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社交排斥对边缘型人格障碍和重度抑郁症患者反应抑制的影响。

The effects of social exclusion on response inhibition in borderline personality disorder and major depression.

机构信息

Sigmund-Freud-Institut, Frankfurt, Germany.

Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe University Hospital, Frankfurt, Germany.

出版信息

Psychiatry Res. 2018 Apr;262:333-339. doi: 10.1016/j.psychres.2017.03.034. Epub 2017 Mar 28.

Abstract

It is a prevalent notion that borderline personality disorder (BPD) is characterized by deficits in executive functions (EF) like inhibition. Yet experimental studies yield inconsistent results. However, despite emotional dysregulation being a core feature of BPD, most paradigms did not control for emotional state or comorbid mental disorders. In the present study, subjects with BPD and comorbid MDD (BPD+MDD), with major depression (MDD) and healthy controls (HC) partook in a social exclusion paradigm combined with an inhibition task. We expected inhibition to be more strongly impaired in BPD+MDD than in depression and HC when experiencing negative emotions. Respecting inhibition, depressed patients performed best while (BPD+MDD) patients performed worst. Surprisingly, MDD & HC participants' performance improved during social exclusion, but this was not the case for BPD+MDD. Inhibition deficits were correlated with childhood trauma. These results challenge the hypothesis that an induction of negative emotion results in inferior inhibition in (BPD+MDD). Instead, patients with (BPD+MDD) seem to suffer from a more general inhibitory dysfunction. Importantly, (BPD+MDD) patients were not able to improve their performance during social exclusion like HC and MDD patients did. These findings need to be investigated further, particularly regarding the efficiency of neural networks regulating inhibition and effects of trauma.

摘要

有一种普遍的观点认为,边缘型人格障碍(BPD)的特征是抑制等执行功能(EF)缺陷。然而,实验研究的结果并不一致。然而,尽管情绪失调是 BPD 的核心特征,但大多数范式并没有控制情绪状态或共病精神障碍。在本研究中,患有 BPD 和共病 MDD(BPD+MDD)、重度抑郁症(MDD)和健康对照组(HC)的受试者参与了一个结合抑制任务的社会排斥范式。我们预计在经历负面情绪时,BPD+MDD 的抑制能力比抑郁和 HC 更差。在抑制方面,抑郁患者表现最好,而(BPD+MDD)患者表现最差。令人惊讶的是,MDD 和 HC 参与者在社会排斥期间表现有所提高,但 BPD+MDD 患者则不然。抑制缺陷与儿童创伤有关。这些结果挑战了这样一种假设,即负面情绪的诱导会导致(BPD+MDD)的抑制能力下降。相反,(BPD+MDD)患者似乎患有更普遍的抑制功能障碍。重要的是,(BPD+MDD)患者无法像 HC 和 MDD 患者那样在社会排斥期间提高他们的表现。这些发现需要进一步研究,特别是关于调节抑制的神经网络的效率和创伤的影响。

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