McLean Hospital, Belmont, MA, United States.
McLean Hospital, Belmont, MA, United States; Bowdoin College, Brunswick, ME, United States.
Psychiatry Res. 2019 Jan;271:76-82. doi: 10.1016/j.psychres.2018.11.020. Epub 2018 Nov 10.
This study had two objectives. The first was to determine the levels of identity disturbance reported by 290 patients with borderline personality disorder (BPD) and 72 personality-disordered comparison subjects over 20 years of prospective follow-up. The second aim was to describe the levels of identity disturbance reported by 152 ever recovered vs. 138 never recovered borderline patients over 20 years of prospective follow-up. Participants were followed and re-assessed every two years for a total of 20 years of follow-up. Borderline patients reported levels of these states that were more than three times higher than personality-disordered comparison subjects, with both groups demonstrating significant declines in these states over time. For three of these inner states ("I feel like I am worthless," "I feel like a complete failure," and "I feel like I am evil"), recovered borderline patients had lower baseline scores and significantly different patterns of decline than non-recovered patients. For the fourth state, "I feel like I am a bad person," recovered patients had lower scores over time, but the groups declined at the same rate. These results suggest that borderline patients report experiencing inner states related to having a negative identity less often over time. Additionally, recovery status is significantly associated with decreased time experiencing these states.
这项研究有两个目的。第一个目的是确定 290 名边缘型人格障碍（BPD）患者和 72 名人格障碍对照者在 20 年前瞻性随访中报告的身份障碍水平。第二个目的是描述 152 名曾经康复的和 138 名从未康复的边缘型患者在 20 年前瞻性随访中报告的身份障碍水平。参与者每两年随访和评估一次，总共随访 20 年。边缘型患者报告的这些状态的水平比人格障碍对照者高出三倍以上，两组随着时间的推移这些状态都有显著下降。对于这三个内在状态（“我觉得自己一文不值”、“我觉得自己是个彻底的失败者”和“我觉得自己很邪恶”），康复的边缘型患者的基线分数较低，下降模式与未康复的患者明显不同。对于第四个状态“我觉得自己是个坏人”，康复患者的分数随着时间的推移有所下降，但两组的下降速度相同。这些结果表明，随着时间的推移，边缘型患者报告经历与消极身份相关的内在状态的频率较低。此外，康复状态与经历这些状态的时间减少显著相关。
