Department of Social and General Psychiatry, Psychiatric University Hospital Zürich, Switzerland.
Eur Arch Psychiatry Clin Neurosci. 2011 Aug;261(5):369-76. doi: 10.1007/s00406-010-0174-2. Epub 2010 Dec 5.
Disgust may be a key emotion and target for psychotherapeutic interventions in borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) at explicit and implicit-automatic levels. However, automatically activated disgust reactions in individuals with these disorders have not been studied. Disgust and its correlation with childhood abuse were assessed in women with BPD, but without PTSD; women with PTSD, but without BPD; women with BPD and PTSD; and healthy women. Disgust sensitivity, anxiety and depression were measured by self-report. Implicit disgust-prone (relative to anxiety-prone) self-concept was assessed using the Implicit Association Test. Women with BPD and/or PTSD reported more disgust sensitivity than controls. The implicit self-concept among patients was more disgust-prone (relative to anxiety-prone) than in controls. Women with BPD, with PTSD, or BPD and PTSD did not differ significantly in self-reported disgust levels or implicit disgust-related self-concept. Among women with BPD and/or PTSD, current psychiatric comorbidity (major depression, anxiety disorder, eating disorder, or substance-related disorder) did not affect disgust-related variables. More severe physical abuse in childhood was associated with a more anxiety-prone (less disgust-prone) implicit self-concept. Independent of psychiatric comorbidity, disgust appears to be elevated at implicit and explicit levels in trauma-related disorders. Psychotherapeutic approaches to address disgust should take implicit processes into account.
厌恶可能是边缘型人格障碍 (BPD) 和创伤后应激障碍 (PTSD) 患者在意识和自动潜意识层面进行心理治疗干预的关键情绪和目标。然而，这些障碍患者的自动激活的厌恶反应尚未得到研究。在患有 BPD 但没有 PTSD 的女性、患有 PTSD 但没有 BPD 的女性、患有 BPD 和 PTSD 的女性以及健康女性中，评估了厌恶及其与儿童期虐待的相关性。通过自我报告评估了厌恶敏感性、焦虑和抑郁。使用内隐联想测验评估了内隐易产生厌恶（相对于易产生焦虑）的自我概念。患有 BPD 和/或 PTSD 的女性比对照组报告了更高的厌恶敏感性。与对照组相比，患者的内隐自我概念更容易产生厌恶（相对于焦虑）。患有 BPD、PTSD 或 BPD 和 PTSD 的女性在自我报告的厌恶水平或内隐与厌恶相关的自我概念方面没有显著差异。在患有 BPD 和/或 PTSD 的女性中，当前的精神共病（重度抑郁症、焦虑症、饮食失调症或物质相关障碍）不会影响与厌恶相关的变量。在童年时期遭受更严重的身体虐待与更易产生焦虑（不易产生厌恶）的内隐自我概念有关。独立于精神共病，在与创伤相关的障碍中，厌恶在意识和潜意识层面上似乎都升高了。针对厌恶的心理治疗方法应该考虑到潜意识过程。
