医疗环境中的破坏性行为与边缘型人格。

Disruptive behaviors in the medical setting and borderline personality.

机构信息

Wright State University and Kettering Medical Center, Ohio, USA.

出版信息

Int J Psychiatry Med. 2011;41(4):355-63. doi: 10.2190/PM.41.4.e.

DOI:10.2190/PM.41.4.e

PMID:22238840

Abstract

OBJECTIVE

Borderline personality disorder (BPD) is characterized in the DSM by anger. While previous studies have examined various types of externalized aggression and violence among individuals with BPD, we are aware of no investigations of disruptive behaviors perpetrated by patients with BPD in medical settings-the focus of the present study.

METHOD

Using a cross-sectional, consecutive sample of internal medicine outpatients from a resident provider clinic, we surveyed 397 participants regarding 17 disruptive behaviors related to medical personnel and assessed BPD using two self-report measures, the BPD scale of the Personality Diagnostic Questionnaire-4 (PDQ-4) and the Self-Harm Inventory (SHI).

RESULTS

A statistically significantly greater proportion of respondents who exceeded the clinical cut-off scores for BPD on both the PDQ-4 and SHI endorsed at least one form of disruptive behavior. However, there were no differences between participants with versus without BPD symptomatology regarding the number of different forms of disruptive behaviors after that initial threshold of one such behavior was reached. Several specific disruptive behaviors were reported more often in those with BPD symptomatology (i.e., yelling, screaming, verbally threatening, and refusing to talk with medical staff as well as talking badly about medical staff to the patients' friends and family).

CONCLUSIONS

BPD appears to be associated with a greater likelihood of disruptive behaviors in the medical setting, but not physical threat.

摘要

目的

边缘型人格障碍（BPD）在 DSM 中以愤怒为特征。虽然先前的研究已经检查了 BPD 个体的各种类型的外化攻击和暴力行为，但我们不知道有任何研究调查 BPD 患者在医疗环境中的破坏性行为 - 这是本研究的重点。

方法

使用居民提供者诊所的内科门诊患者的横断面连续样本，我们调查了 397 名参与者，询问了与医疗人员有关的 17 种破坏性行为，并使用两种自我报告措施评估了 BPD，即人格诊断问卷-4（PDQ-4）的 BPD 量表和自伤清单（SHI）。

结果

在 PDQ-4 和 SHI 上都超过 BPD 临床临界分数的受访者中，有统计学上显著更高比例的人至少有一种形式的破坏性行为。然而，在达到这种行为的初始阈值之后，有 BPD 症状和没有 BPD 症状的参与者之间，破坏性行为的不同形式的数量没有差异。有 BPD 症状的参与者报告了更多的几种特定的破坏性行为（即，大喊大叫，尖叫，口头威胁，拒绝与医务人员交谈，以及对医务人员向患者的朋友和家人说坏话）。