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解析边缘型人格障碍中的情感失调:一个理论模型与实证证据

Unraveling affective dysregulation in borderline personality disorder: a theoretical model and empirical evidence.

作者信息

Ebner-Priemer Ulrich W, Houben Marlies, Santangelo Philip, Kleindienst Nikolaus, Tuerlinckx Francis, Oravecz Zita, Verleysen Gregory, Van Deun Katrijn, Bohus Martin, Kuppens Peter

机构信息

Karlsruhe Institute of Technology.

Faculty of Psychology and Educational Sciences, KU Leuven.

出版信息

J Abnorm Psychol. 2015 Feb;124(1):186-98. doi: 10.1037/abn0000021. Epub 2015 Jan 19.

Abstract

Although emotion dysregulation has consistently been conceptualized as a core problem of borderline personality disorder (BPD), a comprehensive, and empirically and ecologically validated model that captures the exact types of dysregulation remains absent. In the present article, we combine insights from basic affective science and the biosocial theory of BPD to present a theoretical model that captures the most fundamental affective dynamical processes that underlie BPD and stipulates that individuals with BPD are characterized by more negative affective homebases, higher levels of affective variability, and lower levels of attractor strength or return to baseline. Next, we empirically validate this proposal by statistically modeling data from three electronic diary studies on emotional responses to personally relevant stimuli in personally relevant environments that were collected both from patients with BPD (N = 50, 42, and 43) and from healthy subjects (N = 50, 24, and 28). The results regarding negative affective homebases and heightened affective variabilities consistently confirmed our hypotheses across all three datasets. The findings regarding attractor strengths (i.e., return to baseline) were less consistent and of smaller magnitude. The transdiagnostic nature of our approach may help to elucidate the common and distinctive mechanisms that underlie several different disorders that are characterized by affective dysregulation.

摘要

尽管情绪失调一直被视为边缘性人格障碍(BPD)的核心问题,但目前仍缺乏一个全面的、经过实证和生态验证的模型来准确描述失调的具体类型。在本文中,我们结合基础情感科学和BPD的生物社会理论的见解,提出一个理论模型,该模型捕捉了BPD背后最基本的情感动态过程,并指出BPD患者的特征是更消极的情感基础、更高的情感变异性,以及更低的吸引子强度或回归基线水平。接下来,我们通过对三项电子日记研究的数据进行统计建模来实证验证这一假设,这些研究收集了BPD患者(N = 50、42和43)和健康受试者(N = 50、24和28)在个人相关环境中对个人相关刺激的情绪反应。关于消极情感基础和情感变异性增加的结果在所有三个数据集中都一致证实了我们的假设。关于吸引子强度(即回归基线)的结果不太一致,且幅度较小。我们方法的跨诊断性质可能有助于阐明几种以情感失调为特征的不同障碍背后的共同和独特机制。

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