边缘型人格障碍与性行为前经常饮酒。
Borderline personality disorder and regularly drinking alcohol before sex.
作者信息
Thompson Ronald G, Eaton Nicholas R, Hu Mei-Chen, Hasin Deborah S
机构信息
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
Department of Psychology, Stony Brook University, New York, USA.
出版信息
Drug Alcohol Rev. 2017 Jul;36(4):540-545. doi: 10.1111/dar.12476. Epub 2017 Mar 20.
INTRODUCTION AND AIMS
Drinking alcohol before sex increases the likelihood of engaging in unprotected intercourse, having multiple sexual partners and becoming infected with sexually transmitted infections. Borderline personality disorder (BPD), a complex psychiatric disorder characterised by pervasive instability in emotional regulation, self-image, interpersonal relationships and impulse control, is associated with substance use disorders and sexual risk behaviours. However, no study has examined the relationship between BPD and drinking alcohol before sex in the USA. This study examined the association between BPD and regularly drinking before sex in a nationally representative adult sample.
DESIGN AND METHODS
Participants were 17 491 sexually active drinkers from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models estimated effects of BPD diagnosis, specific borderline diagnostic criteria and BPD criterion count on the likelihood of regularly (mostly or always) drinking alcohol before sex, adjusted for controls.
RESULTS
Borderline personality disorder diagnosis doubled the odds of regularly drinking before sex [adjusted odds ratio (AOR) = 2.26; confidence interval (CI) = 1.63, 3.14]. Of nine diagnostic criteria, impulsivity in areas that are self-damaging remained a significant predictor of regularly drinking before sex (AOR = 1.82; CI = 1.42, 2.35). The odds of regularly drinking before sex increased by 20% for each endorsed criterion (AOR = 1.20; CI = 1.14, 1.27) DISCUSSION AND CONCLUSIONS: This is the first study to examine the relationship between BPD and regularly drinking alcohol before sex in the USA. Substance misuse treatment should assess regularly drinking before sex, particularly among patients with BPD, and BPD treatment should assess risk at the intersection of impulsivity, sexual behaviour and substance use. [Thompson Jr RG, Eaton NR, Hu M-C, Hasin DS Borderline personality disorder and regularly drinking alcohol before sex Drug Alcohol Rev 2017;36:540-545].
引言与目的
性行为前饮酒会增加无保护性行为、拥有多个性伴侣以及感染性传播感染的可能性。边缘性人格障碍（BPD）是一种复杂的精神疾病，其特征是在情绪调节、自我形象、人际关系和冲动控制方面普遍存在不稳定，与物质使用障碍和性风险行为有关。然而，在美国，尚无研究探讨BPD与性行为前饮酒之间的关系。本研究在一个具有全国代表性的成年样本中，考察了BPD与性行为前经常饮酒之间的关联。
设计与方法
参与者来自全国酒精及相关状况流行病学调查第二轮中的17491名性活跃饮酒者。逻辑回归模型估计了BPD诊断、特定边缘性诊断标准和BPD标准数量对性行为前经常（大多或总是）饮酒可能性的影响，并对对照因素进行了调整。
结果
边缘性人格障碍诊断使性行为前经常饮酒的几率增加了一倍[调整后的优势比（AOR）=2.26；置信区间（CI）=1.63，3.14]。在九个诊断标准中，自我伤害领域的冲动性仍然是性行为前经常饮酒的一个重要预测因素（AOR=1.82；CI=1.42，2.35）。每认可一个标准因素，性行为前经常饮酒的几率就增加20%（AOR=1.20；CI=1.14，1.27）。
讨论与结论
这是美国第一项研究BPD与性行为前经常饮酒之间关系的研究。物质滥用治疗应评估性行为前的经常饮酒情况，尤其是在BPD患者中，而BPD治疗应评估冲动性、性行为和物质使用交叉点处的风险。[小汤普森RG，伊顿NR，胡M-C，哈辛DS边缘性人格障碍与性行为前经常饮酒《药物与酒精评论》2017；36：540-545]
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