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[创伤后的人格障碍与精神病理学。对诊断分类的思考]

[Personality disorders and psychopathology following trauma. Reflection on diagnostic classification].

作者信息

Wöller W, Kruse J

机构信息

Klinik Wersbach, Klinik für Psychosomatische Medizin und Psychotherapie, Leichlingen-Witzhelden.

出版信息

Nervenarzt. 2003 Nov;74(11):972-6. doi: 10.1007/s00115-003-1492-7.

Abstract

Pervasive personality disorders have been shown to be long-term sequelae of cumulative childhood physical and sexual traumatization. This finding is not reflected in DSM-IV and ICD-10 classifications where post-traumatic stress disorder is confined to intrusions, avoidance, numbing, and hyperarousal. However, there is growing evidence that trauma etiology should be taken into account in planning treatment for personality disorders. It is not yet clear whether childhood traumatization is more strongly associated with borderline personality disorder than with other personality disorders. The finding of a substantial overlap between borderline personality disorder and dissociative identity disorder gives rise to discussions concerning the relationship of these two pathologies.

摘要

广泛性人格障碍已被证明是童年期累积的身体和性创伤的长期后遗症。这一发现并未反映在《精神疾病诊断与统计手册》第四版(DSM-IV)和《国际疾病分类》第十版(ICD-10)的分类中,在这些分类中,创伤后应激障碍仅限于侵入性症状、回避、麻木和过度警觉。然而,越来越多的证据表明,在规划人格障碍的治疗时应考虑创伤病因。童年创伤与边缘型人格障碍的关联是否比与其他人格障碍的关联更强,目前尚不清楚。边缘型人格障碍和解离性身份障碍之间存在大量重叠的这一发现引发了关于这两种病理关系的讨论。

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