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改善家庭功能以(希望)提高边缘型人格障碍的治疗效果:一个不容小觑的机会。

Improving Family Functioning to (Hopefully) Improve Treatment Efficacy of Borderline Personality Disorder: An Opportunity Not to Dismiss.

机构信息

Vita-Salute San Raffaele University, Milan, Italy.

San Raffaele Turro Hospital, Milan, Italy.

出版信息

Psychopathology. 2018;51(2):149-159. doi: 10.1159/000486603. Epub 2018 Feb 27.

Abstract

People having intimate relationships with persons suffering from borderline personality disorder (BPD) - for instance, members of their family - are likely to be involved in stormy, roller coaster relationships. Thus, they may feel overwhelmed by extreme, unpredictable feelings and situations, even when they do not suffer from any mental disorder or have no problems with mentalization. As a consequence of living with a BPD relative, family members often experience an emotional and financial burden, and may blame themselves for their relative's illness or for not being able to do more to help. This can lead to emotional pain including anxiety, guilt, anger, frustration, despair, and hopelessness. Available evidence suggests a possible usefulness of family interventions for relatives of BPD persons. Starting from these background considerations, a qualitative review of the published literature on family interventions for relatives of BPD persons was carried out. The main findings concerning specific contents and available effectiveness data of psychoeducational family interventions, family skills training, and mentalization-based family programs are reported, in the perspective of 3 family intervention scenarios: (a) taking care of the family of origin of the BPD person; (b) taking care of the new family that the BPD person has started; (c) helping the BPD person to be an effective parent.

摘要

与边缘型人格障碍(BPD)患者有亲密关系的人——例如,他们的家庭成员——可能会卷入激烈的、过山车式的关系中。因此,他们可能会被极端、不可预测的感觉和情况所淹没,即使他们没有任何精神障碍,也没有心理化问题。由于与 BPD 亲属生活在一起,家庭成员经常会感到情绪和经济负担,并可能会因为亲属的疾病或因为无法提供更多帮助而自责。这可能会导致情感痛苦,包括焦虑、内疚、愤怒、沮丧、绝望和无助。现有证据表明,对 BPD 患者的亲属进行家庭干预可能是有用的。基于这些背景考虑,对 BPD 患者亲属的家庭干预的已发表文献进行了定性综述。报告了特定内容和心理教育家庭干预、家庭技能训练以及基于心理化的家庭方案的有效性数据,从 3 种家庭干预情景的角度来看:(a)照顾 BPD 患者的原生家庭;(b)照顾 BPD 患者新组建的家庭;(c)帮助 BPD 患者成为有效的父母。

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