and BPD “comorbid” class, Class 2 as an “externalizing BPD” class, Class 3 as an “avoidant BPD” class, and Class 4 as a “low symptom” class. Childhood abuse may heighten the risk for high comorbidity of CPTSD and BPD as well as externalizing-internalizing subgroups of BPD. Beyond the identification of CPTSD and BPD, assessing attachment styles and pathological personality traits based on dimensional approaches would benefit the tailoring of effective treatment.
复杂性创伤后应激障碍(CPTSD)和边缘型人格障碍(BPD)是两种截然不同的诊断,它们的共同风险因素是童年遭受虐待的经历。然而,要确定哪些因素导致了不同症状的表现,还需要更多的证据。研究对象是 499 名韩国中青年成年人,他们主要接受过大学教育,并报告了童年受虐待的经历。他们是通过考虑性别、年龄和居住地信息的分层抽样方法从一个在线小组中招募的。我们进行了潜类分析(LCA),以确定 CPTSD 和 BPD 症状的模式。我们采用了三步潜类分析法来比较不同类别中的童年虐待类型、无效环境、依恋风格和病态人格特征。LCA 显示了四个等级。第一类在所有症状和风险因素方面得分最高。第 2 类与第 3 类的区别在于外化与内化相关的病态人格特征。第 3 类除了受到其他类型的虐待外,还受到严重的情感忽视,并表现出一种额外的回避型依恋风格。第 4 类的症状较轻。第 1 类被命名为 CPTSD 和 BPD "合并 "类,第 2 类被命名为 "外化型 BPD "类,第 3 类被命名为 "回避型 BPD "类,第 4 类被命名为 "低症状 "类。童年虐待可能会增加 CPTSD 和 BPD 以及 BPD 外化-内化亚群高度合并的风险。除了鉴别 CPTSD 和 BPD 外,基于维度方法评估依恋风格和病态人格特征将有利于量身定制有效的治疗方法。
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引用次数: 0
Neural correlates of social exclusion and overinclusion in patients with borderline personality disorder: an fMRI study. 边缘型人格障碍患者社会排斥和过度包容的神经关联:一项功能磁共振成像研究。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-12-01 DOI: 10.1186/s40479-023-00240-1
Adéla Látalová, Monika Radimecká, Martin Lamoš, Martin Jáni, Alena Damborská, Pavel Theiner, Eliška Bartečková, Patrik Bartys, Helena Vlčková, Katarína Školiaková, Tomáš Kašpárek, Pavla Linhartová

Background: Interpersonal difficulties of patients with borderline personality disorder (BPD) are closely related to rejection sensitivity. The aim of the present study was to gain further insight into the experience and cerebral processing of social interactions in patients with BPD by using fMRI during experimentally induced experiences of social exclusion, inclusion, and overinclusion.

Methods: The study involved 30 participants diagnosed with BPD (29 female and 1 male; age: M = 24.22, SD = 5.22) and 30 healthy controls (29 female and 1 male; age: M = 24.66, SD = 5.28) with no current or lifetime psychiatric diagnoses. In the fMRI session, all participants were asked to complete a Cyberball task that consisted of an alternating sequence of inclusion, exclusion, and overinclusion conditions.

Results: Compared to healthy controls, participants with BPD reported higher levels of inner tension and more unpleasant emotions across all experimental conditions. At the neural level, the participants with BPD showed lower recruitment of the left hippocampus in response to social exclusion (relative to the inclusion condition) than the healthy controls did. Lower recruitment of the left hippocampus in this contrast was associated with childhood maltreatment in patients with BPD. However, this difference was no longer significant when we added the covariate of hippocampal volume to the analysis. During social overinclusion (relative to the inclusion condition), we observed no significant differences in a group comparison of neural activation.

Conclusions: The results of our study suggest that patients with BPD experience more discomfort than do healthy controls during social interactions. Compared to healthy participants, patients with BPD reported more inner tension and unpleasant emotions, irrespective of the extent to which others included them in social interactions. At a neural level, the participants with BPD showed a lower recruitment of the left hippocampus in response to social exclusion than the healthy controls did. The reduced activation of this neural structure could be related to a history of childhood maltreatment and smaller hippocampal volume in patients with BPD.

背景:边缘型人格障碍(BPD)患者的人际交往困难与排斥敏感性密切相关。本研究的目的是通过fMRI进一步了解BPD患者在实验诱导的社会排斥、包容和过度包容体验中的社会互动体验和大脑加工。方法:研究纳入了30名被诊断为BPD的参与者(29名女性和1名男性;年龄:M = 24.22, SD = 5.22),健康对照30例(女性29例,男性1例;年龄:M = 24.66, SD = 5.28),目前或终生无精神病诊断。在fMRI测试中,所有的参与者都被要求完成一个由包含、排除和过度包含条件交替序列组成的赛博球任务。结果:与健康对照组相比,BPD参与者在所有实验条件下都报告了更高水平的内心紧张和更多的不愉快情绪。在神经水平上,与健康对照组相比,BPD参与者在社会排斥反应中表现出较低的左侧海马体招募(相对于包容条件)。相比之下,左侧海马体募集较少与BPD患者的童年虐待有关。然而,当我们在分析中加入海马体积的协变量时,这种差异不再显著。在社会过度包容过程中(相对于包容条件),我们观察到神经激活在组间比较中没有显著差异。结论:我们的研究结果表明,BPD患者在社会交往中比健康对照组经历更多的不适。与健康的参与者相比,BPD患者报告了更多的内心紧张和不愉快的情绪,无论其他人在社交互动中包括他们的程度如何。在神经层面上,BPD参与者在面对社会排斥时,左侧海马体的活跃程度低于健康对照组。该神经结构激活的减少可能与儿童期虐待史和BPD患者海马体积较小有关。
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引用次数: 0
The relationship between childhood emotional abuse and borderline personality disorder: the mediating role of difficulties in emotion regulation among Lebanese adults. 儿童情绪虐待与边缘型人格障碍的关系:黎巴嫩成年人情绪调节困难的中介作用。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-11-21 DOI: 10.1186/s40479-023-00241-0
Gaelle Kanj, Souheil Hallit, Sahar Obeid

Objective: The present study investigates the mediating effect of difficulties in emotion regulation in the association between childhood emotional abuse and Borderline Personality Disorder (BPD) among Lebanese adults.

Method: This cross-sectional study, involving 411 participants, was conducted between March and August 2022. Lebanese individuals from all governorates of the country were recruited using the Snowball Sampling technique. Three self-report scales were utilized to complete this research; the 'Difficulties in Emotion Regulation Scale-Brief Version (DERS-16)' which evaluates the difficulties in emotion regulation of individuals, the 'Childhood Trauma Questionnaire-Short Form (CTQ-SF)' which grants a subjective evaluation of the general childhood environment of the participants, as well as the 'Borderline Personality Questionnaire (BPQ)' which measures Borderline Personality Disorder traits, that demonstrate significant convergence with the disorder.

Results: The results indicate that DERS-16 played an indirect effect role between childhood emotional abuse scores and Borderline Personality Disorder. Higher emotional abuse scores were significantly associated with higher DERS-16 scores, which in turn was significantly associated with higher BPQ scores. Moreover, childhood emotional abuse was directly associated with higher BPQ scores.

Conclusion: This work suggests that, among the different forms of childhood abuse, emotional abuse may have a role in the development of Borderline Personality Disorder. Training on emotion regulation strategies would potentially benefit individuals in preventing BPD development and facilitating therapeutic processes.

目的:本研究探讨情绪调节困难在黎巴嫩成人儿童情绪虐待与边缘型人格障碍(BPD)之间的中介作用。方法:这项横断面研究,涉及411名参与者,于2022年3月至8月进行。使用滚雪球抽样技术从该国所有省份招募黎巴嫩人。采用三种自我报告量表完成本研究;评估个人情绪调节困难的“情绪调节困难量表-简要版”(DERS-16),对参与者的一般童年环境进行主观评价的“童年创伤问卷-简短版”(CTQ-SF),以及测量与该障碍有显着融合的“边缘型人格障碍特征问卷(BPQ)”。结果:DERS-16在儿童情绪虐待得分与边缘型人格障碍之间起间接影响作用。较高的情绪虐待得分与较高的DERS-16得分显著相关,而后者又与较高的BPQ得分显著相关。此外,儿童时期的情绪虐待与较高的BPQ得分直接相关。结论:这项研究表明,在不同形式的儿童虐待中,情绪虐待可能在边缘型人格障碍的发展中起作用。对情绪调节策略的培训可能对预防BPD的发展和促进治疗过程有潜在的好处。
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引用次数: 0
Psychometric properties of the Hungarian childhood trauma questionnaire short form and its validity in patients with adult attention-deficit hyperactivity disorder or borderline personality disorder. 匈牙利儿童创伤问卷简表的心理测量特征及其在成人注意缺陷多动障碍或边缘型人格障碍患者中的有效性。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-11-17 DOI: 10.1186/s40479-023-00239-8
Eszter Kenézlői, Eszter Csernela, Zsófia Nemoda, Krisztina Lakatos, Boldizsár Czéh, Zsolt Szabolcs Unoka, Mária Simon, János M Réthelyi

Background: Compelling evidence supports the role of childhood traumatization in the etiology of psychiatric disorders, including adult attention-deficit hyperactivity disorder (aADHD) and borderline personality disorder (BPD). The aim of this study was to examine the psychometric properties of the Hungarian version of the Childhood Trauma Questionnaire Short Form (H-CTQ-SF) and to investigate the differences between patients diagnosed with aADHD and BPD in terms of early traumatization.

Methods: Altogether 765 (mean age = 32.8 years, 67.7% women) patients and control subjects were enrolled from different areas of Hungary. Principal component analysis and confirmatory factor analysis were carried out to explore the factor structure of H-CTQ-SF and test the validity of the five-factor structure. Discriminative validity was assessed by comparing clinical and non-clinical samples. Subsequently, aADHD and BPD subgroups were compared with healthy controls to test for the role of early trauma in aADHD without comorbid BPD. Convergent validity was explored by measuring correlations with subscales of the Personality Inventory for DSM-5 (PID-5).

Results: The five scales of the H-CTQ-SF demonstrated adequate internal consistency and reliability values. The five-factor model fitted the Hungarian version well after exclusion of one item from the physical neglect scale because of its cross-loading onto the emotional neglect subscale. The H-CTQ-SF effectively differentiated between the clinical and non-clinical samples. The BPD, but not the aADHD group showed significant differences in each CTQ domain compared with the healthy control group. All CTQ domains, except for physical abuse, demonstrated medium to high correlations with PID-5 emotional lability, anxiousness, separation insecurity, withdrawal, intimacy avoidance, anhedonia, depressivity, suspiciousness, and hostility subscales.

Conclusions: Our study confirmed the psychometric properties of the H-CTQ-SF, an easy-to-administer, non-invasive, ethically sound questionnaire. In aADHD patients without comorbid BPD, low levels of traumatization in every CTQ domain were comparable to those of healthy control individuals. Thus, the increased level of traumatization found in previous studies of aADHD might be associated with the presence of comorbid BPD. Our findings also support the role of emotional neglect, emotional abuse and sexual abuse in the development of BPD.

背景:令人信服的证据支持童年创伤在精神疾病病因学中的作用,包括成人注意力缺陷多动障碍(aADHD)和边缘型人格障碍(BPD)。本研究的目的是检验匈牙利版儿童创伤问卷简表(H-CTQ-SF)的心理测量特征,并探讨被诊断为aADHD和BPD的患者在早期创伤方面的差异。方法:共纳入来自匈牙利不同地区的765例(平均年龄32.8岁,67.7%为女性)患者和对照组。采用主成分分析和验证性因子分析探讨H-CTQ-SF的因子结构,并检验五因子结构的效度。通过比较临床和非临床样本来评估判别效度。随后,将aADHD和BPD亚组与健康对照组进行比较,以测试早期创伤在无BPD合并症的aADHD中的作用。通过测量与DSM-5 (PID-5)人格量表子量表的相关性来探讨收敛效度。结果:H-CTQ-SF的五个量表具有足够的内部一致性和信度值。在排除了身体忽视量表中的一个项目后,由于其交叉加载到情感忽视子量表中,五因素模型很好地拟合了匈牙利版本。H-CTQ-SF有效区分临床和非临床样本。与健康对照组相比,BPD组的CTQ各域存在显著差异,而adhd组的CTQ各域无显著差异。除身体虐待外,所有CTQ域与PID-5情绪不稳定、焦虑、分离不安全感、退缩、亲密回避、快感缺乏、抑郁、怀疑和敌意亚量表均表现出中高相关性。结论:我们的研究证实了H-CTQ-SF的心理测量特性,这是一份易于管理、无创、合乎伦理的问卷。在没有BPD合并症的aADHD患者中,每个CTQ域的低水平创伤与健康对照个体相当。因此,在先前的研究中发现的aADHD创伤程度的增加可能与BPD共病的存在有关。我们的研究结果也支持了情感忽视、情感虐待和性虐待在BPD发展中的作用。
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引用次数: 0
The relationship between mood disorders, personality disorder and suicidality in adolescence: does general personality disturbance play a significant role in predicting suicidal behavior? 情绪障碍、人格障碍和青少年自杀之间的关系:一般人格障碍在预测自杀行为中是否起重要作用?
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-11-01 DOI: 10.1186/s40479-023-00238-9
Riccardo Williams, Marco Chiesa, Marta Moselli, Camillla Frattini, MariaPia Casini, Peter Fonagy
<p><strong>Introduction: </strong>Current research points to the importance personality pathology and Major Depression e as relevant psycopathological risk factors for understanding suicidal risk in adolescence. Literature has mainly focused on the role of BPD, however current orientations in personality pathological functioning suggest that BPD may be the representative of a general personality disturbance, a factor of vulnerability underlying diverse psychopathological variants and aspects of maladaptive functioning. However, recent studies seem to have neglected the contributions that other specific personality disorders and personality pathology as a general factor of vulnerability for suicidality; and only marginally investigated the interaction of personality disorder (PD) as an overall diagnosis and individual PDs and major depression (MDD). In this paper, the independent and cumulative effects of MDD and DSM-IV PDs on suicidal risk are investigated in a sample of adolescents observed in a longitudinal window of observation ranging from three months preceding the assessment to a six-month follow up period of clinical monitoring.</p><p><strong>Methods: </strong>A sample of 118 adolescents (mean age = 15.48 ± 1.14) referred for assessment and treatment on account of suicidal ideation or behavior were administered the CSSRS, SCID II, Kiddie-SADS at admission at inpatient and outpatient Units. All subjects included in the study had reported suicidal ideation or suicide attempts at the C-SSRS; The CSSRS was applied again to all patients who reported further suicidal episodes during the six-months follow-up period of clinical monitoring. Dimensional diagnoses of PDs was obtained by summing the number of criteria met by each subject at SCID-%-PD 5, In order, to test the significance of the associations between the variables chosen as predictors (categorical and dimensional PDs and MD diagnosis), and the suicidal outcomes variables suicide attempts, number of suicide attempts and potential lethality of suicide attempt, non-parametric bivariate correlations, logistic regression models and mixed-effects Poisson regression were performed PD.</p><p><strong>Results: </strong>The categorical and dimensional diagnosis of PD showed to be a significant risk factors for suicide attempt and their recurrence, independently of BPD, that anyway was confirmed to be a specific significant risk factor for suicidal behaviors. Furthermore, PD assessed at a categorical and dimensional level and Major Depression exert an influence on suicidal behaviors and their lethality both as independent and cumulative risk factors.</p><p><strong>Limitations: </strong>Besides incorporating dimensional thinking into our approach to assessing psychopathology, our study still relied on traditionally defined assessment of PD. Future studies should include AMPD-defined personality pathology in adolescence to truly represent dimensional thinking.</p><p><strong>Conclusion: </strong>These
引言:目前的研究表明,人格病理学和严重抑郁e是了解青春期自杀风险的相关心理病理学危险因素。文献主要集中在BPD的作用上,但目前人格病理功能的研究方向表明,BPD可能是一般人格障碍的代表,这是一个潜在的脆弱因素,包括各种精神病理学变体和适应不良功能。然而,最近的研究似乎忽略了其他特定的人格障碍和人格病理学作为自杀脆弱性的一般因素的贡献;并且仅对作为整体诊断的人格障碍(PD)与个体PD和重度抑郁症(MDD)的相互作用进行了边际研究。在这篇论文中,对MDD和DSM-IV PD对自杀风险的独立和累积影响进行了调查,样本是在评估前三个月到六个月临床监测随访期的纵向观察窗口中观察到的青少年。方法:118名青少年(平均年龄 = 15.48 ± 1.14)因自杀意念或行为而被转诊进行评估和治疗时,在住院和门诊部接受了CSSRS、SCID II、Kiddie SADS。纳入研究的所有受试者都在C-SSRS报告了自杀意念或自杀企图;在六个月的临床监测随访期内,所有报告有进一步自杀事件的患者再次应用CSSRS。PD的维度诊断是通过将每个受试者在SCID-%-PD 5时满足的标准数量相加来获得的。为了测试被选为预测因素的变量(分类和维度PD和MD诊断)与自杀结果变量自杀未遂、自杀未遂次数和自杀未遂的潜在致死率之间的相关性的显著性,结果:PD的分类和维度诊断是自杀未遂及其复发的一个重要危险因素,与BPD无关,无论如何都被证实是自杀行为的一个特定的重要危险因素。此外,在分类和维度水平上评估的PD和严重抑郁对自杀行为及其致命性产生影响,无论是作为独立的还是累积的风险因素。局限性:除了将维度思维纳入我们评估精神病理学的方法之外,我们的研究仍然依赖于传统定义的PD评估。未来的研究应该包括青春期AMPD定义的人格病理学,以真正代表维度思维。结论:这些结果表明,早期识别整个人格病理的严重程度及其与严重抑郁症的共同发生对青少年自杀风险的管理具有重要意义。
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引用次数: 0
The relationship between social support, coping strategies and psychological distress and positive mental well-being in carers of people with borderline personality disorder. 边缘型人格障碍患者护理者的社会支持、应对策略与心理困扰和积极心理健康之间的关系。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-10-12 DOI: 10.1186/s40479-023-00237-w
Aoife Hayes, Maria Dempsey, Mary Kells, Mike Murphy

Background: Informal carers of people with BPD experience high levels of burden and psychological distress relative to other populations. There is a scarcity of research evidencing the influence of modifiable factors on carer outcomes to inform interventions. This study aimed to investigate the relationship between social support, coping strategies and psychological distress and positive mental well-being in this carer population.

Methods: In this cross-sectional study, 1207 carers completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, and the Coronavirus Anxiety Scale. Data for 863 participants who met the inclusion criteria were analysed.

Results: Carers reported low positive mental well-being and high psychological distress. Perceived social support and several coping strategies were significant unique predictors of psychological distress and positive mental well-being. Perceived social support and positive reframing were the strongest predictors of higher positive mental well-being and lower psychological distress. Self-blame, behavioural disengagement and substance use were the strongest predictors of adverse outcomes.

Conclusions: The findings evidence modifiable factors that may be used to improve informal carer outcomes and indicate that carer interventions may be improved by focusing on reducing the use of self-blame, behavioural disengagement and substance use, and development of quality social support and skills to positively reframe caregiving situations.

背景:与其他人群相比,BPD患者的非正式护理人员经历了高水平的负担和心理困扰。很少有研究证明可改变因素对护理人员结果的影响,从而为干预措施提供信息。本研究旨在调查该护理人群的社会支持、应对策略与心理困扰和积极心理健康之间的关系。方法:在这项横断面研究中,1207名护理人员完成了BPD-Career版McLean筛查工具、简明COPE、感知社会支持多维量表、Kessler心理痛苦量表、WHO-5健康指数和冠状病毒焦虑量表。对863名符合入选标准的参与者的数据进行了分析。结果:护理人员报告的积极心理健康水平较低,心理痛苦程度较高。感知的社会支持和几种应对策略是心理困扰和积极心理健康的重要独特预测因素。感知的社会支持和积极的重构是更高的积极心理健康和更低的心理痛苦的最强预测因素。自责、行为脱离和药物使用是不良结果的最强预测因素。结论:研究结果证明了可用于改善非正式护理人员结果的可改变因素,并表明护理人员干预措施可以通过减少自责、行为脱离和药物使用,以及发展高质量的社会支持和技能来积极重塑护理情况来改进。
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Borderline Personality Disorder and Emotion Dysregulation
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