Braakmann Diana, Ludewig Sonia, Milde Jork, Stiglmayr Christian E, Hüppe Michael, Sipos Valerija, Schweiger Ulrich
Klinik für Psychiatrie und Psychotherapie, Universität zu Lübeck, Augustenstrasse 12, 23564 Lübeck.
Psychother Psychosom Med Psychol. 2007 Mar-Apr;57(3-4):154-60. doi: 10.1055/s-2006-951944.
There are hints for a negative predictive power of dissociative states for treatment outcome in patients with borderline personality disorder. A possible explanation is the alteration of information processing associated with dissociation. Dissociative states can be influenced by specific psychotherapeutic interventions. 30 patients with borderline personality disorder were assessed with self-report questionnaires to evaluate dissociation and psychopathology before and after treatment with Dialectic Behavior Therapy. As found in recent studies, dissociation before treatment was correlated to general psychopathology at treatment end. In contrast to the core hypothesis, patients with high initial dissociation did not present less improvement than those with lower initial degrees regarding the parameters of general psychopathology, anxiety, depression and psychosocial functioning. In terms of the parameter of dissociation, patients with high degrees of initial dissociation even achieved the highest extent of relative symptom reduction. This astonishing result can be explained by the treatment setting which to a high extent provided specific psychoeducation and treatment concerning dissociative behavior.
有迹象表明，分离状态对边缘型人格障碍患者的治疗结果具有阴性预测力。一种可能的解释是与分离相关的信息处理改变。分离状态可受特定心理治疗干预的影响。对30例边缘型人格障碍患者在接受辩证行为疗法治疗前后，采用自我报告问卷进行评估，以评价分离及精神病理学情况。正如最近研究所发现的，治疗前的分离与治疗结束时的总体精神病理学相关。与核心假设相反，就总体精神病理学、焦虑、抑郁及社会心理功能参数而言，初始分离程度高的患者与初始分离程度低的患者相比，改善程度并不更低。就分离参数而言，初始分离程度高的患者甚至实现了相对症状减轻的最大程度。这一惊人结果可以通过治疗环境来解释，该治疗环境在很大程度上提供了有关分离行为的特定心理教育和治疗。
