Norup Ditte Aagaard, Bo Sune
Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Central Denmark Region, Aarhus N, Denmark.
Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark.
Scand J Child Adolesc Psychiatr Psychol. 2019 May 30;7:1-7. doi: 10.21307/sjcapp-2019-002. eCollection 2019.
Findings show that deficiencies in the ability to understand mental states are related to many forms of psychopathology. Mentalizing dysfunctions are suggested to be the core pathology underlying borderline personality disorder (BPD). Moreover, research suggests that BPD predicts psychopathology in general and findings display that diminished mentalization is related to a range of psychiatric disorders. As yet, no study has investigated the potential link between borderline personality features, mentalization and internalizing and externalizing psychopathology, and whether internalizing and externalizing psychopathology in BPD might be driven by impaired mentalization.
In a cross-sectional study, 109 patients referred to a child and adolescent psychiatric clinic were assessed with a battery of self-report instruments to asses borderline personality features, mentalization, and internalizing and externalizing psychopathology.
Simple mediation model was used to examine whether mentalizing abilities mediated the relationship between borderline features and psychopathology in regard to externalizing and internalizing psychopathology in adolescents.
The results indicated that mentalization mediated the relationship between borderline personality features and both externalizing and internalizing psychopathology in adolescents, indicating that mentalization underlie externalizing and internalizing psychopathology in adolescents with borderline personality features.
The current study is the first empirical study to evaluate mentalization as a mediating factor between adolescents who met full or sub-threshold criteria for BPD and psychopathology. Clinical implications are discussed.
研究结果表明,理解心理状态能力的缺陷与多种形式的精神病理学有关。心理化功能障碍被认为是边缘型人格障碍(BPD)的核心病理学特征。此外,研究表明,BPD总体上可预测精神病理学,且研究结果显示心理化能力减弱与一系列精神障碍有关。然而,尚无研究调查边缘型人格特征、心理化与内化和外化精神病理学之间的潜在联系,以及BPD中的内化和外化精神病理学是否可能由心理化受损所致。
在一项横断面研究中,使用一系列自我报告工具对转至儿童和青少年精神科诊所的109名患者进行评估,以评估边缘型人格特征、心理化以及内化和外化精神病理学。
采用简单中介模型来检验心理化能力是否在青少年外化和内化精神病理学方面介导了边缘型人格特征与精神病理学之间的关系。
结果表明,心理化介导了青少年边缘型人格特征与外化和内化精神病理学之间的关系,这表明心理化是具有边缘型人格特征青少年外化和内化精神病理学的基础。
本研究是第一项将心理化作为符合BPD全部或亚阈值标准的青少年与精神病理学之间中介因素进行评估的实证研究。文中讨论了临床意义。