BPD 指南针:使用精神病理学维度模型治疗同时存在的边缘型人格障碍和创伤后应激症状。

IF 2.4 3区 医学 Q2 PSYCHIATRY
Caitlyn O. Hood, Matthew W. Southward, Christal L. Badour, Shannon Sauer-Zavala
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引用次数: 0

摘要

BPD Compass 是一种跨诊断的心理疗法,包括认知、行为和正念技能,针对消极情绪、抑制和对抗等人格维度。鉴于边缘型人格障碍(BPD)和创伤后应激障碍(PTSD)之间存在相当大的症状共存性和病因重叠性,本研究调查了 BPD Compass 是否有望作为一种综合方法,同时治疗共存的 BPD 特征和 PTSD 症状。参与者包括84名受到创伤的成年人,他们参加了一项分两个阶段进行的临床试验(第一阶段:BPD Compass与等待表的随机对照试验[n = 43];第二阶段:BPD Compass的开放试验[n = 41])。与等待名单相比,BPD Compass 在 BPD 特征(βs = -.57 -.44)和神经质方面(βs < -.55--.73)有中到大的显著改善,在自我报告(β = -.20)和临床医生评定的创伤后应激障碍症状严重程度(β = -.19)方面也有小幅非显著改善。在治疗期间,个人创伤后应激障碍症状的改善预示着随后 BPD 特征的改善,β = .13,但反之亦然,β = .07。人内创伤后应激障碍症状的减轻也预示着所有人格维度随后的改善,而只有人内绝望(β = .12)、情感失调(β = .11)和分离倾向(β = .12)的改善才预示着创伤后应激障碍症状的减轻。研究结果初步支持了 BPD Compass 针对受创伤成年人的 BPD 特征以及神经质和合意性方面的潜力。此外,创伤后应激障碍症状的改变预示着随后BPD特征的改善,这与当前的阶段性治疗模式背道而驰,当前的治疗模式强调先稳定BPD特征,然后再进行以创伤为重点的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
BPD Compass: Using a dimensional model of psychopathology to treat co-occurring borderline personality disorder and posttraumatic stress symptoms

BPD Compass is a transdiagnostic psychotherapy that includes cognitive, behavioral, and mindfulness skills targeting the personality dimensions of negative affectivity, disinhibition, and antagonism. Given considerable symptom comorbidity and overlap in etiology between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD), this study investigated whether BPD Compass holds promise as an integrated approach to simultaneously treating co-occurring BPD features and PTSD symptoms. Participants included 84 trauma-exposed adults who participated in a two-phase clinical trial (Phase 1: randomized controlled trial of BPD Compass vs. waitlist [n = 43]; Phase 2: open trial of BPD Compass [n = 41]). Compared to waitlist, BPD Compass led to medium-to-large–sized, significant improvements in BPD features, βs = −.57 −.44, and facets of neuroticism, βs < −.55–−.73, as well as small, nonsignificant improvements in self-reported, β = −.20, and clinician-rated PTSD symptom severity, β = −.19. During treatment, within-person improvements in PTSD symptoms predicted subsequent improvements in BPD features, β = .13, but not vice versa, β = .07. Within-person PTSD symptom reduction also predicted subsequent improvement in all personality dimensions, whereas only within-person improvement in despondence, β = .12, affective dysregulation, β = .11, and dissociative tendencies, β = .12, predicted PTSD symptom reductions. Findings offer preliminary support for the potential of BPD Compass to target BPD features and aspects of neuroticism and agreeableness among trauma-exposed adults. Moreover, PTSD symptom change predicting subsequent improvement in BPD features runs counter to current stage-based treatment models that emphasize BPD feature stabilization before engaging in trauma-focused therapy.

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来源期刊
CiteScore
5.80
自引率
6.10%
发文量
125
期刊介绍: Journal of Traumatic Stress (JTS) is published for the International Society for Traumatic Stress Studies. Journal of Traumatic Stress , the official publication for the International Society for Traumatic Stress Studies, is an interdisciplinary forum for the publication of peer-reviewed original papers on biopsychosocial aspects of trauma. Papers focus on theoretical formulations, research, treatment, prevention education/training, and legal and policy concerns. Journal of Traumatic Stress serves as a primary reference for professionals who study and treat people exposed to highly stressful and traumatic events (directly or through their occupational roles), such as war, disaster, accident, violence or abuse (criminal or familial), hostage-taking, or life-threatening illness. The journal publishes original articles, brief reports, review papers, commentaries, and, from time to time, special issues devoted to a single topic.
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