Shearer S L
Anxiety and Stress Disorders Institute of Maryland, Towson 21204.
Am J Psychiatry. 1994 Sep;151(9):1324-8. doi: 10.1176/ajp.151.9.1324.
This study was conducted to determine whether trauma variables and certain behavioral correlates are differentially prevalent in borderline personality disorder patients with greater and those with lesser dissociative experience.
Subjects were 62 female inpatients, all meeting DSM-III-R criteria for borderline personality disorder, 14 of whom also had a concomitant dissociative disorder diagnosis. Structured interviews and published scales were used to collect data addressing a priori hypotheses.
Univariate analyses supported hypotheses that patients with borderline personality disorder and greater dissociative experience are characterized by more self-reported traumatic experiences, posttraumatic symptoms, behavioral dyscontrol, self-injurious behavior, and alcohol abuse. Multivariate analyses suggested that scores on the Dissociative Experiences Scale were predicted particularly by adult sexual assault, behavioral dyscontrol, and both sexual and physical abuse in childhood.
These results support the use of the Dissociative Experience Scale as a brief screening instrument to aid in the identification of borderline personality disorder patients with prominent posttraumatic and dissociative disorders. Patients with borderline personality disorder seem to be characterized by somewhat different life experiences, treatment histories, and behavioral presentations depending on their level of dissociative experience, even though they meet the same DSM-III-R criteria. Neither extreme view of the overlap in diagnostic populations was supported.
本研究旨在确定创伤变量和某些行为相关因素在分离体验较多和较少的边缘型人格障碍患者中是否有不同程度的普遍存在。
研究对象为62名女性住院患者,均符合DSM-III-R边缘型人格障碍标准,其中14人还伴有分离性障碍诊断。使用结构化访谈和已发表的量表收集数据以验证先验假设。
单因素分析支持以下假设:分离体验较多的边缘型人格障碍患者的特征为更多的自我报告创伤经历、创伤后症状、行为失控、自我伤害行为和酒精滥用。多因素分析表明,分离体验量表得分尤其可由成人期性侵犯、行为失控以及童年期性虐待和身体虐待来预测。
这些结果支持将分离体验量表用作一种简短筛查工具,以帮助识别患有明显创伤后和分离性障碍的边缘型人格障碍患者。边缘型人格障碍患者似乎因其分离体验水平不同而具有 somewhat different生活经历、治疗史和行为表现,尽管他们符合相同的DSM-III-R标准。两种关于诊断人群重叠的极端观点均未得到支持。 (注:原文中“somewhat different”翻译为“ somewhat different”可能有误,推测应为“有些不同”,但按照要求未修改)