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边缘型人格障碍自杀未遂者的应激反应:童年行为问题的作用。

Stress Response in Suicide Attempters with Borderline Personality Disorder: The Role of Behavioral Problems in Childhood.

作者信息

Itzhaky Liat, Galfalvy Hanga, Keilp John G, Gratch Ilana, Brodsky Beth S, Stanley Barbara H

出版信息

Psychiatry. 2020 Fall;83(3):221-230. doi: 10.1080/00332747.2020.1716439. Epub 2020 Feb 18.

Abstract

: Suicidal individuals are a heterogeneous population and may differ in systematic ways in their responsiveness to stress. The primary aim of the present study was to identify whether a different pattern of physiological stress response exists among adult suicide attempters with a history of behavioral problems during childhood and adolescence, which earlier studies have related to both decreased activity of the HPA axis and to suicidal behaviors. : Seventy-eight participants with Borderline Personality Disorder were assessed using the SCID-II, and completed self-report measures assessing their history of suicide attempts, history of aggressive behaviors, depressive symptoms, history of lifetime abuse and demographics. Participants' cortisol reactivity was assessed using the . : Analyses indicated that suicide attempters with a history of behavioral problems in youth (n = 30) had a significantly lower response to stress than both suicide attempters without such a history (n = 26) and non-attempters (n = 22), when controlling for lifetime history of abuse. The groups did not differ in basal cortisol. : These findings suggest a unique subtype of suicide attempter among those with Borderline Personality Disorder, characterized by a blunted physiological stress response.

摘要

自杀个体是一个异质性群体,他们在对应激的反应上可能存在系统性差异。本研究的主要目的是确定在童年和青少年时期有行为问题史的成年自杀未遂者中,是否存在不同的生理应激反应模式,早期研究已将其与下丘脑-垂体-肾上腺(HPA)轴活性降低及自杀行为联系起来。

使用《精神障碍诊断与统计手册》第二版修订版(SCID-II)对78名边缘型人格障碍患者进行评估,并完成自我报告测量,以评估他们的自杀未遂史、攻击行为史、抑郁症状、终身虐待史和人口统计学特征。使用[具体方法]评估参与者的皮质醇反应性。

分析表明,在控制终身虐待史的情况下,有青少年行为问题史的自杀未遂者(n = 30)对应激的反应明显低于无此类病史的自杀未遂者(n = 26)和未尝试自杀者(n = 22)。各组的基础皮质醇水平无差异。

这些发现表明,在边缘型人格障碍患者中存在一种独特的自杀未遂亚型,其特征是生理应激反应迟钝。

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本文引用的文献

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Further evidence of low baseline cortisol levels in suicide attempters.进一步证实自杀未遂者的基础皮质醇水平较低。
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