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[边缘型人格障碍是复杂性创伤后应激障碍吗?——研究现状]

[Is the borderline personality disorder a complex post-traumatic stress disorder? - The state of research].

作者信息

Driessen M, Beblo T, Reddemann L, Rau H, Lange W, Silva A, Berea R C, Wulff H, Ratzka S

机构信息

Medizinische Universität zu Lübeck, Germany.

出版信息

Nervenarzt. 2002 Sep;73(9):820-9. doi: 10.1007/s00115-002-1296-1.

Abstract

Regarding the high prevalence of traumatic experiences in patients with borderline personality disorders (BPD), we review the available literature focussing on the hypothesis that BPD is a subtype of trauma associated disorders. The criteria of BPD, of complex post-traumatic stress disorders (PTSD), and of disorders of extreme stress not otherwise specified (DESNOS) substantially overlap. Research of the long-term course of BPD and PTSD, trauma research, and research of vulnerability in both disorders yielded converging results. Neuropsychological deficits in BPD and PTSD as well as psychoendocrinological and neuroimaging studies in BPD und PTSD also revealed common features. A pathogenetic specificity of individual etiologic factors does not appear to exist, however the assumption of a diathesis-stress model with traumatisation as a necessary but etiologically insufficient condition seems justified. Further research will have to prove BPD as a complex and early-onset post-traumatic stress disorder after multiple and/or chronic (type II) traumatic experiences during childhood and/or youth. Definitive conclusions require further research efforts.

摘要

关于边缘型人格障碍(BPD)患者创伤经历的高发生率,我们回顾了现有文献,重点关注BPD是创伤相关障碍的一种亚型这一假设。BPD、复杂性创伤后应激障碍(PTSD)以及未另行规定的极端应激障碍(DESNOS)的标准有很大重叠。对BPD和PTSD的长期病程研究、创伤研究以及两种障碍的易感性研究都得出了趋同的结果。BPD和PTSD中的神经心理学缺陷以及BPD和PTSD中的心理内分泌学和神经影像学研究也揭示了共同特征。个体病因因素的发病机制特异性似乎并不存在,然而,以创伤化为必要但病因上不充分条件的素质-应激模型的假设似乎是合理的。进一步的研究将不得不证明BPD是童年和/或青年时期经历多次和/或慢性(II型)创伤后出现的一种复杂且起病较早的创伤后应激障碍。明确的结论需要进一步的研究努力。

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