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身份认同病理学与边缘型人格障碍:实证综述

Identity pathology and borderline personality disorder: an empirical overview.

作者信息

Kaufman Erin A, Meddaoui Brianna

机构信息

Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada.

Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada.

出版信息

Curr Opin Psychol. 2021 Feb;37:82-88. doi: 10.1016/j.copsyc.2020.08.015. Epub 2020 Aug 25.

Abstract

Pathological identity-related functioning is a core feature of borderline personality disorder (BPD) that is grievously underrepresented in the empirical literature. Burgeoning evidence indicates that identity pathology is multifaceted, influenced by transactions between social and endogenous processes, and associated with a wide variety of maladaptive outcomes. Although historically defined by patterns of instability (e.g. frequent and rapid changes to career goals, religious beliefs, core values, friend groups, etc.), accumulating research indicates that identity pathology also manifests as distress and functional impairment related to excessive rigidity (i.e. unrelenting negative self-evaluations; overidentification with a restricted role or group membership) and/or incongruous behavior (i.e. simultaneously holding discordant beliefs/values/attitudes, actions that are grossly contradictory with values, incoherent sense of self, etc.). Despite the complex nature of this construct, and its centrality to BPD, researchers often assess identity pathology indirectly, inadequately, or fail to measure it entirely. In this article, we briefly describe how identity pathology may fit into etiological models of BPD, highlight emerging themes from recent research, and identify important gaps in our knowledge. We also discuss limitations associated with current assessment practices, recommend alternatives, and articulate a research agenda for the future.

摘要

病理性身份认同相关功能是边缘型人格障碍(BPD)的一个核心特征,但在实证文献中却严重缺乏相关研究。越来越多的证据表明,身份认同病理是多方面的,受社会和内源性过程之间相互作用的影响,并与多种适应不良的结果相关。虽然历史上身份认同病理是由不稳定模式定义的(例如,职业目标、宗教信仰、核心价值观、朋友圈等频繁且快速的变化),但越来越多的研究表明,身份认同病理也表现为与过度僵化(即持续的负面自我评价;过度认同受限的角色或群体成员身份)和/或不一致行为(即同时持有不一致的信念/价值观/态度、与价值观严重矛盾的行为、自我意识不连贯等)相关的痛苦和功能损害。尽管这一概念具有复杂性,且对BPD至关重要,但研究人员常常间接、不充分地评估身份认同病理,或者完全没有对其进行测量。在本文中,我们简要描述身份认同病理如何融入BPD的病因模型,突出近期研究中出现的新主题,并指出我们知识中的重要空白。我们还讨论了当前评估实践的局限性,推荐了替代方法,并阐明了未来的研究议程。

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