Central Institute of Mental Health, Mannheim, Germany.
J Pers Disord. 2011 Aug;25(4):432-47. doi: 10.1521/pedi.2011.25.4.432.
A substantial proportion of Borderline Personality Disorder (BPD) patients respond by a marked decrease of psychopathology when treated with Dialectical Behavioral Therapy (DBT). To further enhance the rate of DBT-response, it is useful to identify characteristics related to unsatisfactory response. As DBT relies on emotional learning, we explored whether dissociation-which is known to interfere with learning- predicts poor response to DBT. Fifty-seven Borderline Personality Disorder (BPD) patients (DSM-IV) were prospectively observed during a three-month inpatient DBT program. Pre-post improvements in general psychopathology (SCL-90-R) were predicted from baseline scores of the Dissociative Experiences Scale (DES) by regression models accounting for baseline psychopathology. High DES-scores were related to poor pre-post improvement (β = -0.017 ± 0.006, p = 0.008). The data yielded no evidence that some facets of dissociation are more important in predicting DBT-response than others. The results suggest that dissociation in borderline-patients should be closely monitored and targeted during DBT. At this stage, research on treatment of dissociation (e.g., specific skills training) is warranted.
相当一部分边缘型人格障碍（BPD）患者在接受辩证行为疗法（DBT）治疗后，其精神病理学显著下降。为了进一步提高 DBT 反应率，识别与反应不满意相关的特征是很有用的。由于 DBT 依赖于情绪学习，我们探讨了分离——已知会干扰学习——是否预测 DBT 反应不佳。57 名边缘型人格障碍（BPD）患者（DSM-IV）在三个月的住院 DBT 项目中进行了前瞻性观察。通过回归模型，根据分离体验量表（DES）的基线评分来预测一般精神病理学（SCL-90-R）的前后改善情况，该模型考虑了基线精神病理学。高 DES 评分与前后改善较差相关（β=-0.017±0.006，p=0.008）。数据没有表明，在预测 DBT 反应方面，某些分离方面比其他方面更为重要。结果表明，边缘型人格障碍患者的分离应在 DBT 期间密切监测和靶向治疗。在现阶段，对分离的治疗（例如，特定技能训练）的研究是必要的。
