Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada; Department of Psychiatry and Behavioral Sciences, University of Washington Medical Center, Seattle, WA, USA.
Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
Psychiatry Res. 2015 Nov 30;230(1):28-35. doi: 10.1016/j.psychres.2015.07.058. Epub 2015 Jul 21.
Although non-suicidal self-injury (NSSI) occurs in people with and without borderline personality disorder (BPD), few studies have compared the clinical characteristics of these two groups. The present study sampled adults with a history of NSSI and compared those with and without BPD on (a) NSSI features, (b) co-occurring psychiatric disorders, and (c) severity of depression, suicidal ideation and emotion dysregulation. Participants (NSSI+BPD, n=46; NSSI Only, n=54) completed semi-structured interviews and self-report measures. Whereas the groups did not differ in age of NSSI onset, the NSSI+BPD group engaged in more frequent, recent and severe NSSI, and reported higher rates of skin carving, head banging, self-punching and self-scratching than the NSSI Only group. Participants with BPD also showed greater diagnostic comorbidity, particularly for anxiety disorders, but did not differ from participants without BPD in rates of mood, substance or psychotic disorders. The NSSI+BPD group reported more severe depressive symptomatology, suicidal ideation and emotion dysregulation than the NSSI Only group. Supplementary analyses on the subset of participants with recent (past year) NSSI revealed similarly medium to large differences between those with and without BPD. Implications for assessment and treatment are discussed.
尽管非自杀性自伤（NSSI）发生在患有和不患有边缘型人格障碍（BPD）的人群中，但很少有研究比较这两组人群的临床特征。本研究对有 NSSI 病史的成年人进行了抽样，并比较了有和没有 BPD 的人群在（a）NSSI 特征、（b）共病精神障碍，以及（c）抑郁、自杀意念和情绪失调严重程度方面的差异。参与者（NSSI+BPD，n=46；NSSI 仅，n=54）完成了半结构化访谈和自我报告量表。虽然两组人群的 NSSI 起始年龄没有差异，但 NSSI+BPD 组的 NSSI 更频繁、更近期、更严重，并且报告的皮肤切割、头撞、自我拳击和自我抓挠的发生率高于 NSSI 仅组。患有 BPD 的参与者还表现出更高的诊断共病率，特别是焦虑障碍，但在心境、物质或精神病障碍的发生率方面与没有 BPD 的参与者没有差异。NSSI+BPD 组报告的抑郁症状、自杀意念和情绪失调比 NSSI 仅组更严重。对最近（过去一年）有 NSSI 的参与者子集进行的补充分析显示，有和没有 BPD 的参与者之间存在类似的中等至大差异。讨论了评估和治疗的意义。
