Centre for Research on Inner City Health, Keenan Research Centre, LiKaShing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
J Abnorm Psychol. 2010 May;119(2):433-9. doi: 10.1037/a0018696.
Variability in mood swings is a characteristic of borderline personality disorder (BPD) and is associated with suicidal behavior. This study investigated patterns of mood variability and whether such patterns could be predicted from demographic and suicide-related psychological risk factors. Eighty-two adults with BPD and histories of recurrent suicidal behavior were recruited from 3 outpatient psychiatric programs in Canada. Experience sampling methodology (ESM) was used to assess negative mood intensity ratings on a visual analogue scale, 6 random times daily, for 21 days. Three-level models estimated variability between times (52.8%), days (22.2%), and patients (25.1%) and supported a quadratic pattern of daily mood variability. Depression scores predicted variability between patients' initial rating of the day. Average daily mood patterns depended on levels of hopelessness, suicide ideation, and sexual abuse history. Patients reporting moderate to severe sexual abuse and elevated suicide ideation were characterized by worsening moods from early morning up through evening, with little or no relief; patients reporting mild sexual abuse and low suicide ideation reported improved mood throughout the day. These patterns, if replicated in larger ESM studies, may potentially assist the clinician in determining which patients require close monitoring.
心境波动的可变性是边缘型人格障碍（BPD）的一个特征，与自杀行为有关。本研究调查了心境可变性的模式，以及这些模式是否可以从人口统计学和与自杀相关的心理风险因素中预测出来。82 名来自加拿大 3 个门诊精神科项目的有反复发作自杀行为史的 BPD 成年人被招募。使用经验采样方法（ESM）在 21 天内每天随机 6 次评估视觉模拟量表上的负性情绪强度评分。三级模型估计了时间（52.8%）、天（22.2%）和患者（25.1%）之间的可变性，并支持每日心境可变性的二次模式。抑郁评分预测了患者对当天初始评分的可变性。平均每日情绪模式取决于绝望、自杀意念和性虐待史的水平。报告中度至重度性虐待和自杀意念升高的患者从清晨到傍晚的情绪逐渐恶化，几乎没有或没有缓解；报告轻度性虐待和自杀意念较低的患者报告全天情绪改善。如果在更大的 ESM 研究中得到复制，这些模式可能有助于临床医生确定哪些患者需要密切监测。
