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[分离的神经机制:对边缘型人格障碍的启示]

[Neural mechanisms of dissociation: implication for borderline personality disorder].

作者信息

Krause-Utz A D, Elzinga B M

出版信息

Tijdschr Psychiatr. 2019;61(4):267-275.

Abstract

Dissociation is a prevalent symptom in borderline personality disorder (BPD), which can have detrimental effects on everyday functioning and treatment. Until now, little is known about the brain networks implicated in dissociation in BPD. Research on dissociative disorders and posttraumatic stress disorder found alterations in networks implicated in cognitive control and arousal modulation. However, it is unknown whether these alterations are also affected in BPD.
AIM: To provide an overview of the definitions, neurobiological models, and neuroimaging research on dissociation in BPD.
METHOD: Review of the literature.
RESULTS: During dissociation in BPD, there is evidence for an altered recruitment and interplay of brain regions implicated in the regulation of stress responses and emotions, attention, memory, and self-referential processing (amygdala, anterior cingulate cortex, inferior frontal gyrus, medial prefrontal cortex, superior temporal gyrus, and inferior parietal lobule).
CONCLUSION: Dissociation is associated with alterations in brain networks that regulate affect-cognitive processing in BPD. Given the substantial impact of dissociation on treatment and neural processing, dissociative symptoms should be taken into account in future research and treatment of BPD, even if they are not the primary focus.

摘要

分离是边缘性人格障碍(BPD)中一种普遍存在的症状,它会对日常功能和治疗产生不利影响。到目前为止,关于BPD中与分离相关的脑网络知之甚少。对分离性障碍和创伤后应激障碍的研究发现,与认知控制和唤醒调节相关的网络存在改变。然而,这些改变在BPD中是否也受到影响尚不清楚。

目的

概述BPD中分离的定义、神经生物学模型和神经影像学研究。

方法

文献综述。

结果

在BPD的分离过程中,有证据表明参与应激反应和情绪调节、注意力、记忆和自我参照加工的脑区(杏仁核、前扣带回皮质、额下回、内侧前额叶皮质、颞上回和顶下小叶)的募集和相互作用发生了改变。

结论

分离与BPD中调节情感-认知加工的脑网络改变有关。鉴于分离对治疗和神经加工有重大影响,即使分离症状不是主要关注点,在未来BPD的研究和治疗中也应予以考虑。

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