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在边缘型人格障碍中分离对立作用的影响:基于实验室的交替治疗设计。

Isolating the effect of opposite action in borderline personality disorder: A laboratory-based alternating treatment design.

机构信息

Center for Anxiety and Related Disorders, Boston University, United states.

Center for Anxiety and Related Disorders, Boston University, United states.

出版信息

Behav Res Ther. 2019 Jun;117:79-86. doi: 10.1016/j.brat.2018.10.006. Epub 2018 Oct 16.

Abstract

Evaluating the unique effects of each component included in treatment protocols for borderline personality disorder (BPD) is a necessary step in refining these interventions so that they only include skills that drive therapeutic change. One strategy, included in several prominent treatments for BPD, is acting opposite to emotion-driven behavioral urges; engaging in behaviors that are inconsistent with an experienced emotion is thought to lead to reductions in its intensity, though this has not been empirically-tested. The present study was a single-case experiment, specifically an alternating treatment design, that explored the effects of a laboratory-based adaptation of opposite action (versus acting consistent) on emotional intensity. Sixteen individuals with BPD attended six laboratory sessions in which they were instructed to act consistent with an induced emotion in half the sessions and opposite in the other half. Participants were randomly assigned to the specific emotion (i.e., anxiety, sadness, anger, and shame/guilt) that was induced across all study sessions. Findings from visual inspection and percentage of non-overlapping data suggest that acting opposite (versus consistent) leads to significantly greater decreases in emotional intensity for those in the sadness and guilt/shame conditions, but not those in the anxiety or anger conditions. Possible interpretations of these findings are presented. Replication outside of the laboratory context is necessary to draw further conclusions of the clinical implications of these findings.

摘要

评估边缘型人格障碍(BPD)治疗方案中每个组成部分的独特效果,是完善这些干预措施的必要步骤,以便只纳入推动治疗变化的技能。一种策略,包含在几种治疗 BPD 的突出方法中,是与情绪驱动的行为冲动相反的行为;从事与体验到的情绪不一致的行为被认为会导致其强度降低,尽管这尚未经过实证检验。本研究是一项单案例实验,具体来说是一项交替治疗设计,旨在探讨基于实验室的相反行动(与一致行动相比)对情绪强度的影响。16 名 BPD 患者参加了六个实验室会议,在其中一半会议中,他们被指示与诱发的情绪保持一致,而在另一半会议中则与情绪相反。参与者被随机分配到所有研究会议中诱发的特定情绪(即焦虑、悲伤、愤怒和羞耻/内疚)。视觉检查和非重叠数据百分比的结果表明,对于处于悲伤和内疚/羞耻状态的人来说,与一致行为相比(与相反行为相比),情绪强度的显著降低更大,但对于处于焦虑或愤怒状态的人则不然。提出了对这些发现的可能解释。有必要在实验室环境之外进行复制,以进一步得出这些发现对临床的影响的结论。

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