Lyons-Ruth Karlen, Brumariu Laura E, Bureau Jean-Francois, Hennighausen Katherine, Holmes Bjarne
Department of Psychiatry, Harvard Medical School, Cambridge, Massachusetts.
Department of Psychology, Derner Institute, Adelphi University, Garden City, New York.
J Pers Disord. 2015 Oct;29(5):641-62. doi: 10.1521/pedi_2014_28_165. Epub 2014 Sep 23.
Borderline symptoms are thought to emerge from the interaction of temperamental factors and environmental stressors. Both parental invalidation and attachment disorganization have been hypothesized to play an etiological role. However, to date the quality of parent-child interaction has not been observed directly. In this study, 120 young adults were assessed for features of borderline personality disorder on the SCID II, for severity of childhood maltreatment on interview and self-report measures, and for disturbance in parent-child interaction during a videotaped conflict discussion task. Borderline traits, as well as suicidality/self-injury specifically, were associated with more role confusion and more disoriented behavior in interaction with the parent. Among young adults with recurrent suicidality/self-injury, 40% displayed high levels of role confusion compared to 16% of those who were not suicidal. Neither form of disturbed interaction mediated the independent effect of childhood abuse on borderline symptoms. A parent-child transactional model is proposed to account for the findings.
边缘型症状被认为源于气质因素与环境压力源的相互作用。父母的无效回应和依恋紊乱都被假定在病因学上起作用。然而，迄今为止，亲子互动的质量尚未得到直接观察。在本研究中，120名年轻成年人接受了评估，包括使用《精神疾病诊断与统计手册》第二版（SCID II）评估边缘型人格障碍特征、通过访谈和自我报告测量童年虐待的严重程度，以及在录像的冲突讨论任务中评估亲子互动的紊乱情况。边缘型特质，尤其是自杀观念/自我伤害，与在与父母互动中更多的角色混乱和更无方向的行为相关。在有反复自杀观念/自我伤害行为的年轻成年人中，40%表现出高水平的角色混乱，而无自杀行为的人中这一比例为16%。两种形式的紊乱互动均未介导童年虐待对边缘型症状的独立影响。本文提出了一个亲子交互模型来解释这些发现。
