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依恋、心理化与《精神疾病诊断与统计手册》第5版人格障碍替代模型(AMPD)的B标准

Attachment, Mentalization, and Criterion B of the Alternative DSM-5 Model for Personality Disorders (AMPD).

作者信息

Ball Cooper Ericka, Anderson Jaime L, Sharp Carla, Langley Hillary A, Venta Amanda

机构信息

Psychology Department, Sam Houston State University, Huntsville, TX, USA.

NextSTEPS Worldwide, PLLC, McKinney, TX, USA.

出版信息

Borderline Personal Disord Emot Dysregul. 2021 Aug 2;8(1):23. doi: 10.1186/s40479-021-00163-9.

Abstract

BACKGROUND

The mentalization theory posits that interpersonal difficulties and maladaptive personality traits develop from an insecure attachment pattern with one's caregiver and corresponding deficits in mentalizing-the ability to understand others' and one's own mental states. Mentalizing deficits have been theorized as the basis for all psychopathology, with the paradigmatic case being Borderline Personality Disorder. Nevertheless, developments in the personality field indicate personality pathology is best represented dimensionally, and such a proposal was outlined by the Alternative DSM-5 Model for Personality Disorders (AMPD). Despite evidence linking the mentalization theory to personality disorders, however, it has yet to be applied to Criterion B of the AMPD. The aim of the present study was to evaluate the moderating role of mentalizing in the relation between attachment and Criterion B maladaptive trait function in a sample of undergraduates. We hypothesized a model in which: (1) attachment insecurity would be positively associated with the Negative Affectivity, Antagonism, and Disinhibition personality domains; (2) mentalizing ability would be negatively associated with these domains; and, (3) there would be an interaction effect between attachment and mentalizing when predicting these same domains.

METHODS

Personality domains were measured dimensionally via the Personality Inventory for DSM-5 (PID-5-SF), while the dependence and avoidance domains of attachment were assessed via the Relationship Questionnaire (RQ). Mentalizing ability was tapped by the Movie for the Assessment of Social Cognition (MASC). The AMPD personality domains and trait facets were examined as dependent variables; attachment dependence, attachment avoidance, and overall mentalizing ability were entered as independent variables; and interaction terms between mentalizing and each attachment dimension were used to test moderation via MANCOVAs.

RESULTS

Consistent with expectations, results indicated overall mentalizing moderated the relation between attachment avoidance and Negative Affectivity. Posthoc analyses revealed similar effects on the relations between attachment avoidance and the Emotional Lability, Hostility, and Perseveration trait facets; however, there were no significant moderation findings related to attachment dependence.

CONCLUSIONS

These results support the mentalization theory's application to Criterion B of the AMPD, particularly in relation to the links between Negative Affectivity and borderline-related traits, and encourage future research of dimensional maladaptive personality. They further bolster support for understanding maladaptive personality as a dimensional construct.

摘要

背景

心理化理论认为,人际困难和适应不良的人格特质源于与照顾者的不安全依恋模式以及相应的心理化缺陷,即理解他人和自己心理状态的能力。心理化缺陷被认为是所有精神病理学的基础,典型案例是边缘型人格障碍。然而,人格领域的发展表明,人格病理学最好用维度来表示,《精神疾病诊断与统计手册》第五版人格障碍替代模型(AMPD)概述了这样一种提议。尽管有证据将心理化理论与人格障碍联系起来,但它尚未应用于AMPD的B标准。本研究的目的是评估在一组本科生样本中,心理化在依恋与AMPD B标准适应不良特质功能之间的关系中所起的调节作用。我们假设了一个模型,其中:(1)依恋不安全感与消极情感性、敌对性和抑制解除人格领域呈正相关;(2)心理化能力与这些领域呈负相关;(3)在预测这些相同领域时,依恋和心理化之间会有交互作用。

方法

通过《精神疾病诊断与统计手册》第五版人格问卷简版(PID-5-SF)从维度上测量人格领域,同时通过关系问卷(RQ)评估依恋的依赖和回避领域。心理化能力通过社会认知评估电影(MASC)来衡量。将AMPD人格领域和特质方面作为因变量进行检验;将依恋依赖、依恋回避和整体心理化能力作为自变量纳入;心理化与每个依恋维度之间的交互项用于通过多变量协方差分析(MANCOVA)检验调节作用。

结果

与预期一致,结果表明整体心理化调节了依恋回避与消极情感性之间的关系。事后分析揭示了对依恋回避与情绪不稳定、敌意和固执特质方面之间关系的类似影响;然而,没有发现与依恋依赖相关的显著调节结果。

结论

这些结果支持将心理化理论应用于AMPD的B标准,特别是与消极情感性和边缘相关特质之间的联系,并鼓励未来对维度性适应不良人格进行研究。它们进一步支持将适应不良人格理解为一种维度结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e85/8327423/7e22ab7b008b/40479_2021_163_Fig1_HTML.jpg

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