Judd Patricia Hoffman
University of California, San Diego, Department of Psychiatry, Outpatient Psychiatric Services, 92103, USA.
Dev Psychopathol. 2005 Fall;17(4):1173-96. doi: 10.1017/s0954579405050558.
Borderline personality disorder (BPD) is characterized by a pervasive instability of interpersonal relationships, affects, self-image, marked impulsivity, dissociation, and paranoia. The cognitive dimension of the disorder has received relatively little attention and is poorly understood. This paper proposes that neurocognitive impairment is a key moderator in the development of BPD and elaborates a possible pathway for the expression of the cognitive domain. Neurocognitive impairment is hypothesized to moderate the relationship between caretaking and insecure disorganized attachment and pathological dissociation in the formation of the disorder contributing to impaired metacognition and a range of cognitive difficulties. The empirical evidence from studies of cognitive processes, brain function, attachment, and dissociation that support this theory are reviewed and discussed. Areas for future research that might verify or refute this theory are suggested.
边缘型人格障碍（BPD）的特征是人际关系、情感、自我形象普遍不稳定，存在明显的冲动性、解离和偏执。该障碍的认知维度相对较少受到关注，人们对此了解不足。本文提出神经认知障碍是BPD发展的关键调节因素，并阐述了认知领域表达的可能途径。据推测，神经认知障碍会调节照顾与不安全混乱依恋以及病理性解离之间的关系，在该障碍形成过程中导致元认知受损和一系列认知困难。本文回顾并讨论了来自认知过程、脑功能、依恋和解离研究的支持这一理论的实证证据。还提出了未来可能验证或反驳该理论的研究领域。
