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Borderline Personality Disorder and Emotion Dysregulation最新文献

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Validation of the French version of the Revised Diagnostic Interview for Borderlines (DIB-R) for assessing the psychopathology of borderline personality disorder. 法国版修订版边缘型诊断访谈(DIB-R)评估边缘型人格障碍精神病理学的有效性。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-09-18 DOI: 10.1186/s40479-023-00233-0
Ines Culina, Pauline Maillard, Janice Loosli, Chantal Martin-Soelch, Sylvie Berney, Stéphane Kolly, Ueli Kramer

Background: Borderline personality disorder (BPD) is frequently subject to misdiagnosis or underdiagnosis. As a matter of fact, its evaluation poses several challenges, highlighting the importance of having validated evaluation instruments. The Revised Diagnostic Interview for Borderlines (DIB-R) is widely used and recognized for its validity when it comes to assessing the psychopathology of BPD, but, as for now, no French version of the interview exists. The aim of the current work is to validate a French version of the DIB-R.

Methods: The sample consists of N = 65 patients with borderline personality disorder (BPD) and N = 57 treatment seeking patients (non-BPD comparison group). For inter-rater reliability, a subsample of N = 84 interviews will be assessed by two raters, n = 47 for the BPD group and n = 37 for the non-BPD comparison group.

Results: To assess reliability, we conducted analyses of internal consistency and inter-rater reliability. The results were good for the overall interview as well as for the four domains of the DIB-R. To assess validity, we calculated the receiver operating characteristic (ROC) curve, sensitivity, specificity, predictive values, convergent and discriminative validity. The optimal cutoff was found to be 7. Regarding convergent validity, we found strong convergence between the Borderline Symptom List (BSL-23) and the DIB-R total score. Additionally, the two groups statistically differed on all the DIB-R scores, which indicates that the interview discriminates between the two groups.

Conclusions: Our results indicate good psychometric properties of the French version of the DIB-R. This has important implications as the interview is useful both in clinical settings and for research purposes. Additionally, the present paper aims to contribute to the more general effort of demonstrating generalizability and transportability of the scale.

背景:边缘型人格障碍(BPD)经常被误诊或诊断不足。事实上,它的评价提出了若干挑战,突出了经过验证的评价工具的重要性。在评估BPD的精神病理学时,修订的边缘人群诊断访谈(DIB-R)被广泛使用,并因其有效性而得到认可,但目前还没有法语版的访谈。当前工作的目的是验证法国版本的DIB-R。方法:样本由N = 65例边缘型人格障碍(BPD)和N = 57名寻求治疗的患者(非BPD对照组)。对于评级机构间的可靠性,N的子样本 = 84次面试将由两名评分员进行评估,n = BPD组为47,n = 37用于非BPD对照组。结果:为了评估可靠性,我们进行了内部一致性和评分者间可靠性分析。结果对整个面试以及DIB-R的四个领域都很好。为了评估有效性,我们计算了受试者操作特征(ROC)曲线、敏感性、特异性、预测值、收敛有效性和判别有效性。最佳截止值为7。关于收敛有效性,我们发现边界症状表(BSL-23)和DIB-R总分之间有很强的收敛性。此外,两组在所有DIB-R得分上存在统计学差异,这表明访谈在两组之间存在差异。结论:我们的结果表明法语版DIB-R具有良好的心理测量特性。这具有重要意义,因为访谈在临床环境和研究目的中都很有用。此外,本文旨在为证明量表的可推广性和可移植性做出更普遍的努力。
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引用次数: 0
Sub-threshold or full-syndrome borderline personality disorder in adolescents with recurrent self-harm - distinctly or dimensionally different? 复发性自残青少年的亚阈值或全综合征边缘型人格障碍-明显或维度不同?
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-09-14 DOI: 10.1186/s40479-023-00234-z
Anne Brager-Larsen, Pål Zeiner, Lars Mehlum

Background: Borderline personality disorder (BPD) is a severe mental disorder frequently seen in individuals with recurrent self-harm behaviour. To what extent there are distinguishing characteristics between self-harming adolescents who meet the criteria for a full diagnosis of BPD, a sub-threshold number of BPD criteria and those who don't have BPD, with respect to clinical characteristics, is still uncertain and could have important clinical implications.

Methods: Data from 103 adolescents with recurrent self-harm behaviour recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports. Bivariate analyses comparing participants with or without a diagnosis of BPD were performed. Group differences based on the number of BPD criteria fulfilled (few-if-any BPD: 0-2 criteria, sub-threshold BPD: 3-4 criteria, full-syndrome BPD: 5 or more criteria) were tested and regression analyses performed.

Results: Adolescents with a diagnosis of BPD (28.2%) had significantly higher numbers of co-morbid DSM-5 disorders, suicide attempts and self-harm methods. They also reported significantly higher levels of suicidal ideation, depression, anxiety and impulsivity, compared with adolescents without BPD. Adolescents with sub-threshold BPD (20.4%) place themselves in the intermediate position between participants with full-syndrome BPD and participants with few-if-any BPD, in terms of these symptoms. Higher levels of emotional regulation difficulties and a lower level of global functioning were significantly associated with fulfilling a higher number of BPD criteria.

Conclusion: Adolescents with recurrent self-harm who meet diagnostic criteria for a full-syndrome BPD or sub-threshold BPD seem to have difficulties within the same spectrum. They seem dimensionally, but not categorically, different with respect to the severity of their difficulties. These adolescents need interventions aimed at their dysfunctional self-harm behaviour, emotional regulation difficulties and BPD symptoms at an earlier, rather than at a later stage of symptom development.

背景:边缘型人格障碍(BPD)是一种严重的精神障碍,常见于反复自我伤害行为的个体。就临床特征而言,符合BPD完全诊断标准的自残青少年、低于阈值的BPD标准以及没有BPD的青少年之间的区别特征在多大程度上仍不确定,但可能具有重要的临床意义。方法:采用临床访谈和自我报告的方法,收集103名儿童和青少年精神科门诊有反复自残行为的青少年的资料。进行双变量分析,比较有或没有诊断为BPD的参与者。基于满足BPD标准数量的组间差异(很少BPD: 0-2个标准,亚阈值BPD: 3-4个标准,全综合征BPD: 5个或更多标准)进行测试和回归分析。结果:被诊断为BPD的青少年(28.2%)共患DSM-5障碍、自杀企图和自残方法的数量显著增加。与没有BPD的青少年相比,他们的自杀意念、抑郁、焦虑和冲动程度也明显更高。就这些症状而言,亚阈值BPD青少年(20.4%)将自己置于完全综合征BPD和很少(如果有的话)BPD参与者之间的中间位置。较高水平的情绪调节困难和较低水平的整体功能与较高数量的BPD标准显著相关。结论:符合全症候群BPD或亚阈值BPD诊断标准的复发性自残青少年似乎在同一谱系内存在困难。就困难的严重程度而言,他们似乎只是维度上的不同,而不是绝对的不同。这些青少年需要在症状发展的较早阶段,而不是较晚阶段,针对其功能失调的自残行为、情绪调节困难和BPD症状进行干预。
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引用次数: 0
Shame-coping clusters: comparisons regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for general emotion dysregulation. 羞耻应对集群:在控制一般情绪失调的情况下,关于依恋不安全感、心理缺陷和人格病理的比较。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-09-08 DOI: 10.1186/s40479-023-00231-2
Ahmad Asgarizadeh, Carla Sharp, Saeed Ghanbari

Background: General Emotion Dysregulation (GED) is increasingly implicated as an underlying factor in personality pathology; however, the regulation of specific emotions, such as shame, has been relatively overlooked in the literature. We aimed to identify distinct clusters of shame-coping/regulation and compare them regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for GED.

Methods: A convenience sample of 600 participants (351 females and 249 males) from the general population with ages ranging from 18 to 65 (M = 33.78, SD = 12.80) completed a battery of self-report instruments, measuring shame-coping styles, GED, attachment insecurities, mentalizing deficits, criteria A and B of the alternative model for personality disorders, and borderline personality traits. A two-stage clustering method was employed, with shame-coping styles as the clustering variables. The identified clusters were then compared for their effects on dependent variables using multivariate and univariate analyses. These comparisons were also performed after controlling for GED.

Results: Multiple determination methods suggested a two-cluster solution: maladaptive and adaptive shame-coping. Attack-self, withdrawal, and attack-other styles were the main discriminators. Compared with the adaptive cluster, the maladaptive cluster was characterized by higher use of maladaptive and lower use of adaptive shame-coping styles. Multivariate analyses demonstrated significant differences for all the between-cluster comparisons, with and without GED as the covariate (p < .001).

Conclusions: The current study provides evidence for the presence of homogenous clusters of shame-coping in community-based adults. Between-cluster contrasts after controlling for GED suggest that addressing shame-coping could have incremental utility over and above GED.

背景:一般情绪失调(GED)越来越多地被认为是人格病理学的一个潜在因素;然而,对特定情绪的调节,如羞耻感,在文献中相对被忽视了。我们的目的是识别不同的羞耻应对/调节集群,并在控制GED的情况下,比较它们在依恋不安全感、心理缺陷和人格病理方面的差异。方法:选取年龄在18 ~ 65岁(M = 33.78, SD = 12.80)的普通人群600名(女性351名,男性249名),完成了一系列自我报告工具,包括羞耻感应对方式、GED、依恋不安全感、心理缺陷、人格障碍替代模型标准A和B以及边缘型人格特征。采用两阶段聚类方法,以羞耻应对方式为聚类变量。然后使用多变量和单变量分析比较确定的集群对因变量的影响。这些比较也是在控制GED后进行的。结果:多种判定方法均提示两类解决方案:适应不良和适应羞耻应对。攻击-自我、退缩和攻击-其他类型是主要的区别因素。与适应群体相比,适应不良群体对适应不良行为的使用较多,而对适应羞耻应对方式的使用较少。多变量分析表明,在有或没有GED作为协变量的情况下,所有簇间比较都存在显著差异(p)。结论:目前的研究为社区成人中羞耻应对同质簇的存在提供了证据。控制GED后的集群间对比表明,解决羞耻应对可能具有超过GED的增量效用。
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引用次数: 0
Self-disgust in patients with borderline personality disorder. The associations with alexithymia, emotion dysregulation, and comorbid psychopathology. 边缘型人格障碍患者的自我厌恶。与述情障碍、情绪失调和共病精神病理的关系。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-08-29 DOI: 10.1186/s40479-023-00232-1
Emilia Kot, Barbara Kostecka, Joanna Radoszewska, Katarzyna Kucharska

Background: Self-disgust is a negative self-conscious emotion, which has been linked with borderline personality disorder (BPD). However, it has not yet been investigated in relation to both emotion dysregulation and alexithymia, which are recognized as crucial to BPD. Therefore, the aim of our study was to measure these variables and examine the possible mediational role of emotional alterations and comorbid anxiety and depression symptoms in shaping self-disgust in patients with BPD and healthy controls (HCs).

Methods: In total, the study included 100 inpatients with BPD and 104 HCs. Participants completed: the Self-Disgust Scale (SDS), Disgust Scale - Revised (DS-R), Toronto Alexithymia Scale (TAS-20), Emotion Dysregulation Scale short version (EDS-short), Borderline Personality Disorder Checklist (BPD Checklist), State-Trait Anxiety Inventory (STAI), and Center for Epidemiologic Studies Depression Scale (CESD-R).

Results: Inpatients with BPD showed higher self-disgust, alexithymia, emotion dysregulation, core and comorbid symptoms levels, and lower disgust sensitivity. Alexithymia, emotion dysregulation, and trait anxiety partially mediated between BPD diagnosis and self-disgust. The relationship between the severity of BPD symptoms and self-disgust was fully mediated by alexithymia, emotion dysregulation, depressive symptoms, and trait anxiety.

Conclusions: The results of our study may imply the contribution of emotion dysregulation, alexithymia, and comorbid psychopathology to self-referenced disgust in BPD.

背景:自我厌恶是一种消极的自我意识情绪,与边缘型人格障碍(BPD)有关。然而,还没有研究它与情绪失调和述情障碍的关系,这被认为是BPD的关键。因此,我们研究的目的是测量这些变量,并检查情绪改变和共病焦虑和抑郁症状在BPD患者和健康对照(hc)中形成自我厌恶的可能中介作用。方法:本研究共纳入100例BPD和104例hc住院患者。参与者完成了自我厌恶量表(SDS)、厌恶量表修订(DS-R)、多伦多述情障碍量表(TAS-20)、情绪失调简易量表(EDS-short)、边缘型人格障碍量表(BPD)、状态-特质焦虑量表(STAI)和流行病学研究中心抑郁量表(CESD-R)。结果:BPD患者自我厌恶、述情障碍、情绪失调、核心症状及合并症水平较高,厌恶敏感性较低。述情障碍、情绪失调和特质焦虑在BPD诊断与自我厌恶之间的部分中介作用。BPD症状严重程度与自我厌恶之间的关系由述情障碍、情绪失调、抑郁症状和特质焦虑完全介导。结论:我们的研究结果可能暗示情绪失调、述情障碍和共病精神病理对BPD患者自我参照厌恶的贡献。
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引用次数: 1
Psychometric properties of the Chinese Mandarin version of the Borderline Symptom List, short form (BSL-23) in suicidal adolescents. 自杀青少年《边缘性症状表》(BSL-23)的心理测量特征
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-08-09 DOI: 10.1186/s40479-023-00230-3
Jui-En Shen, Yu-Hsin Huang, Hui-Chun Huang, Hui-Ching Liu, Tsung-Han Lee, Fang-Ju Sun, Chiu-Ron Huang, Shen-Ing Liu

Background: The short form of the Borderline Symptom List (BSL-23) is a self-rated instrument developed from the initial 95-item German version of the Borderline Symptom List (BSL-95). It is widely used among Chinese adults, but its applicability, factor structure and validity remain uncertain in adolescents. This study aimed to evaluate the psychometric properties of the Chinese Mandarin version of the BSL-23 in a sample of suicidal adolescents.

Methods: The Chinese Mandarin BSL-23 was given to 279 outpatient adolescents with self-injurious thoughts or behaviors. The factor structure, reliability, convergent validity, criterion-related validity and cut-off value were investigated.

Results: The Chinese Mandarin version of the BSL-23 demonstrated a one-factor structure and replicated the original version. The scale had high reliability and good test-retest stability. The Chinese Mandarin BSL-23 was correlated with depression, hopelessness, impulsivity, emotional dysregulation, self-esteem, loneliness, childhood trauma and parental bonding patterns evaluated with a variety of scales. The measure showed good criterion-related validity and predictive accuracy (AUC = 0.87) for self-injurious and suicidal adolescents with borderline personality disorder (BPD) at a cut-off point of 60/61 (mean score 2.60/2.65), with a sensitivity of 0.76 and specificity of 0.83.

Conclusions: The Chinese Mandarin version of the BSL-23 is a reliable and valid self-reported instrument to assess BPD symptomatology among suicidal adolescents.

背景:《边缘性症状表》(BSL-23)是由最初的95项德文版《边缘性症状表》(BSL-95)发展而来的自评量表。它在中国成年人中被广泛使用,但在青少年中的适用性、因素结构和效度仍不确定。本研究旨在评价汉语普通话版BSL-23在自杀青少年样本中的心理测量特性。方法:对279例有自伤思想或行为的门诊青少年进行汉语普通话BSL-23量表测试。考察了量表的因子结构、信度、收敛效度、标准相关效度和截止值。结果:BSL-23的中文普通话版本呈现单因子结构,并与原版本复制。量表信度高,重测稳定性好。汉语普通话BSL-23与抑郁、绝望、冲动、情绪失调、自尊、孤独、童年创伤和父母关系模式相关。在60/61(平均得分2.60/2.65)的分界点上,该测量方法显示出良好的标准相关效度和预测准确性(AUC = 0.87),敏感性为0.76,特异性为0.83。结论:中文版BSL-23是一种可靠、有效的评估自杀青少年BPD症状的自我报告工具。
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引用次数: 0
Borderline personality disorder features and their relationship with trauma and dissociation in a sample of community health service users. 社区卫生服务使用者样本中的边缘性人格障碍特征及其与创伤和分离的关系
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-07-03 DOI: 10.1186/s40479-023-00228-x
Hong Wang Fung, Ming Yu Claudia Wong, Stanley Kam Ki Lam, Emily Nga Man Wong, Wai Tong Chien, Suet Lin Hung, Kun-Hua Lee, Jialiang Cui, Colin A Ross

Background: Previous studies have indicated that borderline personality disorder (BPD) is closely associated with trauma and dissociation. Nevertheless, BPD is a heterogeneous condition, and not all people with BPD have severe dissociation. This study examined whether the relationship of BPD features with trauma and dissociation would remain significant after controlling for some general non-specific mental health distress. We also made the first attempt to explore which specific BPD features would be particularly associated with dissociation.

Methods: We analyzed survey data from a sample of community health service users in Hong Kong (N = 376). Hierarchical multiple regression and data-driven network analysis were used.

Results: The lifetime prevalence of DSM-5 BPD was 16.0% in our sample. Of participants who met criteria for BPD, 43.3% scored above cutoff on the dissociation measures, thus possibly having clinically significant dissociative symptoms. BPD features were associated with adulthood trauma and psychoform dissociation even after controlling for age, depression and self-esteem. Network analysis showed that some BPD features - including impulsivity, identity disturbance and suicidal/self-mutilation behaviors - were particularly associated with dissociation; other BPD features such as interpersonal-related problems had relatively weak to no connection with dissociation.

Conclusions: Our results suggested that some particular BPD features might be dissociative in nature, although further longitudinal research is required. We argue that a trauma-informed perspective should be employed when working with clients presenting with BPD features despite these features being commonly stigmatized. Further research on the intervention needs of the people with BPD who suffer from high levels of dissociation is required.

背景:以往的研究表明边缘型人格障碍(BPD)与创伤和分离密切相关。然而,BPD是一种异质性疾病,并不是所有的BPD患者都有严重的分离。本研究考察了在控制了一些一般的非特异性精神健康困扰后,BPD特征与创伤和分离的关系是否仍然显著。我们还首次尝试探索哪些特定的BPD特征与解离特别相关。方法:我们分析了来自香港社区卫生服务使用者样本的调查数据(N = 376)。采用层次多元回归和数据驱动网络分析。结果:我们的样本中DSM-5 BPD的终生患病率为16.0%。在符合BPD标准的参与者中,43.3%的人在解离测量中得分高于临界值,因此可能具有临床显著的解离症状。即使在控制了年龄、抑郁和自尊之后,BPD特征仍与成年期创伤和精神形态分离有关。网络分析显示,一些BPD特征——包括冲动、身份障碍和自杀/自残行为——与分离特别相关;其他BPD特征,如人际关系问题,与分离的联系相对较弱或没有联系。结论:我们的研究结果表明,尽管需要进一步的纵向研究,但某些特定的BPD特征可能在本质上是游离性的。我们认为,在治疗具有BPD特征的患者时,应采用创伤知情的观点,尽管这些特征通常被污名化。需要进一步研究重度分离的BPD患者的干预需求。
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引用次数: 1
Altered intrinsic functional network connectivity is associated with impulsivity and emotion dysregulation in drug-naïve young patients with borderline personality disorder. drug-naïve年轻边缘型人格障碍患者的内在功能网络连接改变与冲动和情绪失调有关。
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-06-19 DOI: 10.1186/s40479-023-00227-y
Wanyi Cao, Ying Liu, Mingtian Zhong, Haiyan Liao, Sainan Cai, Jun Chu, Shuxin Zheng, Changlian Tan, Jinyao Yi

Background: Despite impulse control and emotion regulation being altered in borderline personality disorder (BPD), the specific mechanism of these clinical features remains unclear. This study investigated the functional connectivity (FC) abnormalities within- and between- default mode network (DMN), salience network (SN), and central executive network (CEN) in BPD, and examined the association between aberrant FC and clinical features. We aimed to explore whether the abnormal large-scale networks underlie the pathophysiology of impulsivity and emotion dysregulation in BPD.

Methods: Forty-one young, drug-naïve patients with BPD (24.98 ± 3.12 years, 20 males) and 42 healthy controls (HCs; 24.74 ± 1.29 years, 17 males) were included in resting-state functional magnetic resonance imaging analyses. Independent component analysis was performed to extract subnetworks of the DMN, CEN, and SN. Additionally, partial correlation was performed to explore the association between brain imaging variables and clinical features in BPD.

Results: Compared with HCs, BPD showed significant decreased intra-network FC of right medial prefrontal cortex in the anterior DMN and of right angular gyrus in the right CEN. Intra-network FC of right angular gyrus in the anterior DMN was significantly negatively correlated with attention impulsivity in BPD. The patients also showed decreased inter-network FC between the posterior DMN and left CEN, which was significantly negatively correlated with emotion dysregulation.

Conclusion: These findings suggest that impaired intra-network FC may underlie the neurophysiological mechanism of impulsivity, and abnormal inter-network FC may elucidate the neurophysiological mechanism of emotion dysregulation in BPD.

背景:尽管边缘型人格障碍(BPD)患者的冲动控制和情绪调节发生了改变,但这些临床特征的具体机制尚不清楚。本研究探讨了BPD中默认模式网络(DMN)、突出网络(SN)和中央执行网络(CEN)内部和之间的功能连接(FC)异常,并探讨了FC异常与临床特征的关系。我们的目的是探讨这种异常的大规模网络是否在BPD患者冲动和情绪失调的病理生理基础上起作用。方法:41例年轻(drug-naïve) BPD患者(24.98±3.12岁,男性20例)和42例健康对照(hc;(24.74±1.29)岁,男性17例,静息状态磁共振成像分析。进行独立分量分析,提取DMN、CEN和SN的子网。此外,采用部分相关方法探讨脑成像变量与BPD临床特征之间的关系。结果:与hc相比,BPD显示DMN前部右侧内侧前额叶皮层和CEN右侧角回的网络内FC明显减少。DMN前部右侧角回网络内FC与BPD患者的注意冲动性呈显著负相关。患者还表现出DMN后部与左侧CEN之间的网络间FC减少,与情绪失调呈显著负相关。结论:网络内FC受损可能是冲动性神经生理机制的基础,网络间FC异常可能阐明BPD情绪失调的神经生理机制。
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引用次数: 0
Associations of state or trait dissociation with severity of psychopathology in young people with borderline personality disorder. 边缘型人格障碍青少年精神病理严重程度与状态或特质分离的关系
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-06-12 DOI: 10.1186/s40479-023-00226-z
Ashleigh P Salmon, Katie Nicol, Michael Kaess, Martina Jovev, Jennifer K Betts, Andrew M Chanen

Background: State and trait dissociation are associated with borderline personality disorder (BPD) severity and severity of commonly co-occurring mental health symptoms. Although these distinct constructs do not consistently co-occur in experimental settings, they are frequently reported as the same construct, namely dissociation. This study aimed to investigate the co-occurrence of state and trait dissociation among young people with BPD and to examine whether state or trait dissociation were associated with symptom severity in this population.

Methods: State dissociation was induced using a stressful behavioural task in a clinical sample of 51 young people (aged 15-25 years) with three or more BPD features. Diagnoses, state and trait dissociation, BPD severity and severity of posttraumatic stress disorder (PTSD), depressive, and stress symptoms were assessed by self-report or research interview.

Results: A chi-square test of independence showed a strong association between state and trait dissociation. Bonferroni corrected t-tests showed that state dissociation was significantly associated with PTSD symptom severity and likely associated with BPD severity and severity of depressive and stress symptoms. Trait dissociation was not associated with symptom severity or severity of BPD features.

Conclusions: These findings highlight the need to distinguish between state and trait dissociation in personality disorder research. They suggest that state dissociation might be an indicator of higher severity of psychopathology in young people with BPD.

背景:状态和特质分离与边缘型人格障碍(BPD)的严重程度和常见的共同发生的精神健康症状的严重程度有关。虽然这些不同的构念并不总是在实验环境中同时出现,但它们经常被报道为相同的构念,即分离。本研究旨在探讨状态性和特质性分离在年轻BPD患者中的共同发生情况,并探讨状态性或特质性分离是否与该人群的症状严重程度相关。方法:在51名具有三个或更多BPD特征的年轻人(15-25岁)的临床样本中,使用应激行为任务诱导状态分离。诊断、状态和特质分离、BPD严重程度、创伤后应激障碍(PTSD)严重程度、抑郁和应激症状通过自我报告或研究访谈进行评估。结果:独立性卡方检验显示状态解离和特质解离之间有很强的相关性。Bonferroni校正t检验显示,状态分离与PTSD症状严重程度显著相关,并可能与BPD严重程度、抑郁和应激症状严重程度相关。特质分离与症状严重程度或BPD特征严重程度无关。结论:这些发现强调了在人格障碍研究中区分状态解离和特质解离的必要性。他们认为,状态分离可能是年轻BPD患者精神病理更严重的一个指标。
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引用次数: 0
Does trait mindfulness mediate the relationship between borderline personality symptoms and emotion dysregulation? 特质正念是否介导边缘型人格症状与情绪失调之间的关系?
IF 4.1 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-06-08 DOI: 10.1186/s40479-023-00225-0
Alison Roberts, Richard de Visser, Claire Rosten, Helen Startup, Clara Strauss

Background: Emotion dysregulation is core to many biopsychosocial models of Borderline Personality Disorder (BPD) and is often targeted as part of their associated psychological therapies. Several distinct specialist psychotherapies are thought to be effective for people diagnosed with BPD but it is unclear whether they share common change mechanisms. Some evidence suggests that Mindfulness Based Interventions improve competency in emotion regulation as well as trait mindfulness, which are both plausibly associated with good treatment outcomes. It is unclear whether the association between the severity of BPD symptoms and emotion dysregulation is mediated by trait mindfulness. Would improvement in trait mindfulness mediate an association between lower severity of BPD symptoms and fewer problems of emotion dysregulation?

Methods: One thousand and twelve participants completed online, single time-point, self-report questionnaires.

Results: As predicted, the severity of BPD symptoms was significantly and positively associated with emotion dysregulation with a large effect size (r = .77). Trait mindfulness mediated this relationship as the 95% confidence interval for the indirect effect did not cross zero (size of direct effect = .48 and size of indirect effect = .29 [.25, .33].

Conclusions: The relationship between the severity of BPD symptoms and emotion dysregulation was confirmed in this dataset. As hypothesised, this relationship was mediated by trait mindfulness. Process measures of emotion dysregulation and mindfulness should be included in intervention studies for people diagnosed with BPD to understand if improvements in these factors are a universal occurrence with good response to treatment. Other process measures should also be explored to identify other factors involved in the relationship between BPD symptoms and emotion dysregulation.

背景:情绪失调是许多边缘型人格障碍(BPD)的生物心理社会模型的核心,并且经常作为其相关心理治疗的一部分。几种不同的专业心理疗法被认为对BPD患者有效,但尚不清楚它们是否有共同的改变机制。一些证据表明,基于正念的干预提高了情绪调节能力和特质正念,这两者似乎都与良好的治疗结果有关。目前尚不清楚BPD症状严重程度与情绪失调之间的关联是否由特质正念介导。正念特质的改善是否在BPD症状的较轻程度和较少的情绪失调问题之间起到中介作用?方法:1212名参与者完成在线、单时间点、自我报告问卷。结果:正如预测的那样,BPD症状的严重程度与情绪失调呈显著正相关,且效应量大(r = 0.77)。特质正念介导了这种关系,因为间接效应的95%置信区间没有跨越零(直接效应的大小=)。间接效应的大小=。29[。25日,.33]。结论:本数据集证实了BPD症状严重程度与情绪失调之间的关系。正如假设的那样,这种关系是由特质正念介导的。情绪失调和正念的过程测量应该包括在BPD患者的干预研究中,以了解这些因素的改善是否普遍存在,并且对治疗反应良好。还应探索其他过程措施,以确定BPD症状与情绪失调之间关系的其他因素。
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引用次数: 0
Psychopathology and Theory of Mind in patients with personality disorders. 人格障碍患者的精神病理学和心智理论。
IF 4 2区 医学 Q1 PSYCHIATRY Pub Date : 2023-06-01 DOI: 10.1186/s40479-023-00224-1
Juliane Burghardt, Silvia Gradl, Magdalena Knopp, Manuel Sprung

Objective: People with mental disorders frequently suffer from deficits in the ability to infer other's mental states (Theory of Mind; ToM). Individuals with borderline personality disorder (BPD) show ToM deficits characterized by exceeding ToM (over-attributions of mental states). The present study analyzed associations between ToM, BPD severity, and depression severity in patients with BPD and other personality disorders.

Method: We analyzed ToM abilities in 128 patients with BPD and 82 patients with 'mixed and other personality disorders' (MOPD). MOPD are diagnosed if symptoms of multiple personality disorders are present without any set of symptoms being dominant enough to allow a specific diagnosis. We used the movies for the assessment of social cognition (MASC) to measure ToM abilities, the Patient Health Questionnaire (PHQ-9) to assess severity of depression and the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) to assess the severity of BPD symptoms.

Results: Both symptoms of BPD and depression were associated with exceeding ToM in separate regressions. Using a stepwise regression, only the association of depression severity with exceeding ToM was reliable. Patients with BPD and MOPD did not differ in exceeding ToM. Age was most reliably associated with ToM.

Conclusion: The results imply that exceeding ToM is associated with general psychopathology instead of BPD-symptoms in specific. Patients with MOPD show deficits similar to BPD patients.

目的:精神障碍患者通常在推断他人心理状态(心智理论;ToM)方面存在缺陷。边缘型人格障碍(BPD)患者的ToM缺陷表现为ToM过度(对精神状态的过度归因)。本研究分析了BPD和其他人格障碍患者的ToM、BPD严重程度和抑郁严重程度之间的关联:我们分析了 128 名 BPD 患者和 82 名 "混合型及其他人格障碍"(MOPD)患者的 ToM 能力。如果存在多重人格障碍的症状,但没有任何一组症状明显到足以做出具体诊断,则可诊断为混合型人格障碍。我们使用社会认知评估电影(MASC)来测量ToM能力,使用患者健康问卷(PHQ-9)来评估抑郁症的严重程度,使用麦克林边缘型人格障碍筛查工具(MSI-BPD)来评估BPD症状的严重程度:在不同的回归中,BPD 和抑郁症状都与 ToM 超标有关。使用逐步回归法,只有抑郁严重程度与超过 ToM 值之间的关系是可靠的。BPD患者和MOPD患者在超过ToM方面没有差异。年龄与 ToM 的关系最为可靠:结论:研究结果表明,超越 ToM 与一般精神病理学有关,而不是与 BPD 症状有关。MOPD患者表现出的缺陷与BPD患者相似。
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Borderline Personality Disorder and Emotion Dysregulation
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