Ceumern-Lindenstjerna I A, Brunner R, Parzer P, Fiedler P, Resch F
Psychiatrische Klinik der Universität Heidelberg, Abteilung Kinder- und Jugendpsychiatrie, Germany.
Fortschr Neurol Psychiatr. 2002 Jun;70(6):321-30. doi: 10.1055/s-2002-32027.
The purpose of this review is to analyse nature, degree and consequences of attentional biases in patients with borderline personality disorder based on existing literature. The clinical importance of these phenomena in patients with borderline personality disorder is strengthened and the link between theoretical models, empirical findings and therapeutic interventions is elaborated. This link between selective attention and borderline personality disorder is demonstrated on the basis of studies, which indicate a context between borderline pathology, affective disorders, anxiety disorders, and attention-deficit/hyperactivity disorders and also give evidence to neuropsychological deficits in patients with borderline personality disorder. The present article comparatively describes three theoretical models of borderline personality disorder and their possible links to attentional biases. The dialectical behavior approach postulates a pronounced attentional narrowing to emotional stimuli in connection with deficits regarding affect regulation. The cognitive approach assumes that rigid dysfunctional schemata initiate a cognitive-emotional circuit, which leads to a reinforcement of the symptomatology as a result of a biased perception and memory. Additionally the present article specifies the trauma approach which emphasizes the relation between borderline pathology and childhood trauma with recourse to theories of attentional biases in patients with traumatic experiences. Preliminary empiricial findings suggest that patients with borderline personality disorder demonstrate a general attentional bias for any emotional negative stimuli and not a selective attentional bias to borderline-specific stimuli. Further studies should clarify, whether therapeutical interventions with the aim to influence attentional processes represent a useful complement to established therapies in patients with borderline personality disorder.
本综述的目的是基于现有文献分析边缘型人格障碍患者注意力偏差的性质、程度和后果。这些现象在边缘型人格障碍患者中的临床重要性得到了强化，并阐述了理论模型、实证研究结果与治疗干预之间的联系。基于一些研究证明了选择性注意与边缘型人格障碍之间的这种联系，这些研究表明边缘型病理、情感障碍、焦虑障碍和注意力缺陷多动障碍之间存在某种关联，同时也为边缘型人格障碍患者的神经心理学缺陷提供了证据。本文比较描述了边缘型人格障碍的三种理论模型及其与注意力偏差可能存在的联系。辩证行为疗法认为，与情感调节缺陷相关的是，对情绪刺激存在明显的注意力狭窄。认知疗法认为，僵化的功能失调图式会引发认知 - 情感回路，由于存在偏差的感知和记忆，这会导致症状的强化。此外，本文还详细阐述了创伤疗法，该疗法借助创伤经历患者注意力偏差的理论，强调边缘型病理与童年创伤之间的关系。初步实证研究结果表明，边缘型人格障碍患者对任何负面情绪刺激都表现出普遍的注意力偏差，而不是对边缘型特定刺激的选择性注意力偏差。进一步的研究应阐明，旨在影响注意力过程的治疗干预是否是边缘型人格障碍患者现有治疗方法的有益补充。
