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刚出煎锅,又入火坑:日常生活中边缘型和回避型人格障碍患者对社交亲近的混合情感反应。

Out of the frying pan, into the fire: mixed affective reactions to social proximity in borderline and avoidant personality disorders in daily life.

作者信息

Gadassi Reuma, Snir Avigal, Berenson Kathy, Downey Geraldine, Rafaeli Eshkol

机构信息

Department of Psychology, Bar-Ilan University.

Department of Psychology, Gettysburg College.

出版信息

J Abnorm Psychol. 2014 Aug;123(3):613-22. doi: 10.1037/a0036929. Epub 2014 Jun 16.

Abstract

Social proximity typically helps individuals meet their belongingness needs, but several forms of psychopathology, including borderline and avoidant personality disorders (BPD and APD, respectively) are characterized by social difficulties. This experience-sampling study is one of the first to directly investigate the affective reactions of individuals with BPD and APD (compared with healthy controls [HC]) to social proximity in daily life. We examined both person-level and day-level reactions. At the person level, the rate of social proximity across the diary period was associated with diminished feelings of rejection, isolation, shame, and dissociation in the HC group. In contrast, it was not associated with any affective reaction in the BPD group, and was associated with decreased rejection and isolation on the one hand, but also with increased anxiety in the APD group. At the day level, we used multilevel regression to examine affective reactions when in social proximity. The HC group showed a consistent benefit when in social proximity. In contrast, both PD groups exhibited mixed affective reactions to social proximity; specifically, benefits (increased positive affect, decreased rejection, isolation, and dissociation) were interspersed with costs (increased shame for both PD groups; increased anger for BPD; increased anxiety for APD). The mixed reactions found in both PDs may contribute to the disturbed relationships of individuals with these disorders.

摘要

社交亲近通常有助于个体满足其归属感需求,但包括边缘型人格障碍和回避型人格障碍(分别为BPD和APD)在内的几种精神病理学形式的特征是存在社交困难。这项经验取样研究是首批直接调查BPD和APD患者(与健康对照组[HC]相比)在日常生活中对社交亲近的情感反应的研究之一。我们考察了个体层面和每日层面的反应。在个体层面,整个日记记录期间的社交亲近率与HC组中被拒绝感、孤独感、羞耻感和解离感的减轻相关。相比之下,它与BPD组的任何情感反应均无关联,在APD组中一方面与被拒绝感和孤独感的降低相关,但也与焦虑感的增加相关。在每日层面,我们使用多层次回归来考察处于社交亲近状态时的情感反应。HC组在处于社交亲近状态时显示出持续的益处。相比之下,两个患有PD的组对社交亲近均表现出混合的情感反应;具体而言,益处(积极情感增加、被拒绝感、孤独感和解离感降低)与代价(两个患有PD的组羞耻感增加;BPD组愤怒感增加;APD组焦虑感增加)相互交织。在两种患有PD的情况下发现的这种混合反应可能导致患有这些障碍的个体出现关系紊乱。

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