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急性自杀情感障碍和边缘型人格障碍症状:不同但相关的结构。

Acute suicidal affective disturbance and borderline personality disorder symptoms: Distinct yet correlated constructs.

机构信息

Department of Psychology, Florida State University, Tallahassee, FL, USA.

Department of Psychology, Florida State University, Tallahassee, FL, USA.

出版信息

J Affect Disord. 2023 Mar 15;325:62-72. doi: 10.1016/j.jad.2022.12.131. Epub 2022 Dec 28.

DOI:10.1016/j.jad.2022.12.131
PMID:36586595
Abstract

OBJECTIVE

Acute Suicidal Affective Disturbance (ASAD) has been proposed to address the need for a suicide-specific diagnostic entity that better accounts for the psychological symptoms that may emerge during an acute suicidal crisis and that may precede imminent suicidal behaviors. However, additional research is needed to establish ASAD's delimitation from preexisting psychological disorders, especially disorders that include suicidal thoughts and behaviors in their diagnostic criteria such as borderline personality disorder (BPD).

METHODS

We estimated two Gaussian graphical models (GGMs), exploratory factor analysis (EFA) models, and confirmatory factor analysis models in a sample of psychiatric outpatients (N = 460) to examine the structure of ASAD and BPD symptoms.

RESULTS

Our estimated models showed while most ASAD and BPD symptoms largely shared associations with other symptoms belonging to their respective disorder construct, strong associations connected some ASAD symptoms with BPD symptoms, which, in a network model, emerged in the form of nonzero edges among those symptoms, and in EFA models, as factors that featured both ASAD and BPD symptoms as indicators.

CONCLUSIONS

Our findings suggest the network structure of the proposed criteria of ASAD features symptoms that are largely distinct to ASAD but do include symptoms that share meaningful correlations with BPD symptoms that suggest ASAD and BPD are correlated constructs.

摘要

目的

急性自杀情感障碍(ASAD)的提出是为了满足对特定自杀诊断实体的需求,该实体更好地解释了在急性自杀危机期间可能出现的心理症状,这些症状可能先于即将发生的自杀行为。然而,需要进一步的研究来确定 ASAD 与先前存在的心理障碍的界限,特别是那些在其诊断标准中包括自杀念头和行为的障碍,如边缘型人格障碍(BPD)。

方法

我们在一组精神科门诊患者(N=460)中估计了两个高斯图形模型(GGM)、探索性因素分析(EFA)模型和验证性因素分析模型,以检查 ASAD 和 BPD 症状的结构。

结果

我们估计的模型表明,虽然大多数 ASAD 和 BPD 症状与属于各自障碍结构的其他症状有很大的关联,但一些 ASAD 症状与 BPD 症状有很强的关联,这些关联在网络模型中表现为这些症状之间存在非零边缘,在 EFA 模型中,作为包含 ASAD 和 BPD 症状作为指标的因素。

结论

我们的研究结果表明,所提出的 ASAD 标准的网络结构具有很大程度上与 ASAD 不同的症状,但也包括与 BPD 症状有显著相关性的症状,这表明 ASAD 和 BPD 是相关的构念。

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