Ociskova Marie, Prasko Jan, Kantor Krystof, Vanek Jakub, Nesnidal Vlastimil, Belohradova Kamila
Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.
Jessenia Inc. Rehabilitation Hospital Beroun, Akeso Holding, MINDWALK, S.r.o, Beroun, Czech Republic.
Psychol Res Behav Manag. 2024 Oct 30;17:3761-3777. doi: 10.2147/PRBM.S476768. eCollection 2024.
Child abuse and trauma are significant risk factors in the etiology of borderline personality disorder (BPD). Apart from affecting the risk of developing BPD, adverse childhood experiences seem to increase its symptoms and related disability. Self-stigma presents another common issue with equally prominent consequences for mental health. Despite being theoretically linked, the connections among childhood trauma, self-stigma, and mental health have not been explored in patients with BPD. This study aimed to provide first insights into this understudied topic.
This cross-sectional study included 283 inpatients diagnosed with BPD participating in a residential transdiagnostic psychotherapeutic program. The patients completed several measurements - the Internalized Stigma of Mental Illness Scale, the Childhood Trauma Questionnaire - Short Form, the Clinical Global Impression - Severity, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Dissociative Experiences Scale, the Sheehan Disability Scale, and a demographic questionnaire. The data was statistically analyzed using IBM SPSS and AMOS 26 programs, and bivariate correlation tests and structural equation modeling explored the hypotheses.
Retrospectively reported childhood trauma positively correlated with current self-stigma. Both childhood trauma and self-stigma were also positively related to several indicators of general psychopathology and disability. The significance of these connections was subsequently confirmed by structural equation modeling, where self-stigma acted as a partial mediator of childhood trauma, general psychopathology, and disability.
Self-stigma significantly mediates the relationship between childhood trauma and selected mental health symptoms among adult patients diagnosed with BPD. Longitudinal studies are necessary to explore the causality of the findings. Therapeutic and societal efforts to tackle childhood trauma or self-stigma might benefit from reflecting its broader psychosocial context.
儿童期受虐和创伤是边缘性人格障碍（BPD）病因中的重要风险因素。除了影响患BPD的风险外，童年不良经历似乎还会加重其症状及相关残疾情况。自我污名化是另一个常见问题，对心理健康也有同样显著的影响。尽管从理论上讲存在关联，但BPD患者童年创伤、自我污名化和心理健康之间的联系尚未得到探讨。本研究旨在首次深入了解这一研究不足的主题。
这项横断面研究纳入了283名被诊断为BPD并参加住院跨诊断心理治疗项目的患者。患者完成了多项测评——精神疾病内化污名量表、儿童创伤问卷简表、临床总体印象严重程度量表、贝克抑郁量表第二版、贝克焦虑量表、解离体验量表、希恩残疾量表以及一份人口统计学问卷。使用IBM SPSS和AMOS 26程序对数据进行统计分析，通过双变量相关检验和结构方程模型来探究假设。
回顾性报告的童年创伤与当前的自我污名化呈正相关。童年创伤和自我污名化也都与一般精神病理学和残疾的多项指标呈正相关。这些联系的显著性随后通过结构方程模型得到证实，其中自我污名化在童年创伤、一般精神病理学和残疾之间起到部分中介作用。
自我污名化在成年BPD患者童年创伤与特定心理健康症状之间的关系中起到显著的中介作用。需要进行纵向研究来探究这些发现的因果关系。应对童年创伤或自我污名化的治疗和社会努力可能会受益于对其更广泛社会心理背景的考量。
