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成年边缘型人格障碍患者生活中的暴力行为。

Violence in the lives of adult borderline patients.

作者信息

Zanarini M C, Frankenburg F R, Reich D B, Marino M F, Haynes M C, Gunderson J G

机构信息

McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts 02478, USA.

出版信息

J Nerv Ment Dis. 1999 Feb;187(2):65-71. doi: 10.1097/00005053-199902000-00001.

Abstract

The purpose of this study was to assess the experiences of adult violence reported by a sample of criteria-defined borderline patients and axis II controls. The experiences of having had a physically abusive partner and/or having been raped reported by 362 personality-disordered inpatients were assessed blind to diagnostic status using a semistructured research interview. Forty-six percent of borderline patients reported having been a victim of violence since the age of 18. Borderline patients (N = 290) were significantly more likely than axis II controls (N = 72) to report having had a physically abusive partner, having been raped, having been raped multiple times, having been raped by a known perpetrator, and having been both physically assaulted by a partner and raped. Female borderline patients were significantly more likely than male borderline patients to have been physically and/or sexually assaulted as adults (50% vs. 26%). However, a significantly higher percentage of borderline patients of both genders reported experiences of adult violence than controls of the same gender. Four risk factors were found to significantly predict whether borderline patients had an adult history of being a victim of violence: female gender, a substance use disorder that began before the age of 18, childhood sexual abuse, and emotional withdrawal by a caretaker. The results of this study suggest that both male and female borderline patients are at substantial risk for being physically and/or sexually victimized as adults.

摘要

本研究的目的是评估一组符合标准定义的边缘型患者和轴II对照组所报告的成人期暴力经历。通过半结构化研究访谈,对362名住院的人格障碍患者报告的曾有过身体虐待伴侣和/或曾被强奸的经历进行了评估,评估过程中对诊断状态不知情。46%的边缘型患者报告自18岁起曾是暴力受害者。边缘型患者(N = 290)比轴II对照组(N = 72)更有可能报告曾有过身体虐待伴侣、曾被强奸、曾多次被强奸、曾被已知犯罪者强奸,以及既遭受伴侣身体攻击又被强奸。成年女性边缘型患者比成年男性边缘型患者更有可能遭受身体和/或性侵犯(50%对26%)。然而,与相同性别的对照组相比,两性边缘型患者报告的成人期暴力经历比例显著更高。发现有四个风险因素能显著预测边缘型患者是否有成人期暴力受害者的经历:女性、18岁前开始的物质使用障碍、童年期性虐待以及照顾者情感上的疏离。本研究结果表明,成年男性和女性边缘型患者都有遭受身体和/或性侵害的重大风险。

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