Dammann Gerhard, Riemenschneider Anke, Walter Marc, Sollberger Daniel, Küchenhoff Joachim, Gündel Harald, Clarkin John F, Gremaud-Heitz Daniela J
Psychiatric Hospital, University of Basel, Basel, Switzerland.
Psychopathology. 2016;49(3):172-80. doi: 10.1159/000446661. Epub 2016 Jun 29.
Borderline personality disorder (BPD) is a very common illness; interpersonal problems are one of the core features. The purpose of this study was to investigate the changes in interpersonal problems after transference-focused psychotherapy (TFP)-based disorder-specific treatment and to explore whether the severity of interpersonal problems could serve as a predictor for other variables.
A sample of 37 inpatients with BPD was assessed with the Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID I and II) and had to complete a questionnaire including the Inventory of Interpersonal Problems (IIP-C), Inventory of Personality Organization (IPO), Beck Depression Inventory (BDI), Spielberger State and Trait Inventory (STAI), Spielberger State and Trait Anger Inventory (STAXI), and Symptom Checklist-90 (SCL-90-R). After 12 weeks of TFP-based disorder-specific treatment, the patients repeated the same questionnaire; 7 patients had to be excluded from the study, and thus calculations were conducted with 30 patients.
After treatment, the patients showed a significant decrease in the IIP total item score and all 8 subscales except the domineering, intrusive, and cold scales. The IIP total item baseline score was correlated with borderline symptomatic and psychopathology [e.g. anxiety, Global Severity Index (GSI)] after 12 weeks as well as with most IIP postsubscales.
Although interpersonal problems are considered one of the more stable features of BPD, our results showed a significant improvement after 12 weeks of TFP-based disorder-specific inpatient treatment, especially in the total score and the subscales on the friendly submissive level. The severity of interpersonal problems at baseline was connected to outcome values of other borderline features as well as general psychiatric complaints. It therefore seems important to consider the treatment of interpersonal problems in therapy to be of greater significance.
边缘型人格障碍(BPD)是一种非常常见的疾病;人际问题是其核心特征之一。本研究的目的是调查基于移情焦点心理治疗(TFP)的针对性障碍治疗后人际问题的变化,并探讨人际问题的严重程度是否可作为其他变量的预测指标。
对37名BPD住院患者进行了《精神疾病诊断与统计手册》第四版轴I和轴II障碍的结构化临床访谈(SCID I和II)评估,并要求他们完成一份问卷,包括人际问题量表(IIP-C)、人格组织量表(IPO)、贝克抑郁量表(BDI)、斯皮尔伯格状态与特质焦虑量表(STAI)、斯皮尔伯格状态与特质愤怒量表(STAXI)以及症状自评量表90(SCL-90-R)。经过12周基于TFP的针对性障碍治疗后,患者重复填写相同问卷;7名患者被排除在研究之外,因此对30名患者进行了计算。
治疗后,患者的IIP总项目得分以及除专横、侵扰和冷漠量表外的所有8个分量表均显著下降。IIP总项目基线得分与12周后的边缘症状和精神病理学[如焦虑、总体严重程度指数(GSI)]以及大多数IIP后分量表相关。
尽管人际问题被认为是BPD较为稳定的特征之一,但我们的结果显示,经过12周基于TFP的针对性住院治疗后有显著改善,尤其是在总分以及友好顺从水平的分量表上。基线时人际问题的严重程度与其他边缘特征的结果值以及一般精神症状相关。因此,在治疗中考虑人际问题的治疗似乎具有更重要的意义。