Schindler Andreas, Sack Peter-Michael
*Department for Personality and Stress Disorders and †German Center for Addiction Research in Childhood and Adolescence, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Nerv Ment Dis. 2015 Nov;203(11):820-6. doi: 10.1097/NMD.0000000000000377.
Studies exploring attachment patterns in samples of patients with borderline personality disorder (BPD) report a combination of preoccupied and fearful-avoidant patterns. This has been interpreted as reflecting the approach-avoidance dilemma of BPD. Comorbid substance use disorders (SUD) have not been considered in these studies, despite the high proportions of SUD among BPD patients and despite the more avoidant attachment in SUD samples. This cross-sectional, naturalistic study explores attachment patterns in a sample of comorbid (BPD and SUD) patients, comparing them to two samples of patients with either SUD or BPD only. Within-group comparisons replicated findings of both preoccupied and fearful-avoidant attachment in BPD and comorbid groups. But between-group comparisons showed that comorbid patients were significantly less preoccupied (p = 0.018) and more dismissing-avoidant (p = 0.030). Although both groups were similar in several psychiatric measures, attachment patterns of the comorbid group were more similar to substance abusers than to borderline patients.
探索边缘型人格障碍（BPD）患者样本中依恋模式的研究报告了一种过度关注型和恐惧-回避型模式的组合。这被解释为反映了BPD的趋近-回避困境。尽管BPD患者中物质使用障碍（SUD）的比例很高，且SUD样本中的依恋更具回避性，但这些研究并未考虑共病的SUD。这项横断面自然主义研究探索了共病（BPD和SUD）患者样本中的依恋模式，并将其与仅患有SUD或BPD的两组患者样本进行比较。组内比较重复了BPD组和共病组中过度关注型和恐惧-回避型依恋的发现。但组间比较显示，共病患者的过度关注程度显著较低（p = 0.018），且更倾向于疏离-回避型（p = 0.030）。尽管两组在多项精神科指标上相似，但共病组的依恋模式与药物滥用者更为相似，而非与边缘型患者相似。
