Vestfold Hospital Trust, Division of Mental Health, Box 2267, Tonsberg, Norway.
Compr Psychiatry. 2013 Feb;54(2):149-57. doi: 10.1016/j.comppsych.2012.07.003. Epub 2012 Sep 18.
This study examined the relationships between affect consciousness (AC) and symptom distress, interpersonal problems, low self-esteem, and the number of PD traits in patients with avoidant personality disorder (APD) and borderline personality disorder (BPD).
Within the setting of a treatment trial, 52 patients with APD or BPD were examined with structured interviews and self-report questionnaires before treatment and at 3-year follow-up. The evaluations included the Affect Consciousness Interview, the SCID-II interview, the Symptom Checklist 90-R, the Circumplex of Interpersonal Problems, and the Index of Self-esteem. A low global level of AC was expected to be associated with the severity of psychopathology; a low AC for interest, joy, and tenderness was expected to be associated with social detachment; and a low AC for anger, contempt, and disgust was expected to be associated with nonassertiveness.
A low AC was associated with interpersonal problems and low self-esteem, but not symptom distress or the number of fulfilled SCID-II criteria. Despite a significant reduction in the psychopathology based on most clinical variables, the associations measured at baseline were maintained after 3years. Examination of specific affect categories showed a pattern of convergent and discriminative relationships with different types of interpersonal problems. A low AC for pleasant affects was specifically related to communion problems, like cold, detached behavior, both at baseline and follow-up. In contrast, a low AC for self-boundary affects was specifically related to agency problems, like non-assertiveness, at follow-up.
Our results showed that a low AC was associated with central domains of psychopathology in patients with PDs. This suggested that AC would be an important focus for treatment and further research in PDs. Future studies are needed to examine how AC is related to various forms of personality pathology.
本研究探讨了回避型人格障碍（APD）和边缘型人格障碍（BPD）患者的情感意识（AC）与症状困扰、人际问题、低自尊和 PD 特征数量之间的关系。
在一项治疗试验中，对 52 名 APD 或 BPD 患者进行了结构访谈和自我报告问卷评估，分别在治疗前和 3 年随访时进行。评估包括情感意识访谈、SCID-II 访谈、症状清单 90-R、人际问题的心境环量表和自尊指数。预计低整体 AC 水平与精神病理学严重程度相关；预计对兴趣、喜悦和温柔的低 AC 与社交分离有关；预计对愤怒、轻蔑和厌恶的低 AC 与非攻击性有关。
低 AC 与人际问题和低自尊有关，但与症状困扰或满足 SCID-II 标准的数量无关。尽管基于大多数临床变量，精神病理学显著降低，但在 3 年后仍保持了基线时测量的关联。对特定情感类别的检查显示出与不同类型的人际问题具有一致和区分性的关系。在基线和随访时，对愉悦情感的低 AC 与共融问题特别相关，如冷漠、分离行为。相比之下，对自我边界情感的低 AC 与代理问题特别相关，如非攻击性，仅在随访时。
我们的研究结果表明，低 AC 与 PD 患者的精神病理学核心领域有关。这表明 AC 将是 PD 治疗和进一步研究的重要重点。未来的研究需要检查 AC 与各种形式的人格病理学之间的关系。
