Mental Health and Wellbeing, Division of Health Sciences, University of Warwick, CV47AL, UK; Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Operational Research and Management Sciences Group, Warwick Business School, University of Warwick, CV4 7AL, UK.
J Affect Disord. 2018 Dec 1;241:492-498. doi: 10.1016/j.jad.2018.08.046. Epub 2018 Aug 14.
Affective instability (AI) is transdiagnostic, and associated with suicidality and healthcare use. It has rarely been compared between diagnoses or to controls. We investigated: whether AI differs between clinical cases and controls and between diagnoses; how different AI components are correlated; and whether AI is associated with functioning in clinical cases.
Cases (N = 69) from psychiatric services had a diagnosis of borderline personality disorder, bipolar disorder, major depression or psychosis and were compared to primary care controls (N = 25). Participants completed the affective lability scale (ALS), affective intensity measure (AIM), affective control scale (ACS), scored mood fluctuation rate and the WHO-DAS.
There was a significant difference in affective lability between cases and controls and across diagnostic groups (p < 0.001). Compared to controls, cases showed lower affective control (p < 0.05). There were no differences in affective intensity between cases and controls or between diagnostic groups, or in mood fluctuation rate between groups. ALS score (p < 0.001), and total number of medications (p < 0.046), were associated with functioning, independent of diagnosis.
The sample size was modest. Cases were not in an acute illness episode and this could bias estimates of group difference towards the null.
Individuals with mental disorder demonstrate higher levels of affective lability and lower affect control than those without mental disorder. In contrast affective intensity may not be useful in demarcating abnormal affective experience. Independent of diagnosis, affective instability, as measured by affect lability, adversely impacts day-to-day functioning. It could be an important target for clinical intervention.
情感不稳定（AI）是一种跨诊断的现象，与自杀倾向和医疗保健的使用有关。它很少在诊断之间或与对照组进行比较。我们调查了：AI 是否在临床病例和对照组以及不同诊断之间存在差异；不同的 AI 成分如何相关；以及 AI 是否与临床病例的功能相关。
来自精神科服务的病例（N=69）有边缘型人格障碍、双相情感障碍、重度抑郁症或精神病的诊断，并与初级保健对照组（N=25）进行了比较。参与者完成了情感不稳定性量表（ALS）、情感强度测量（AIM）、情感控制量表（ACS），评分了情绪波动率和世界卫生组织残疾评定量表（WHO-DAS）。
病例和对照组以及不同诊断组之间的情感不稳定性存在显著差异（p<0.001）。与对照组相比，病例组表现出较低的情感控制（p<0.05）。病例和对照组之间，或不同诊断组之间，情感强度或情绪波动率没有差异。ALS 评分（p<0.001）和总用药数量（p<0.046）与功能独立于诊断相关。
样本量不大。病例组不在急性疾病发作期，这可能会使组间差异的估计偏向于零。
患有精神障碍的个体表现出比没有精神障碍的个体更高的情感不稳定性和更低的情感控制。相比之下，情感强度可能无法用于区分异常情感体验。独立于诊断，情感不稳定性，如情感不稳定性测量所示，对日常功能产生不利影响。它可能是临床干预的一个重要目标。
