Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
Curr Opin Psychol. 2018 Jun;21:44-49. doi: 10.1016/j.copsyc.2017.09.005. Epub 2017 Sep 14.
In this paper we conceptualize borderline personality disorder as a disorder of mentalizing, social cognition, and loss of resilience. Several treatment approaches are effective, and meta-analyses suggest that there are few substantive differences in effectiveness between them and between specialized and non-specialized approaches. We propose that these findings arise because of shared mechanisms of change, congruent with current thinking both about the existence of a general 'p' factor of psychopathology and a reconceptualization of personality disorders as involving a lack of resilience resulting from problems with epistemic trust and salutogenesis, the capacity to derive benefit from the social environment. Effective treatments share the characteristics of consistency, coherence and continuity, qualities particularly relevant to borderline personality disorder. They create the conditions for the reopening of epistemic trust, an essential component in therapeutic change, as it enables the individual to use the experience of being mentalized, to learn mentalizing of others, and then apply and develop these experiences in day-to-day life, which is the basis for meaningful therapeutic change.
在本文中，我们将边缘型人格障碍概念化为一种心理化、社会认知和恢复力丧失的障碍。有几种治疗方法是有效的，荟萃分析表明，它们之间以及专业和非专业方法之间在有效性方面几乎没有实质性差异。我们提出，这些发现是由于共同的变化机制，与当前关于普遍存在的“p”因素精神病理学和人格障碍概念化为由于认识论信任和健康促进方面的问题而导致的恢复力丧失的观点相一致，即从社会环境中获得益处的能力。有效的治疗方法具有一致性、连贯性和连续性的特点，这对于边缘型人格障碍尤为重要。它们为重新建立认识论信任创造了条件，这是治疗变化的一个重要组成部分，因为它使个体能够利用被心理化的经验，学习对他人的心理化，并将这些经验应用和发展到日常生活中，这是有意义的治疗变化的基础。
