边缘型人格障碍与抑郁障碍及健康对照者相比精神痛苦的特异性。
The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls.
机构信息
Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA ; New York State Psychiatric Institute, New York, NY USA.
Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, USA.
出版信息
Borderline Personal Disord Emot Dysregul. 2016 Feb 24;3:2. doi: 10.1186/s40479-016-0036-2. eCollection 2016.
BACKGROUND
Individuals with Borderline Personality Disorder (BPD) may experience a qualitatively distinct depression which includes "mental pain." Mental pain includes chronic, aversive emotions, negative self-concept, and a sense of pervasive helplessness. The present study investigated whether mental pain is elevated in BPD compared to Depressive Disorders (DD) without BPD.
METHODS
The Orbach and Mikulincer Mental Pain Scale (OMMP) was administered to BPD (N = 57), DD (N = 22), and healthy controls (N = 31). The OMMP assesses total mental pain, comprised of nine subtypes: irreversibility, loss of control, narcissistic wounds, emotional flooding, freezing, self-estrangement, confusion, social distancing, and emptiness. Co-occurring psychiatric diagnoses, depression severity, and other potentially confounding clinical and demographic variables were also assessed.
RESULTS
The total Mental Pain score did not differentiate BPD from DD. Moreover, most of the subscales of the OMMP were not significantly different in BPD compared to DD. However, the elevation of mental pain subscale "narcissistic wounds," characterized by feeling rejected and having low self-worth, was a specific predictor of BPD status and the severity of BPD symptoms.
CONCLUSION
On OMMP total score, mental pain was similarly elevated in BPD and DD. However, the narcissistic wounds sub-type of mental pain was a sensitive and specific diagnostic indicator of BPD and, therefore, may be an important aspect of BPD in need of increased focus in assessment and theoretical models.
背景
边缘型人格障碍（BPD）患者可能会经历一种与抑郁障碍（DD）不同的抑郁体验，这种抑郁体验包括“精神痛苦”。精神痛苦包括慢性、痛苦的情绪、消极的自我概念以及普遍无助的感觉。本研究旨在调查与无 BPD 的 DD 相比，BPD 患者的精神痛苦是否更高。
方法
使用奥巴赫和米库林策尔精神痛苦量表（OMMP）对 BPD（N=57）、DD（N=22）和健康对照组（N=31）进行评估。OMMP 评估总精神痛苦，由九个亚类组成：不可逆转、失去控制、自恋伤口、情绪淹没、冻结、自我疏远、困惑、社会疏远和空虚。还评估了共病的精神诊断、抑郁严重程度和其他潜在的混杂临床和人口统计学变量。
结果
BPD 与 DD 之间的总精神痛苦评分没有差异。此外，与 DD 相比，OMMP 的大多数亚量表在 BPD 中没有显著差异。然而，精神痛苦亚量表“自恋伤口”的升高，其特征是感到被拒绝和自我价值感低，是 BPD 状态和 BPD 症状严重程度的一个特定预测指标。
结论
在 OMMP 总分上，BPD 和 DD 的精神痛苦程度相似。然而，精神痛苦的自恋伤口亚型是 BPD 的敏感和特异性诊断指标，因此，可能是评估和理论模型中需要更加关注的 BPD 的一个重要方面。
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