Scott Lori N, Stepp Stephanie D, Hallquist Michael N, Whalen Diana J, Wright Aidan G C, Pilkonis Paul A
Department of Psychiatry, University of Pittsburgh School of Medicine.
Department of Psychology, University of Pittsburgh.
Personal Disord. 2015 Jan;6(1):53-63. doi: 10.1037/per0000107.
Recent theoretical and empirical work suggests that adults with borderline personality disorder (BPD) have difficulty regulating both shame and anger, and that these emotions may be functionally related in clinically relevant ways (e.g., Schoenleber & Berenbaum, 2012b). The covariation of shame with anger-related emotions has important clinical implications for interventions targeting shame and uncontrolled anger in BPD. However, no studies have examined shame, anger, and their covariation in adolescents who may be at risk for developing BPD. Therefore, this study focuses on associations between BPD symptoms and patterns of covariation between daily experiences of shame and anger-related affects (i.e., hostile irritability) in a community sample of adolescent girls using ecological momentary assessment. Multilevel models revealed that girls with greater BPD symptoms who reported greater mean levels of shame across the week also tended to report more hostile irritability, even after controlling for guilt. Additionally, examination of within-person variability showed that girls with greater BPD symptoms reported more hostile irritability on occasions when they also reported greater concurrent shame, but this was only the case in girls of average socioeconomic status (i.e., those not receiving public assistance). Unlike shame, guilt was not associated with hostile irritability in girls with greater BPD symptoms. Results suggest that shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms.
近期的理论和实证研究表明,患有边缘型人格障碍(BPD)的成年人在调节羞耻感和愤怒情绪方面存在困难,并且这些情绪在临床上可能以相关方式相互关联(例如,舍恩勒伯和贝伦鲍姆,2012b)。羞耻感与愤怒相关情绪的共变对针对BPD中羞耻感和失控愤怒的干预措施具有重要的临床意义。然而,尚无研究考察可能有患BPD风险的青少年的羞耻感、愤怒情绪及其共变情况。因此,本研究聚焦于在一个青少年女孩社区样本中,使用生态瞬时评估法探究BPD症状与羞耻感和愤怒相关情绪(即敌意易怒)的日常体验之间的共变模式的关联。多层次模型显示,在一周内报告羞耻感平均水平较高的、具有更严重BPD症状的女孩,即使在控制了内疚感之后,也往往报告有更多的敌意易怒情绪。此外,对个体内部变异性的考察表明,具有更严重BPD症状的女孩在报告同时出现更高水平羞耻感的情况下,会报告更多的敌意易怒情绪,但这种情况仅发生在社会经济地位中等的女孩中(即那些未接受公共援助的女孩)与之不同的是,内疚感与具有更严重BPD症状的女孩的敌意易怒情绪无关。研究结果表明,羞耻感可能是治疗有BPD症状的青少年女孩愤怒相关问题的关键临床靶点。