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[边缘型人格障碍中的神经心理功能障碍:检测策略]

[Neuropsychological dysfunctions in personality borderline disorder: detection strategies].

作者信息

Arza R, Díaz-Marsa M, López-Micó C, de Pablo N Fernández, López-Ibor J J, Carrasco J L

机构信息

Instituto de Psiquiatría y Salud, Mental Hospital, Clínico San Carlos, Madrid, Spain.

出版信息

Actas Esp Psiquiatr. 2009 Jul-Aug;37(4):185-90.

Abstract

INTRODUCTION

Borderline personality disorder (BPD) is characterized by emotional instability and impulsivity. However, there is evidence that neurocognitive alterations have a relevant role in the clinical features of these patients. The present study investigates cognitive function in BPD in order to search for a specific profile of neuropsychological alterations.

METHODS

Based on previous research and cognitive complaints reported by patients, a neuropsychological assessment protocol focused on prefrontal functioning was applied. The applied neuropsychological battery included tests assessing the following cognitive domains: memory (fixation, consolidation and recovery processes) categorical evocation, cognitive flexibility, sustained attention, processing rate, inhibitory control and working memory. The patient sample was recruited from an outpatient BPD unit and was composed by 26 patients (14 women, 12 men) diagnosed of BPD.

RESULTS

In comparison to the normative values, BPD patients have a deficit in the execution of most of the neuropsychological tests. This deficit was especially present in the following: recovery processes of the immediate and differed memory, working memory, sustained attention and processing rate, verbal fluency, impulse control, cognitive flexibility, abstraction and planning.

CONCLUSIONS

BPD patients could present a pattern of neurocognitive alterations that suggests a specific impairment of the prefrontal areas and requires a more detailed study. The neuropsychological dysfunctions could partially explain the behavioral alterations in BPD patients.

摘要

引言

边缘型人格障碍(BPD)的特征是情绪不稳定和冲动。然而,有证据表明神经认知改变在这些患者的临床特征中起相关作用。本研究调查BPD患者的认知功能,以寻找神经心理学改变的特定模式。

方法

基于先前的研究以及患者报告的认知主诉,应用了一项侧重于前额叶功能的神经心理学评估方案。所应用的神经心理成套测验包括评估以下认知领域的测试:记忆(固定、巩固和恢复过程)、分类唤起、认知灵活性、持续注意力、处理速度、抑制控制和工作记忆。患者样本来自一个门诊BPD科室,由26名被诊断为BPD的患者组成(14名女性,12名男性)。

结果

与常模值相比,BPD患者在大多数神经心理学测试的执行方面存在缺陷。这种缺陷尤其体现在以下方面:即时和延迟记忆的恢复过程、工作记忆、持续注意力和处理速度、言语流畅性、冲动控制、认知灵活性、抽象和计划。

结论

BPD患者可能呈现出一种神经认知改变模式,提示前额叶区域存在特定损害,需要更详细的研究。神经心理学功能障碍可能部分解释了BPD患者的行为改变。

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