边缘性人格障碍发病机制研究进展

目的回顾最近几年有关边缘性人格障碍的研究,探讨边缘性人格障碍的发病机制。方法应用Medline和中国知网期刊文献检索2008年2月之前关于边缘性人格障碍的相关文献,检索词为边缘性人格障碍(borderline personality disorder)和发病机制(mechanisms)。结果选择以边缘性人格障碍发病机制相关的文献有46篇,分别涉及到边缘性人格障碍的神经传递素、亲附特点、神经成像、遗传学、认知以及分型。结论边缘性人格障碍是指一群异质的个体,他们在症状表现、病因、心理病理机制的反应等方面可能都存在着很大的差异,它是受生物、心理和社会多方面影响的。     

边缘性人格障碍患者的情绪反应研究

边缘性人格障碍的情绪反应已受到西方精神卫生界的普遍关注.许多研究认为情绪反应是探讨边缘性人格障碍发病原因的核心问题.本文就边缘性人格障碍的情绪反应特点和诊断模型进行了深入的探讨,以期为进一步研究边缘性人格障碍的治疗、诊断和评估等领域提供理论框架.     

边缘性人格障碍临床表现与治疗现状综述

边缘性人格障碍（BPD）是一种患者个体以情绪反应失调、自我意识和人际关系不稳定,常有行为冲动为临床特征的严重精神疾病。国外研究显示,BPD患者占普通人群的2%,精神科门诊患者的10%,住院患者的20%,人格障碍患者的30%～60%[1]。由于BPD缺乏特征性的临床症状并常与其他一种或一种     

用"代际-脑-经验模型"理解边缘性人格障碍的病理机制

边缘性人格障碍（Borderline personality disorder,BPD）在西方是一种常见的人格障碍,而在中国大陆没有进入CCMD诊断系统,因此缺乏相应的研究.本文将对BPD的临床现象学内容进行回顾和澄清,并在国外有关研究BPD的脑神经科学、神经生化学和发展心理病理学研究进展的基础上,建立了“代际-脑-经验模型”（Intergenera-tional Brain-and-Experience Model, IBEM）,并以之为线索探讨BPD的病理机制,以期深入理解BPD作为一种人格障碍的独特性,最后对在我国大陆开展BPD的研究方向进行了探讨.     

边缘性人格障碍者的工作记忆特征

目的:考察边缘性人格障碍患者的工作记忆功能是否存在缺陷。方法:31名边缘性人格障碍患者和31名正常对照组受试完成了改良版N-back任务(0-back和2-back)。采用重复测量方差分析比较两组在工作记忆指标(反应时、总正确率及连续反应正确率)上的差异。结果:方差分析结果显示工作记忆负荷主效应显著,2-back任务的总正确率显著低于0-back任务;边缘性人格障碍组的连续正确反应率显著低于正常对照组,但连续正确反应率与冲动得分相关不显著。结论:边缘性人格障碍的工作记忆存在某些缺陷。     

边缘性人格障碍临床表现与治疗现状综述

<正>边缘性人格障碍(BPD)是一种患者个体以情绪反应失调、自我意识和人际关系不稳定,常有行为冲动为临床特征的严重精神疾病。国外研究显示,BPD患者占普通人群的2%,精神科门诊患者的10%,住院患者的20%,人格障碍患者的30%～60%[1]。由于BPD缺乏特征性的临床症状并常与其他一种或一种     

环境与基因对边缘性人格障碍的影响

边缘性人格障碍(BPD)是精神科常见的一种人格障碍,虽然目前对BPD的发病机制尚未完全明了,但已有研究提示基因与环境及两者的交互作用在BPD的发生发展中具有非常重要的作用。本文通过CNKI,MEDLINE和PsysNET等数据库上检索有关边缘性人格与环境、基因之间关系的研究文献,并对文献进行系统总结,发现目前已有较多研究结果支持了基因与环境之间的交互作用在BPD发生发展中的作用。然而,已有关于两者交互作用相关研究尚存在缺陷,需未来的研究进行完善。     

边缘性人格障碍治疗1例

边缘性人格障碍（BPD）是一种以人际关系、自我形象和情感的不稳定,同时有明显冲动性行为为临床特征的心理疾病,患者具有较大的社会功能损害,并存在10％的自杀率（高于普通人群50倍）。在普通人群中的患病率为1％～2％,在精神科病人中检出率较高：门诊病人为10％,住院病人为20％;女性的发病率显著高于男性（7：3）。     

边缘性人格障碍和焦虑障碍患者光诱发电位的对照研究

目的:探讨边缘性人格障碍(BPD)和焦虑障碍(AN)在光诱发电位(VEP)中的特点。方法:收集28例BPD组、36例AN组及49名正常成人对照(NC),应用美国仪器以及红光刺激,完成光诱发电位(VEP)检查。结果:与NC相比,BPD组潜伏期VEP/P1、P2前移,波幅VEP/N1-P2、P3增高,但波幅VEP/P2-N2、P2降低。与NC相比,AN组潜伏期VEP/P1、P3前移;波幅VEP/P2-N2、P2降低。BPD组与AN组相比,在潜伏期VEP/P2以及波幅VEP/N1-P2上两者有显著性意义,BPD组前移于AN组,波幅增高。结论:在VEP若干指标上,BPD组前移于AN组,波幅增高。BPD组光诱发电位特点,值得进一步跟踪随访。     

边缘性人格障碍治疗脱落引发的思考

目的验证心理动力学为背景的辩证行为心理治疗技术(Dialectical behavior therapy,DBT)对边缘性人格障碍患者的疗效。方法药物治疗和门诊心理治疗相结合。结果治理过程中出现移情与反移情,最终导致治疗关系恶化,在第8次治疗后患者攻击治疗师。结论边缘性人格障碍患者将不稳定的人际关系投射到治疗关系中,医生往往会替代现实中的客体被攻击和指责,现阶段的心理治疗还处于艰难状态。     

Disorganized attachment and Borderline Personality Disorder: A clinical perspective

The aim of this paper is to explore the links between the attachment-theory derived concept of disorganized attachment, and the psychiatric diagnosis of Borderline Personality Disorder (BPD). Disorganized attachment can be understood in terms of an approach-avoidance dilemma for infants for whom stressed or traumatized/traumatizing caregivers are simultaneously a source of threat and a secure base. Interpersonal relationships in BPD including those with care givers is similarly seen in terms of approach-avoidance dilemmas, which manifests themselves in disturbed transference/countertransference interactions between therapists and BPD sufferers. Possible ways of handling these phenomena are suggested, based on Main's () notion of ‘meta-cognitive monitoring’, in the hope of re-instating meaning and more stable self-structures, in these patients' lives.     

Borderline Personality Disorder in Adolescents

Sizeable numbers of youth in community and clinical settings meet diagnostic criteria for borderline personality disorder (BPD). Early assessment and treatment may positively alter the life‐course trajectory of young people with BPD and reduce future suffering and impairment. This article reviews the potential etiological bases of BPD, including genetic, neurobiological, social‐cognitive, and the biosocial theory. Prospective, retrospective, and correlational research including infant and child temperament, internalizing and externalizing psychopathology, as well as suicidal and nonsuicidal self‐injurious behaviors provide additional information to better understand potential risk factors for the development of BPD as well as points for intervention (e.g., emotion regulation). To date, dialectical behavior therapy and mentalization‐based treatment appear promising as effective treatments for adolescents who carry at least three borderline personality features in addition to self‐harm. Directions for future research are discussed.     

The Efficacy of Dialectical Behavior Therapy for Borderline Personality Disorder

The most scientifically appropriate conclusion to draw from the body of research on dialectical behavior therapy (DBT) is that it is probably useful in producing initial improvement on multiple variables relevant to outcome in borderline personality disorder, particularly parasuicidal behavior. These are promising and clinically relevant findings. However, its genuine efficacy in producing changes that last after the treatment has been discontinued is unknown. A major gap in the literature is the absence of any follow-up data at intervals appropriate for assessing the efficacy of a treatment for a disorder that is chronic by definition. The gap between the data and widespread beliefs about the efficacy of DBT is not, however, specific to DBT. A recent metaanalysis suggests that similar disparities are the norm in most research on empirically supported therapies, such as brief treatments for depression.     

Co-Occurrence of Dissociative Identity Disorder and Borderline Personality Disorder

The literature indicates that, among individuals with borderline personality disorder, pathological dissociation correlates with a wide range of impairments and difficulties in psychological function. It also predicts a poorer response to dialectical behavior therapy for borderline personality disorder. We hypothesized that (a) dissociative identity disorder commonly co-occurs with borderline personality disorder and vice versa, and (b) individuals who meet criteria for both disorders have more comorbidity and trauma than individuals who meet criteria for only 1 disorder. We interviewed a sample of inpatients in a hospital trauma program using 3 measures of dissociation. The most symptomatic group was those participants who met criteria for both borderline personality disorder and dissociative identity disorder on the Dissociative Disorders Interview Schedule, followed by those who met criteria for dissociative identity disorder only, then those with borderline personality disorder only, and finally those with neither disorder. Greater attention should be paid to the relationship between borderline personality disorder and dissociative identity disorder.     

A Rorschach exploration of the DSM-IV Borderline Personality Disorder.

Rorschach data has been useful in identifying the DSM Borderline Personality Disorder (BPD) and has potential for improving our understanding of this disorder. Recently, the DSM-IV BPD has been shown to be composed of 3 primary or core factors: Factor I-unstable self-other images. Factor II-deficits in affect and thought modulation, and Factor III-impulsive self-damaging actions. In a sample of outpatients with personality disorders. we explored the relationships among 6 psychoanalytically derived Rorschach scales (primitive aggression, oral dependency, self-other differentiation, splitting, devaluation, and projective identification), and the core BPD features. Significant correlations were found between 5 of the Rorschach variables and BPD total scores. Correlations between these 5 variables and the BPD core features showed that oral dependency needs were negatively associated with all 3 BPD core features, whereas the defenses of devaluation and splitting were positively associated with these core features. The clinical implications of these findings are reviewed.