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青少年边缘型人格特质的亚型:来自交叉滞后面板网络分析的见解。

Subtypes of borderline personality features in adolescence: Insights from cross-lagged panel network analysis.

机构信息

Beijing Key Laboratory of Behavior and Mental Health, Clinical and Health Psychology Department, School of Psychological and Cognitive Science, Peking University.

出版信息

Personal Disord. 2024 Nov;15(6):457-468. doi: 10.1037/per0000694. Epub 2024 Sep 30.

Abstract

Borderline personality disorder (BPD) is a complex and severe psychiatric condition characterized by emotional, self-image, behavior, and relational instability. While adult BPD heterogeneity has been extensively studied, the phenomenological borderline personality features (BPFs) in adolescence remain uninvestigated. This study aimed to explore the potentially dynamic causal relationships between BPFs in adolescence and identify the subtypes through cross-lagged panel network (CLPN) analysis. Two independent Chinese adolescent samples were followed over 18 months (₁ = 1,056, = 15.37, SD1 = 1.86) and 6 months (₂ = 723, = 16.84, ₂ = 0.48) to track BPFs. CLPN modeling was employed to investigate the stability, potential causal relations, and subtypes of adolescent BPFs. The results revealed a relatively stable overall adolescent BPF network structure with some subtle changes over time. Impulsivity emerged as the BPF with the highest out-expected influence, indicating its predictive role for other BPFs. A strong reciprocal causal relationship was observed between impulsivity and affective instability. Based on the CLPN estimation, two distinct BPFs subgroups were spontaneously clustered: externalized-dysregulation subtype (impulsivity, affective instability, and self-harm/suicide) and introjective-disturbance subtype (identity disturbance, chronic emptiness, and stress-related dissociation). The present study tentatively explores a potential typology for adolescent BPF based on these two clusters, which possibly have different pathological mechanisms, and moreover offer insights into the essential construct and clinical intervention of adolescent BPD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

边缘型人格障碍(BPD)是一种复杂而严重的精神疾病,其特征为情绪、自我形象、行为和人际关系不稳定。虽然成人 BPD 的异质性已经得到广泛研究,但青少年时期的边缘型人格特征(BPFs)仍未得到研究。本研究旨在探索青少年时期 BPFs 之间潜在的动态因果关系,并通过交叉滞后面板网络(CLPN)分析确定其亚类型。两个独立的中国青少年样本分别在 18 个月(₁=1056,=15.37,SD₁=1.86)和 6 个月(₂=723,=16.84,₂=0.48)进行随访,以跟踪 BPFs。采用 CLPN 建模来研究青少年 BPFs 的稳定性、潜在因果关系和亚类型。结果显示,青少年 BPF 网络结构整体相对稳定,但随着时间的推移存在一些细微变化。冲动性是 BPF 中具有最高预期外影响的因素,表明其对其他 BPFs 具有预测作用。冲动性和情感不稳定之间存在强烈的相互因果关系。基于 CLPN 估计,两个不同的 BPF 亚组自动聚类:外化-失调亚型(冲动性、情感不稳定和自残/自杀)和内摄-障碍亚型(身份障碍、慢性空虚和与压力相关的分离)。本研究基于这两个聚类,初步探讨了青少年 BPF 的潜在类型学,这两种聚类可能具有不同的病理机制,为青少年 BPD 的基本结构和临床干预提供了深入了解。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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