Zanarini M C, Gunderson J G, Marino M F, Schwartz E O, Frankenburg F R
Psychosocial Research Program, McLean Hospital, Belmont, MA 02178.
Compr Psychiatry. 1989 Jan-Feb;30(1):18-25. doi: 10.1016/0010-440x(89)90114-4.
The childhood histories of 50 outpatients meeting both Diagnostic Interview for Borderlines (DIB) and DSM-III criteria for Borderline Personality Disorder, 29 outpatients meeting DSM-III criteria for Antisocial Personality Disorder, and 26 outpatients meeting DSM-III for Dysthymic Disorder as well as DSM-III criteria for some other type of Axis II disorder were assessed, blind to proband diagnosis, using a semistructured interview. Borderlines were significantly more likely than those in either control group to report a history of abuse, particularly verbal and sexual abuse. They were also significantly more likely than antisocial controls to report a history of neglect, particularly emotional withdrawal, and significantly more likely than dysthymic other personality disorder controls to report a history of early separation experiences. The authors conclude that the development of Borderline Personality Disorder is more strongly associated with (1) exposure to chronically disturbed caretakers than prolonged separations from these same adults and (2) a history of abuse than a history of neglect.
对50名同时符合边缘型人格障碍的《边缘型人格障碍诊断访谈》（DIB）和《精神疾病诊断与统计手册》第三版（DSM-III）标准的门诊患者、29名符合DSM-III反社会人格障碍标准的门诊患者以及26名符合DSM-III恶劣心境障碍标准以及DSM-III其他某种轴II障碍标准的门诊患者的童年经历进行了评估，评估者对先证者的诊断不知情，采用半结构化访谈。与两个对照组中的任何一组相比，边缘型人格障碍患者报告受虐待史的可能性显著更高，尤其是言语和性虐待。与反社会对照组相比，他们报告被忽视史的可能性也显著更高，尤其是情感退缩，与恶劣心境障碍合并其他人格障碍对照组相比，他们报告早期分离经历史的可能性显著更高。作者得出结论，边缘型人格障碍的发展与以下因素的关联更强：（1）长期接触情绪紊乱的照料者，而非与这些成年人长期分离；（2）受虐待史，而非被忽视史。
