Fung Hong Wang, Wong Ming Yu Claudia, Lam Stanley Kam Ki, Wong Emily Nga Man, Chien Wai Tong, Hung Suet Lin, Lee Kun-Hua, Cui Jialiang, Ross Colin A
Department of Social Work, Hong Kong Baptist University, Kowloon, Hong Kong.
Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong.
Borderline Personal Disord Emot Dysregul. 2023 Jul 3;10(1):22. doi: 10.1186/s40479-023-00228-x.
Previous studies have indicated that borderline personality disorder (BPD) is closely associated with trauma and dissociation. Nevertheless, BPD is a heterogeneous condition, and not all people with BPD have severe dissociation. This study examined whether the relationship of BPD features with trauma and dissociation would remain significant after controlling for some general non-specific mental health distress. We also made the first attempt to explore which specific BPD features would be particularly associated with dissociation.
We analyzed survey data from a sample of community health service users in Hong Kong (N = 376). Hierarchical multiple regression and data-driven network analysis were used.
The lifetime prevalence of DSM-5 BPD was 16.0% in our sample. Of participants who met criteria for BPD, 43.3% scored above cutoff on the dissociation measures, thus possibly having clinically significant dissociative symptoms. BPD features were associated with adulthood trauma and psychoform dissociation even after controlling for age, depression and self-esteem. Network analysis showed that some BPD features - including impulsivity, identity disturbance and suicidal/self-mutilation behaviors - were particularly associated with dissociation; other BPD features such as interpersonal-related problems had relatively weak to no connection with dissociation.
Our results suggested that some particular BPD features might be dissociative in nature, although further longitudinal research is required. We argue that a trauma-informed perspective should be employed when working with clients presenting with BPD features despite these features being commonly stigmatized. Further research on the intervention needs of the people with BPD who suffer from high levels of dissociation is required.
先前的研究表明，边缘型人格障碍（BPD）与创伤和分离密切相关。然而，BPD是一种异质性疾病，并非所有BPD患者都有严重的分离症状。本研究探讨了在控制一些一般非特异性心理健康困扰后，BPD特征与创伤和分离之间的关系是否仍然显著。我们还首次尝试探索哪些特定的BPD特征与分离特别相关。
我们分析了来自香港社区卫生服务使用者样本（N = 376）的调查数据。使用了分层多元回归和数据驱动的网络分析。
在我们的样本中，DSM-5 BPD的终生患病率为16.0%。在符合BPD标准的参与者中，43.3%在分离测量中的得分高于临界值，因此可能具有临床上显著的分离症状。即使在控制了年龄、抑郁和自尊之后，BPD特征仍与成年期创伤和心理形式分离相关。网络分析表明，一些BPD特征——包括冲动性、身份障碍和自杀/自残行为——与分离特别相关；其他BPD特征，如人际关系相关问题，与分离的联系相对较弱或没有联系。
我们的结果表明，一些特定的BPD特征可能本质上是分离性的，尽管需要进一步的纵向研究。我们认为，在与表现出BPD特征的客户合作时，应采用创伤知情的观点，尽管这些特征通常会受到污名化。需要对患有高度分离症状的BPD患者的干预需求进行进一步研究。
