Fitzpatrick Skye, Liebman Rachel E, Monson Candice M
Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
Department of Psychology, York University, Behavioural Science Building, 4700 Keele Street, Toronto, ON M3J 1P3, Canada; Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
Clin Psychol Rev. 2021 Mar;84:101983. doi: 10.1016/j.cpr.2021.101983. Epub 2021 Jan 24.
Prominent explanatory models for borderline personality disorder (BPD) are intrapersonal in nature and hold that it is an emotional disorder. However, the empirical support for emotional models of BPD is mixed. Refinements to BPD explanatory models are needed to increase the precision with which BPD can be understood and treated. Drawing on existing theoretical and empirical research in BPD, this manuscript presents the Borderline Interpersonal-Affective Systems (BIAS) model. The BIAS model purports that harmful early life relationships and subsequent conflictual relationships lead individuals with BPD to develop a sensitivity to interpersonal threat in the form of attentional and appraisal biases. Individuals with BPD are posited to 1) experience heightened emotional reactivity specifically to perceived interpersonal threat and 2) engage in destructive behaviors both to regulate increasing emotion and to meet interpersonal needs. We review the empirical support for each component of the BIAS model, along with the role of the cognitions, emotions, and behaviors of significant others in influencing BIAS model processes in individuals with BPD over time. The BIAS model highlights a novel way of understanding and integrating interpersonal and emotional components of the disorder. Key directives for future research and clinical implications are discussed.
边缘型人格障碍（BPD）的主要解释模型本质上是个体内部的，并认为它是一种情绪障碍。然而，对BPD情绪模型的实证支持参差不齐。需要对BPD解释模型进行完善，以提高对BPD理解和治疗的精准度。基于BPD现有的理论和实证研究，本文提出了边缘型人际-情感系统（BIAS）模型。BIAS模型认为，早期有害的生活关系以及随后的冲突性关系，导致患有BPD的个体以注意力和评估偏差的形式对人际威胁产生敏感性。患有BPD的个体被认为：1）对感知到的人际威胁会经历增强的情绪反应；2）会采取破坏性行为，既是为了调节不断增加的情绪，也是为了满足人际需求。我们回顾了对BIAS模型各组成部分的实证支持，以及重要他人的认知、情绪和行为在随着时间推移影响患有BPD个体的BIAS模型过程中的作用。BIAS模型突出了一种理解和整合该障碍人际和情绪成分的新方法。文中还讨论了未来研究的关键方向和临床意义。
