复发性自残青少年的亚阈值或全综合征边缘型人格障碍-明显或维度不同?

IF 4 2区 医学 Q1 PSYCHIATRY
Anne Brager-Larsen, Pål Zeiner, Lars Mehlum
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引用次数: 0

摘要

背景:边缘型人格障碍(BPD)是一种严重的精神障碍,常见于反复自我伤害行为的个体。就临床特征而言,符合BPD完全诊断标准的自残青少年、低于阈值的BPD标准以及没有BPD的青少年之间的区别特征在多大程度上仍不确定,但可能具有重要的临床意义。方法:采用临床访谈和自我报告的方法,收集103名儿童和青少年精神科门诊有反复自残行为的青少年的资料。进行双变量分析,比较有或没有诊断为BPD的参与者。基于满足BPD标准数量的组间差异(很少BPD: 0-2个标准,亚阈值BPD: 3-4个标准,全综合征BPD: 5个或更多标准)进行测试和回归分析。结果:被诊断为BPD的青少年(28.2%)共患DSM-5障碍、自杀企图和自残方法的数量显著增加。与没有BPD的青少年相比,他们的自杀意念、抑郁、焦虑和冲动程度也明显更高。就这些症状而言,亚阈值BPD青少年(20.4%)将自己置于完全综合征BPD和很少(如果有的话)BPD参与者之间的中间位置。较高水平的情绪调节困难和较低水平的整体功能与较高数量的BPD标准显著相关。结论:符合全症候群BPD或亚阈值BPD诊断标准的复发性自残青少年似乎在同一谱系内存在困难。就困难的严重程度而言,他们似乎只是维度上的不同,而不是绝对的不同。这些青少年需要在症状发展的较早阶段,而不是较晚阶段,针对其功能失调的自残行为、情绪调节困难和BPD症状进行干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sub-threshold or full-syndrome borderline personality disorder in adolescents with recurrent self-harm - distinctly or dimensionally different?

Background: Borderline personality disorder (BPD) is a severe mental disorder frequently seen in individuals with recurrent self-harm behaviour. To what extent there are distinguishing characteristics between self-harming adolescents who meet the criteria for a full diagnosis of BPD, a sub-threshold number of BPD criteria and those who don't have BPD, with respect to clinical characteristics, is still uncertain and could have important clinical implications.

Methods: Data from 103 adolescents with recurrent self-harm behaviour recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports. Bivariate analyses comparing participants with or without a diagnosis of BPD were performed. Group differences based on the number of BPD criteria fulfilled (few-if-any BPD: 0-2 criteria, sub-threshold BPD: 3-4 criteria, full-syndrome BPD: 5 or more criteria) were tested and regression analyses performed.

Results: Adolescents with a diagnosis of BPD (28.2%) had significantly higher numbers of co-morbid DSM-5 disorders, suicide attempts and self-harm methods. They also reported significantly higher levels of suicidal ideation, depression, anxiety and impulsivity, compared with adolescents without BPD. Adolescents with sub-threshold BPD (20.4%) place themselves in the intermediate position between participants with full-syndrome BPD and participants with few-if-any BPD, in terms of these symptoms. Higher levels of emotional regulation difficulties and a lower level of global functioning were significantly associated with fulfilling a higher number of BPD criteria.

Conclusion: Adolescents with recurrent self-harm who meet diagnostic criteria for a full-syndrome BPD or sub-threshold BPD seem to have difficulties within the same spectrum. They seem dimensionally, but not categorically, different with respect to the severity of their difficulties. These adolescents need interventions aimed at their dysfunctional self-harm behaviour, emotional regulation difficulties and BPD symptoms at an earlier, rather than at a later stage of symptom development.

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来源期刊
CiteScore
6.00
自引率
9.80%
发文量
30
审稿时长
28 weeks
期刊介绍: Borderline Personality Disorder and Emotion Dysregulation provides a platform for researchers and clinicians interested in borderline personality disorder (BPD) as a currently highly challenging psychiatric disorder. Emotion dysregulation is at the core of BPD but also stands on its own as a major pathological component of the underlying neurobiology of various other psychiatric disorders. The journal focuses on the psychological, social and neurobiological aspects of emotion dysregulation as well as epidemiology, phenomenology, pathophysiology, treatment, neurobiology, genetics, and animal models of BPD.
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