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当前患有及已缓解的边缘型人格障碍女性对自身身体的评估:童年期性虐待长期影响的证据

Evaluation of the own body in women with current and remitted borderline personality disorder: evidence for long-lasting effects of childhood sexual abuse.

作者信息

Kleindienst Nikolaus, Löffler Annette, Herzig Madeleine, Bertsch Katja, Bekrater-Bodmann Robin

机构信息

Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

Eur J Psychotraumatol. 2020 Jun 25;11(1):1764707. doi: 10.1080/20008198.2020.1764707.

Abstract

BACKGROUND

Evaluation of one's own body highly depends on psychopathology. In contrast to healthy women, body evaluation is negative in women from several diagnostic groups. Particularly negative ratings have been reported in disorders related to childhood sexual abuse (CSA) including borderline personality disorder (BPD). However, it is unknown whether this negative evaluation persists beyond symptomatic remission, whether it depends on the topography of body areas (sexually connoted versus neutral areas), and whether it depends on CSA.

OBJECTIVE

First, we aimed at a quantitative comparison of body evaluation across three diagnostic groups: current BPD (cBPD), remitted BPD (rBPD), and healthy controls (HC). Second, we aimed at clarifying the potentially moderating role of a history of CSA and of the sexual connotation of body areas.

METHODS

The study included 68 women from the diagnostic groups of interest (cBPD, rBPD, and HC). These diagnoses were established with the International Personality Disorder Examination. The participants used the Survey of Body Areas to quantify the evaluation of the own body and the Childhood Trauma Questionnaire for assessing CSA.

RESULTS

While the evaluation of the own body was generally negative in women from the cBPD group it was positive in those who had remitted from BPD. However, their positive scores were strictly confined to neutral body areas, whereas the evaluation of sexually connoted body areas was negative, resembling the respective evaluation in cBPD patients and contrasting the positive evaluation of sexually connoted areas in healthy women. The negative evaluation of sexually connoted areas in remitted women was significantly related to a history of CSA.

CONCLUSIONS

Women with BPD may require a specifically designed intervention to achieve a positive evaluation of their entire body. The evaluation of sexually connoted body areas seems to remain an issue even after remission from the disorder has been achieved.

摘要

背景

对自身身体的评价高度依赖于精神病理学。与健康女性相比,来自几个诊断组的女性对身体的评价是负面的。在与童年性虐待(CSA)相关的疾病中,包括边缘型人格障碍(BPD),尤其有负面评价的报道。然而,尚不清楚这种负面评价在症状缓解后是否持续存在,是否取决于身体部位的特征(具有性暗示的部位与中性部位),以及是否取决于CSA。

目的

首先,我们旨在对三个诊断组进行身体评价的定量比较:当前的BPD(cBPD)、缓解期的BPD(rBPD)和健康对照组(HC)。其次,我们旨在阐明CSA病史和身体部位性暗示的潜在调节作用。

方法

该研究纳入了来自感兴趣诊断组(cBPD、rBPD和HC)的68名女性。这些诊断通过国际人格障碍检查确定。参与者使用身体部位调查来量化对自身身体的评价,并使用儿童创伤问卷来评估CSA。

结果

虽然cBPD组女性对自身身体的评价总体上是负面的,但BPD缓解期女性的评价是正面的。然而,她们的正面评分严格局限于中性身体部位,而对具有性暗示的身体部位的评价是负面的,类似于cBPD患者的相应评价,与健康女性对具有性暗示部位的正面评价形成对比。缓解期女性对具有性暗示部位的负面评价与CSA病史显著相关。

结论

患有BPD的女性可能需要专门设计的干预措施,以实现对其整个身体的正面评价。即使在疾病缓解后,对具有性暗示的身体部位的评价似乎仍然是一个问题。

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