Zlotnick C, Mattia J I, Zimmerman M
Brown University, Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island 02906, USA.
J Nerv Ment Dis. 1999 May;187(5):296-301. doi: 10.1097/00005053-199905000-00005.
The aims of this study were to examine whether certain axis I disorders characterized by impulsive aggression were associated with self-mutilative behavior and to evaluate the clinical correlates of self-mutilation in a sample of general psychiatric outpatients. Two hundred fifty-six outpatients were administered diagnostic interviews for axis I and axis II disorders. In addition, questionnaires that measured self-mutilative acts within the last 3 months, dissociation, and childhood abuse were completed. This study found that axis I disorders of substance abuse, posttraumatic stress disorder, and intermittent explosive disorder were significantly related to self-mutilative behavior, independent of borderline personality disorder and antisocial personality disorder. Also, a higher level of dissociation was related to self-mutilation, controlling for borderline personality disorder and childhood abuse. Outpatients with certain axis I disorders and those who dissociate may represent a sizable group of patients who are at risk for self-mutilative behavior.
本研究的目的是检验某些以冲动性攻击为特征的轴I障碍是否与自我伤害行为相关,并评估普通精神科门诊患者样本中自我伤害行为的临床相关因素。对256名门诊患者进行了轴I和轴II障碍的诊断访谈。此外,还完成了测量过去3个月内自我伤害行为、分离和童年期受虐情况的问卷。本研究发现,物质滥用、创伤后应激障碍和间歇性爆发障碍等轴I障碍与自我伤害行为显著相关,与边缘型人格障碍和反社会人格障碍无关。此外,在控制边缘型人格障碍和童年期受虐情况后,较高水平的分离与自我伤害行为相关。患有某些轴I障碍的门诊患者以及存在分离情况的患者可能是有自我伤害行为风险的相当大的患者群体。