{"title":"林恩的生物社会理论与 DSM-5 人格障碍替代模式对边缘型人格障碍的兼容性","authors":"Nicholas R. Livingston, Kasey Stanton","doi":"10.1002/pmh.1635","DOIUrl":null,"url":null,"abstract":"Borderline personality disorder (BPD) is characterized by affective, interpersonal, and identity instability, as well as marked impulsivity. There is evidence that BPD may be best operationalized dimensionally using models such as the Alternative Model for Personality Disorders (AMPD) described in Section III of the <jats:italic>Diagnostic and Statistical Manual for Mental Disorders</jats:italic> (<jats:italic>DSM</jats:italic>). Moreover, biosocial theory is a well‐known etiological theory of BPD emphasizing emotion dysregulation, inherited impulsivity, and development within invalidating contexts as key etiological mechanisms. Given that current research and clinical efforts for BPD are informed by both nosology and etiology, this narrative review examined how well biosocial theory (a) aligns with AMPD conceptualizations, (b) accounts for psychiatric comorbidity, and (c) accounts for heterogeneity in BPD presentation. Findings suggested that tenets of biosocial theory align well with Criteria A and B of the AMPD; however, biosocial theory focuses narrowly on roles of emotion dysregulation, impulsivity, and invalidating contexts, and empirical support is lacking in some ways for several etiological explanations proposed by biosocial theory. Additionally, although biosocial theory captures empirically supported features of BPD and emphasizes high‐risk subgroups, the theory may not account for lower‐risk subgroups. Finally, the theory accounts for diagnostic co‐occurrence via the central role of emotion dysregulation, but biosocial theory may not be specific to BPD and may broadly apply to a range of psychopathology. Based on the literature reviewed, implications for future research and clinical efforts are highlighted.","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":"4 1","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Compatibility of Linehan's biosocial theory and the DSM‐5 Alternative Model of Personality Disorders for borderline personality disorder\",\"authors\":\"Nicholas R. 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Given that current research and clinical efforts for BPD are informed by both nosology and etiology, this narrative review examined how well biosocial theory (a) aligns with AMPD conceptualizations, (b) accounts for psychiatric comorbidity, and (c) accounts for heterogeneity in BPD presentation. Findings suggested that tenets of biosocial theory align well with Criteria A and B of the AMPD; however, biosocial theory focuses narrowly on roles of emotion dysregulation, impulsivity, and invalidating contexts, and empirical support is lacking in some ways for several etiological explanations proposed by biosocial theory. Additionally, although biosocial theory captures empirically supported features of BPD and emphasizes high‐risk subgroups, the theory may not account for lower‐risk subgroups. Finally, the theory accounts for diagnostic co‐occurrence via the central role of emotion dysregulation, but biosocial theory may not be specific to BPD and may broadly apply to a range of psychopathology. 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引用次数: 0
摘要
边缘型人格障碍(BPD)的特点是情感、人际关系和身份不稳定,以及明显的冲动性。有证据表明,使用《精神疾病诊断与统计手册》(DSM)第三部分中描述的人格障碍替代模型(AMPD)等模型,可以从多个维度对 BPD 进行最佳操作。此外,生物社会理论是一种众所周知的 BPD 病因学理论,强调情绪失调、遗传性冲动和在无效环境中发展是关键的病因机制。鉴于目前针对 BPD 的研究和临床工作都是以病名学和病因学为基础的,本叙述性综述研究了生物社会理论(a)与 AMPD 概念的一致性,(b)对精神疾病合并症的解释,以及(c)对 BPD 表现的异质性的解释。研究结果表明,生物社会理论的原则与 AMPD 的标准 A 和 B 非常一致;但是,生物社会理论狭隘地关注情绪失调、冲动和无效环境的作用,而且生物社会理论提出的一些病因学解释在某些方面缺乏经验支持。此外,虽然生物社会理论捕捉到了经验支持的 BPD 特征,并强调了高风险亚群,但该理论可能无法解释低风险亚群。最后,该理论通过情绪失调的核心作用解释了诊断的共存性,但生物社会理论可能并非专门针对 BPD,而是广泛适用于一系列精神病理学。在回顾文献的基础上,强调了未来研究和临床工作的意义。
Compatibility of Linehan's biosocial theory and the DSM‐5 Alternative Model of Personality Disorders for borderline personality disorder
Borderline personality disorder (BPD) is characterized by affective, interpersonal, and identity instability, as well as marked impulsivity. There is evidence that BPD may be best operationalized dimensionally using models such as the Alternative Model for Personality Disorders (AMPD) described in Section III of the Diagnostic and Statistical Manual for Mental Disorders (DSM). Moreover, biosocial theory is a well‐known etiological theory of BPD emphasizing emotion dysregulation, inherited impulsivity, and development within invalidating contexts as key etiological mechanisms. Given that current research and clinical efforts for BPD are informed by both nosology and etiology, this narrative review examined how well biosocial theory (a) aligns with AMPD conceptualizations, (b) accounts for psychiatric comorbidity, and (c) accounts for heterogeneity in BPD presentation. Findings suggested that tenets of biosocial theory align well with Criteria A and B of the AMPD; however, biosocial theory focuses narrowly on roles of emotion dysregulation, impulsivity, and invalidating contexts, and empirical support is lacking in some ways for several etiological explanations proposed by biosocial theory. Additionally, although biosocial theory captures empirically supported features of BPD and emphasizes high‐risk subgroups, the theory may not account for lower‐risk subgroups. Finally, the theory accounts for diagnostic co‐occurrence via the central role of emotion dysregulation, but biosocial theory may not be specific to BPD and may broadly apply to a range of psychopathology. Based on the literature reviewed, implications for future research and clinical efforts are highlighted.
期刊介绍:
Personality and Mental Health: Multidisciplinary Studies from Personality Dysfunction to Criminal Behaviour aims to lead and shape the international field in this rapidly expanding area, uniting three distinct literatures: DSM-IV/ICD-10 defined personality disorders, psychopathy and offending behaviour. Through its multi-disciplinary and service orientated approach, Personality and Mental Health provides a peer-reviewed, authoritative resource for researchers, practitioners and policy makers working in the areas of personality and mental health.