3140例一、二年级大学生B群人格障碍患病率调查

目的:调查我国大学生B群人格障碍患病现状.方法:用PDQ 4问卷从3140名一、二年级大学生中筛选出DSM-IV的B群人格障碍划界分阳性者,再以PDI-Ⅳ定式晤谈法进一步确定大学生群体的患病率.结果:3140名大学生样本中有38例符合B群人格障碍PDI-Ⅳ半定式晤谈的评定标准,总患病率为1.21%,符合反社会型人格障碍评定标准的大学生1例;边缘型21例,患病率0.67%;自恋型20例,患病率0.64%;表演型8例,患病率0.25%.其中10例符合一种以上的诊断标准,共病率为26.3%.结论:B群大学生B群人格障碍患病率低于国外报道的普通人群患病率,但略高于国内以往的调查结果,B群人格障碍各型之间有较高的共病率.     

四种人格障碍检测工具效度比较研究：—人格障碍检测工具系列研究Ⅱ

目的：对四来自西方的人格障碍检测工具的效度进行比较研究,母\方法：本研究将四种人格障碍检测工具IPDE（国际人格障碍检查）、SCIⅡ（DSM-Ⅲ-R人格障碍临床定式检测）、SCI－ⅡPQ（DSM-Ⅲ-R人格障碍筛查问卷）,PDI－Ⅳ（DSM-Ⅳ人格障碍检测）在中国大陆人群中抽样测试并进行效度检验。结果：在四个检测工具中强迫型、回避型、依赖型、表演型、边缘型、反社会型、分裂样型和偏执型等8个人格障碍型别具有较好的效度;IPDE较其他检测工具的效度更为完善,IPED的不足之处;项目8、结构稳定性差,项目2、3、8、24、25、29、52的区分度较差。结论：迫型、回避型、依赖型,表演型、边缘型、反社会型、分裂样型和偏执型等8个人格障碍型别有较好的独特性和鉴别诊断效能;IPED较其他检测工具有更好的可操作性。     

四种人格障碍检测工具信度比较研究：—人格障碍检测工具系列研究Ⅰ

目的：将来自西方的四种人格障碍检测工具IPDE、SCID－Ⅱ、SCID-ⅡPQ和PDI－Ⅳ中文版本（简称IPDESCID－Ⅱ、SCID-ⅡPQ和PDI－Ⅳ）在中国文化背景下进行检测和信度比较研究,方法：以上述四个人格障碍检测工具分别检测153名被试（缓解重型精神病患者42名,病情稳定的神经症患者41名,人格障碍碍者29名,正常对照被试41名）并对其信度进行了系统检检和比较,结果：信度检验显示,强迫型、回避型（IPDE中为焦眠／回避型）、依赖型,表演型、边缘型（IPDE中为情绪不稳定型）、反社会型（IPDE中为社交紊乱型）、分裂祥型和偏执型等8个人格障碍分量表的重测信度、评定者信度1分半信度和同质性信度较好;在四个人格障碍检测工具中,IPDE的信度较其它人格障碍工具更好。结论：强迫型、回避型（IPDE中为焦虑／回避型）依赖型、表演型、边缘型（IPDE中为情绪不稳定型）、反社会型（IPDE中为社交紊乱型）、分裂祥型和偏执型等8个人格障碍型另具有较的稳定性,客观性、内部同源性。IPDE有较为完善的信度。     

Ethnicity in trauma and psychiatric disorders: findings from the collaborative longitudinal study of personality disorders

The study's aims are to explore ethnic differences in rates of adverse childhood experiences and lifetime traumatic events and in rates of psychiatric disorders for patients exposed to similar traumas. Rates of these events and rates of major depressive disorder, posttraumatic stress, substance use, and borderline personality disorders were compared among 506 non‐Hispanic Whites (N‐HW), 108 Latina(o)s, and 94 African Americans (AA) participating in the Collaborative Longitudinal Personality Disorder Study. We found that Whites reported higher rates of neglect than African Americans and Latina(o)s, higher rates of verbal/emotional abuse than African Americans, and higher rates of accidents and injuries/feared serious injury than Latina(o)s. African Americans had higher rates of seeing someone injured/killed than Whites. No significant interaction was observed between adverse events and ethnicity for mental disorders. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1–16, 2010.     

大学生B群人格障碍患者童年期创伤性经历的研究

目的：了解大学生B群人格障碍被试童年期创伤性经历的特点。方法：先用PDQ＋4问卷筛查，冉以PDI—IV对筛查的阳性被试进行半定式查询确诊B群人格障碍患者，然后用童年期创伤性经历问卷（CTQ）测查所有被试的章年负性经历。结果：除情感忽视因子外，B群人格障碍组CTQ各因子和总分均显著高于正常对照组。进一步将边缘型人格障碍（Borderline Personality Disordel ，BPD）组和自恋型人格障碍（Narcissistic Personality Disorder．NPD）组分别与正常对照组比较．发现BPD组情感虐待和情感忽视的因子分和总分屁著高于正常对照组。NPD组与对照组比较无鼎著性差异。结论：大学生B群人格障碍被试的童年期创伤较正常组严重。BPD在情感方面的创伤性经历尤其明显，提示情感虐待和忽视是大学生BPD发病的特征性因素。     

Relationship of borderline syndrome disorders to early schizophrenia on the MMPI

An intriguing question in modern psychopathology is the relationship of borderline syndrome disorders to other psychopathological conditions and to each other. The present study compared groups of DSM-III defined Borderline Personality Disorder (N = 51), Schizotypal Personality Disorder (N = 14), and Mixed Borderline-Schizotypal Personality Disorder (N = 17), with CATEGO diagnosed Schizophrenic Disorder of recent onset (N = 30) and nonpsychiatric controls (N = 20) on the MMPI. Profile and individual scale analyses revealed gross elevations on multiple scales in each of the patient groups, as compared with controls. Subtle differences in test performance between the borderline personality and schizotypal personality groups are noted and are consistent with their separation as disorders in DSM-III. Multivariate profile analyses distinguished the borderline, schizotypal, and early schizophrenic groups from each other, but not from the mixed personality group. Thus, this latter group may serve to bridge these diverse populations.     

A momentary assessment study of the reputed emotional phenotype associated with borderline personality disorder

SUMMARY BACKGROUND: Stress is postulated to play an essential role in the expression of core borderline symptoms. However, the phenomenology of stress reactivity in borderline personality disorder remains unclear. The current study investigated the phenomenology of stress sensitivity in borderline personality disorder in the flow of daily life and compared this with stress sensitivity in patients suffering from psychotic disorders, a group so far known to report the largest reactivity to stress.MethodA total of 44 borderline patients, 42 patients with psychotic disorder and 49 healthy controls were studied with the Experience Sampling Method (a structured diary technique assessing current context and mood in daily life) to assess: (1) appraised subjective stress related to daily events and activities; and (2) emotional reactivity conceptualized as changes in positive and negative affect. RESULTS: Multilevel regression analysis revealed that subjects with borderline personality disorder experienced significantly more emotional reactivity to daily life stress compared with both patients with psychosis and healthy controls, as evidenced by a larger increase in negative affect and a larger decrease in positive affect following stress.ConclusionThese results are the first to ecologically validate the incorporation of stress reactive symptoms in the diagnosis of borderline personality disorder. Borderline patients continually react stronger than patients with psychosis and healthy controls to small disturbances that continually happen in the natural flow of everyday life. Altered emotional stress reactivity may define borderline personality disorder.     

边缘型人格障碍大学生的童年期创伤经历特征

目的:探讨边缘型人格障碍(borderline personality disorder,BPD)大学生的童年期创伤经历特征。方法:用人格诊断问卷第四版(Personality Diagnosis Questionnaire-4+,PDQ-4+)从3227名二、三年级本科生中筛选出边缘型阳性者293例,用个性障碍晤谈手册第四版(Personality Disorder Interview,PDI-IV)半定式晤谈法进一步筛选出BPD患者(得分5分)31例。从PDQ-4+划界分阴性的大学生中按年龄和性别比随机选取114例为对照组。用童年期创伤经历问卷(Childhood Trauma Questionnaire,CTQ-SF)对两组进行测评。结果:①在PDQ-4+筛查中,总体的边缘型分量表分为(2.62±1.70);31例BPD患者中女18例,男13例,女性CTQ-SF不良环境因子得分高于男性[(13.63±4.54)vs.(9.83±1.95),P0.01]。②BPD组的CTQ-SF各因子分均高于对照组[如,情感虐待(2.11±0.77)vs.(1.66±0.49),P0.01]。结论:大学生边缘型人格障碍者均有不同程度的童年期创伤经历,而且这种创伤经历存在性别差异。     

The interplay of subjective social status and essentialist beliefs about cognitive aging on cortisol reactivity to challenge in older adults

Older adults are more likely than younger adults to experience stress when confronted with cognitive challenges. However, little is known about individual differences that might explain why some older adults exhibit stronger stress responses than others. We examined the interplay of two social‐cognitive factors to explain older adults' cortisol reactivity: (1) subjective social status, and (2) essentialist beliefs about cognitive aging. We hypothesized that, depending on whether older adults believe that aging‐related cognitive decline is inevitable versus modifiable, low subjective social status should lead to stronger or weaker cortisol reactivity. Using longitudinal data, we assessed the impact of cognitive challenges on stress reactivity in a sample of older adults (N = 389; 61–86 years). As predicted, regression analyses confirmed that 44 min after cognitively challenging tasks, older adults exhibited a significantly different cortisol reactivity depending on their subjective social status and their essentialist beliefs about cognitive aging. Specifically, older adults with low subjective social status and high essentialist beliefs showed a significantly elevated cortisol reactivity. We discuss the role of essentialist beliefs about cognitive aging to predict when and why high versus low subjective social status leads to stress responses in older adults.     

Moderators and predictors of outcome in metacognitive and cognitive behavioural therapy for co‐morbid anxiety disorders

This study aimed to investigate whether two theoretically derived moderators of treatment, degree of worry and avoidance at pretreatment, moderated anxiety from pretreatment to post‐treatment in a randomized controlled trial comparing metacognitive therapy and cognitive behavioural therapy. Personality problems, degree of co‐morbidity, and demographic characteristics (work status and education) were also investigated. Seventy‐four patients with a primary diagnosis of post‐traumatic stress disorder, social phobia, or panic disorder with and without agoraphobia were analysed using multilevel modelling. There were no significant predictors of treatment outcome, indicating that the slope was not dependent on worry, avoidance, personality problems, degree of co‐morbidity, and demographic characteristics. Furthermore, no interaction with treatment condition was found. Due to the sample size, the results of the moderator analysis should be interpreted with caution and replicated. Worry, avoidance, personality problems, degree of co‐morbidity, and demographic variables did not moderate the effect of metacognitive therapy and cognitive behavioural therapy or predict treatment outcome for co‐morbid anxiety disorders. Clinical implications are discussed.     

Neuroticism and brain responses to anticipatory fear

Personality is known to influence cognitive and affective functioning as well as the risk of psychiatric disorders. Exploration of the neurobiological correlates of personality traits has the potential to enhance understanding of their significance in development of related psychopathological states. The authors examined the association between individual differences in neuroticism and brain activity in response to threat of electric shocks. Fourteen right-handed healthy men underwent functional MRI during a 5-min experiment that involved repeated presentations of two 30-s alternating conditions. In 1 of these conditions, subjects were told to expect mild but painful electric shocks; there was no possibility of receiving shocks in the other condition. The results revealed that neuroticism correlated positively with the ratings of fear of shock and negatively (indicating suppression) with brain activity from safe to shock conditions in the anterior and posterior cingulate, superior/middle temporal gyrus extending to the hippocampus, precuneus, putamen, thalamus, and middle occipital gyrus. The observations support recent psychophysiological research that has demonstrated reduced processing of pain in subjects with higher levels of neuroticism, especially the anxiety component of this trait.     

MCMI-II personality disorders in recent-onset bipolar disorders.

This study investigated the personality disorders of 21 recent-onset Bipolar Disorder patients using the revised Million Clinical Multiaxial Inventory (MCMI-II; Millon, 1987). Personality disorder assessments, conducted after patients' clinical symptoms had settled, indicated that 17 patients received at least one MCMI-II personality disorder diagnosis with a trend toward multiple diagnoses. Narcissistic, Antisocial, and Histrionic personality disorders were diagnosed most frequently and were the scales most elevated. Schizoid and Compulsive personality disorders were the scales least elevated. Diagnostic concordance between the MCMI-II and the Structured Interview for DSM-III Personality (SIDP; Pfohl, Stangl, & Zimmerman, 1983) was poor; the MCMI-II made more multiple diagnoses. Implications of the discrepancies between these instruments and suggestions for future research are discussed.     

青春期C类人格障碍检测工具的信度和效度

目的:分析CCMD-2-R的C类人格障碍诊断标准在青少年群体中的适用性,编制适用于青少年的人格障碍检测工具.方法:根据CCMD-2-R,将相匹配的成人人格障碍筛查问卷(PDQC)和结构式访谈手册(SCICP)修编成适合青少年群体的工具(PDQC-A-R和SCICP-A-R),利用PDQC-A-R从深圳市912名中学生中筛选出168名,根据SCICP-A-R进行临床半定式访谈,最终确定符合C类人格障碍诊断者89名,将其作为观察组,再抽取31名健康中学生作为对照组,进行信、效度检验.结果:①PDQC-A-R和SCICP-A-R的信度与实证效度符合心理测量学要求;②PDQC-A-R与SCICP-A-R的结构与CCMD-2-R基本一致,但C类人格障碍在青春期群体的结构并不完全符合DSM-Ⅳ的理论构想;③PDQC-A-R维度法评估的特异度明显高于分类法评估.结论:CCMD-2-R的C类人格障碍诊断标准可用于评估青春期人格病理,PDQC-A-R和SCICP-A-R具有良好的信度和效度.     

强迫障碍及其共病人格障碍患者的心理防御特点

目的:研究强迫障碍及其共病人格障碍患者的心理防御方式。方法:符合DSM-IV临床诊断标准的35例OCD患者和35名正常对照者。用人格诊断问卷筛查人格障碍,再用人格障碍晤谈手册确定共病人格障碍的患者;所有被试接受防御方式问卷测查。结果:35例OCD患者有22例(62.9%)共病人格障碍;共病人格障碍组在诸多不成熟(P<0.05或P<0.001)和中间防御方式上(P<0.05,P<0.01或P<0.001)高于对照组,在某些成熟防御方式上低于对照组(P<0.05或P<0.01)。非共病人格障碍组在不成熟和中间防御方式上仅退缩和制止得分高于对照组(P<0.05),而成熟防御方式低于对照组(P<0.05或P<0.001)。结论:共病人格障碍的强迫障碍患者更多地使用不成熟和中间型防御方式,同时较少使用成熟的防御方式。而没有共病人格障碍的强迫障碍患者只是较少使用成熟的防御方式。     

The Rorschach test in clinical diagnosis: a critical review, with a backward look at Garfield (1947)

The present article comments on a classic study by Garfield (1947) then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy.     

The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity

BACKGROUND: There are numerous reports of personality disorder pathology in different eating disorders. However, few studies have directly compared personality pathology in bulimia nervosa, binge eating disorder and obesity. The present study examines group differences in DSM-IV personality pathology, considering the potential utility of understanding personality disorders in terms of diagnosis and dimensional scores. METHOD: Eating disorder diagnoses were established using the Eating Disorder Examination interview. Thirty-five bulimia nervosa patients, 15 binge eating disorder patients and 37 obese patients were assessed and compared on the International Personality Disorder Examination using categorical and dimensional personality disorder scores. RESULTS: For most personality disorders, there was a dichotomy of binge eaters versus non-binge eaters. In contrast, there was a continuum of severity in borderline personality disorder pathology between the groups. The dimensional system of measurement of personality pathology allowed for clearer differentiation between the groups. CONCLUSION: The study strongly indicates that personality disorder difficulties are present in patients who binge eat, while obese patients who do not binge eat display significantly less personality disorder pathology. Assessment of bulimia nervosa, binge eating disorder and obesity needs to address personality disorders and pathology. Dimensional markers of personality pathology can be used to supplement categorical diagnoses, providing information about the traits that underlie diagnosis.     

Insomnia does not affect heart rate changes when young adults watch humorous films: An exploratory study

Emotional reactivity in insomnia is affected both subjectively and on a physiological level for negative emotional material, but little is known about reactions to positive stimuli. We here investigated whether in younger adult insomnia patients, presentation of short humorous films would lead to heart rate decreases during and after film viewing, as compared to heart rate changes when falling asleep. Investigating 20 participants with DSM‐5‐diagnosed insomnia and 18 participants without insomnia, we found that heart rate decreased when falling asleep, increased when watching humorous films and returned to normal values afterwards for all participants. Film‐related heart rate increases were strongly related to humour ratings of the films. No differences were found between those with and without insomnia on subjective ratings of the films, film‐related heart rate changes or when falling asleep. We conclude that the experience of positive daily life stimuli in younger adults is not affected by insomnia in our study, despite insomnia having a known more profound effect on negative stimuli. Future studies exploring insomnia‐related autonomous nervous system responses combining different neurophysiological modalities should confirm our findings.     

Borderline personality traits and adult attention‐deficit hyperactivity disorder symptoms: A genetic analysis of comorbidity

Previous research has established the comorbidity of adult Attention‐Deficit Hyperactivity Disorder (ADHD) with different personality disorders including Borderline Personality Disorder (BPD). The association between adult ADHD and BPD has primarily been investigated at the phenotypic level and not yet at the genetic level. The present study investigates the genetic and environmental contributions to the association between borderline personality traits (BPT) and ADHD symptoms in a sample of 7,233 twins and siblings (aged 18–90 years) registered with the Netherlands Twin Register and the East Flanders Prospective Twin Survey (EFPTS) . Participants completed the Conners' Adult ADHD Rating Scales (CAARS‐S:SV) and the Personality Assessment Inventory‐Borderline Features Scale (PAI‐BOR). A bivariate genetic analysis was performed to determine the extent to which genetic and environmental factors influence variation in BPT and ADHD symptoms and the covariance between them. The heritability of BPT and ADHD symptoms was estimated at 45 and 36%, respectively. The remaining variance in BPT and ADHD symptoms was explained by unique environmental influences. The phenotypic correlation between BPT and ADHD symptoms was estimated at r = 0.59, and could be explained for 49% by genetic factors and 51% by environmental factors. The genetic and environmental correlations between BPT and ADHD symptoms were 0.72 and 0.51, respectively. The shared etiology between BPT and ADHD symptoms is thus a likely cause for the comorbidity of the two disorders. © 2011 Wiley‐Liss, Inc.     

Psychosocial Correlates of Cardiovascular Reactivity to Anticipation of an Exercise Stress Test Prior to Attending Cardiac Rehabilitation: A Preliminary Test1

We examined social and psychological correlates of cardiovascular reactivity (CVR), or exaggerated heart rate (HR) and blood pressure (BP) responses to mental stress, in 45 men (mean age = 60.1, SD = 9.9) and 17 women (mean age = 9.9, SD = 11.8) prior to cardiac rehabilitation. HR and BP increased from rest to anticipation, and women had higher resting and preexercise BP. Anxiety was positively related to HR reactivity. HR reactivity was negatively related to self‐efficacy in women and positively related to self‐efficacy in men. Men and women with more self‐efficacy had lower systolic blood pressure (SBP) reactivity, and anxiety was positively related to SBP reactivity in women. Results suggest that the relationship among psychosocial factors and CVR might differ among men and women.     

强迫症与人格障碍的共病研究

目的：评估强迫症患者中人格障碍的发生率，探讨强迫症患者与人格障碍的共病情况。方法：使用SCID—Ⅱ对47例强迫症患者和47例正常对照进行人格障碍的评估。结果：61．7％的强迫症患者至少符合一种人格障碍的诊断标准，显著高于对照组，且34％同时患有两种以上的人格障碍；强迫症患者中员常见的人格障碍为强迫型、回避型、消极型以及偏执型；患者的性别及是否有精神疾病家族史对人格障碍的共病率无显著影响。结论：强迫症与人格障碍常有共病现象，强迫型人格障碍同强迫症具有特殊关系，今后在强迫症的生物学研究中应考虑人格特质与人格障碍的影响。