Orme William, Bowersox Lauren, Vanwoerden Salome, Fonagy Peter, Sharp Carla
1Baylor College of Medicine, The Menninger Clinic, Houston, Texas USA.
2University of Houston, Houston, Texas USA.
Borderline Personal Disord Emot Dysregul. 2019 Aug 28;6:13. doi: 10.1186/s40479-019-0110-7. eCollection 2019.
Recent extensions of mentalization theory have included the hypothesis that a reduced capacity for epistemic trust in the context of attachment relationships may represent a core vulnerability for the development of borderline personality disorder (BPD). The first aim of the current study was to explore empirical relationships between epistemic trust and symptoms of BPD. The second aim was to explore the effect of epistemic trust on treatment response.
Data were collected from 322 inpatient adolescents. The Inventory of Parent and Peer Attachment (IPPA) trust in mother and father subscales were used to approximate epistemic trust in the absence of a validated measure. A multimodal approach was used to measure BPD including self-report, parent-report, and interviewer ratings. Regression analyses were performed to explore the relationship between IPPA trust scores and measures of BPD. Mixed-design analyses of variance were conducted to evaluate whether self-reported parent trust at admission influenced progress in treatment.
As hypothesized, results indicated that reduced IPPA trust in parents correlated with BPD symptoms across various measures. Levels of IPPA trust in parents at admission did not moderate a reduction in BPD symptoms over the course of treatment.
This study provides support for the theoretical association between deficits in epistemic trust and BPD while also highlighting the need for a validated measure of epistemic trust. Although parent trust at admission did not moderate a reduction in BPD symptoms over the course of treatment, this result may suggest that progress in treatment, and perhaps the ability to cultivate trust in the treatment setting and providers, may not be overly determined by levels of parent trust.
心理化理论最近的扩展内容包括这样一种假设，即在依恋关系背景下认知信任能力的下降可能是边缘型人格障碍（BPD）发展的核心脆弱因素。本研究的首要目的是探讨认知信任与BPD症状之间的实证关系。第二个目的是探讨认知信任对治疗反应的影响。
收集了322名住院青少年的数据。在没有经过验证的测量工具的情况下，使用父母与同伴依恋量表（IPPA）中对母亲和父亲信任的子量表来近似认知信任。采用多模式方法测量BPD，包括自我报告、父母报告和访谈者评分。进行回归分析以探讨IPPA信任分数与BPD测量指标之间的关系。进行混合设计方差分析以评估入院时自我报告的对父母的信任是否会影响治疗进展。
正如所假设的那样，结果表明，IPPA中对父母信任的降低与各种测量指标下的BPD症状相关。入院时IPPA对父母的信任水平并没有缓和治疗过程中BPD症状的减轻。
本研究为认知信任缺陷与BPD之间的理论关联提供了支持，同时也强调了需要一种经过验证的认知信任测量工具。尽管入院时对父母的信任并没有缓和治疗过程中BPD症状的减轻，但这一结果可能表明，治疗进展，也许还有在治疗环境和提供者中培养信任的能力，可能不会过度取决于对父母的信任水平。
