Zanarini Mary C, Martinho Eduardo, Temes Christina M, Glass Isabel V, Aguirre Blaise A, Goodman Marianne, Fitzmaurice Garrett M
McLean Hospital, McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA.
Harvard Medical School, Boston, MA, USA.
Borderline Personal Disord Emot Dysregul. 2023 Mar 9;10(1):9. doi: 10.1186/s40479-023-00217-0.
The first purpose of this study was to assess the severity of dissociative experiences reported by adolescent inpatients with borderline personality disorder (BPD). The second purpose was to compare the severity of their dissociative symptoms to those reported by a sample of adult inpatients with BPD. The third purpose of this study was to assess a range of clinically meaningful predictors of the severity of dissociation in adolescents and adults with BPD.
The Dissociative Experiences Scale (DES) was administered to a total of 89 hospitalized girls and boys aged 13-17 with BPD and 290 adult inpatients with BPD. Predictors of the severity of dissociation in adolescents and adults with BPD were assessed using the Revised Childhood Experiences Questionnaire (a semi-structured interview), the NEO, and the SCID I.
Borderline adolescents and adults had non-significant differences on their overall DES scores and subscale scores. They also had a non-significant distribution of low, moderate, and high scores. In terms of multivariate predictors, neither temperament nor childhood adversity was a significant predictor of the severity of dissociative symptoms in adolescents. However, co-occurring eating disorders were found in multivariate analyses to be the only bivariate predictor to significantly predict this outcome. In adults with BPD, however, both the severity of childhood sexual abuse and co-occurring PTSD were significantly related to the severity of dissociative symptoms in multivariate analyses.
Taken together, the results of this study suggest that the severity of dissociation is not significantly different in adolescents and adults with BPD. However, the etiological factors differ substantially.
本研究的首要目的是评估边缘型人格障碍（BPD）青少年住院患者所报告的分离体验的严重程度。第二个目的是将他们的分离症状严重程度与成年BPD住院患者样本所报告的严重程度进行比较。本研究的第三个目的是评估一系列对患有BPD的青少年和成年人分离严重程度具有临床意义的预测因素。
对总共89名年龄在13 - 17岁患有BPD的住院女孩和男孩以及290名成年BPD住院患者施行了分离体验量表（DES）。使用修订版儿童经历问卷（一种半结构化访谈）、大五人格量表（NEO）和精神疾病诊断与统计手册第一版（SCID I）评估患有BPD的青少年和成年人分离严重程度的预测因素。
边缘型青少年和成年人在总体DES得分及子量表得分上无显著差异。他们在低、中、高分的分布上也无显著差异。在多变量预测因素方面，气质和童年逆境都不是青少年分离症状严重程度的显著预测因素。然而，在多变量分析中发现，共病的饮食失调是唯一能显著预测这一结果的双变量预测因素。然而，在患有BPD的成年人中，童年性虐待的严重程度和共病的创伤后应激障碍在多变量分析中都与分离症状的严重程度显著相关。
总体而言，本研究结果表明，患有BPD的青少年和成年人的分离严重程度没有显著差异。然而，病因因素有很大不同。
