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边缘型人格障碍中的反刍思维、创伤后应激障碍及情绪症状

Rumination, posttraumatic stress disorder, and mood symptoms in borderline personality disorder.

作者信息

Dell'Osso Liliana, Cremone Ivan M, Carpita Barbara, Dell'Oste Valerio, Muti Dario, Massimetti Gabriele, Barlati Stefano, Vita Antonio, Fagiolini Andrea, Carmassi Claudia, Gesi Camilla

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

出版信息

Neuropsychiatr Dis Treat. 2019 May 13;15:1231-1238. doi: 10.2147/NDT.S198616. eCollection 2019.

Abstract

The interrelationship between mood disorders and borderline personality disorder (BPD) has been long debated in the literature. Increasing attention has also been paid to the relationship between posttraumatic stress disorder (PTSD) and BPD, as well as to the role of rumination in the development and severity of BPD. This study aims to evaluate the association of rumination, PTSD, and mood spectrum among patients with BPD with or without comorbid mood disorders. Fifty patients with BPD and 69 healthy controls were assessed with the Structured Clinical Interview for the 5, Mood Spectrum Self-Report (MOODS-SR), and Ruminative Response Scale (RRS). The BPD group was split into subjects with BPD+ mood disorder (MD) or BPD only) . PTSD-criteria fulfillment, MOODS, and RRS scores were significantly higher in both BPD subgroups than in controls, while BPD+MD patients scored significantly higher than the BPD-only group. RRS scores and PTSD-criteria fulfillment were significantly related to the presence of both BPD and BPD+MD, with no effect of MOODS-SR scores. Our findings confirm the presence of a relationship between BPD and the PTSD spectrum, highlighting also a possible role of rumination in BPD psychopathology. Rumination and PTSD symptoms seem to prevail in the effect of mood spectrum in predicting BPD.

摘要

情绪障碍与边缘性人格障碍(BPD)之间的相互关系在文献中一直存在争议。创伤后应激障碍(PTSD)与BPD之间的关系,以及反复思考在BPD的发展和严重程度中的作用也越来越受到关注。本研究旨在评估有或无共病情绪障碍的BPD患者中反复思考、PTSD和情绪谱之间的关联。对50名BPD患者和69名健康对照者进行了《精神障碍诊断与统计手册》第五版结构化临床访谈、情绪谱自评量表(MOODS-SR)和反复思考反应量表(RRS)评估。BPD组分为BPD合并情绪障碍(MD)患者和单纯BPD患者。两个BPD亚组的PTSD标准满足率、MOODS和RRS评分均显著高于对照组,而BPD+MD患者的评分显著高于单纯BPD组。RRS评分和PTSD标准满足率与BPD和BPD+MD的存在均显著相关,MOODS-SR评分无影响。我们的研究结果证实了BPD与PTSD谱之间存在关联,同时也强调了反复思考在BPD精神病理学中的可能作用。在预测BPD时,反复思考和PTSD症状似乎在情绪谱的影响中占主导地位。

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