成人边缘型人格障碍的自杀沟通:临床关联及辩证行为疗法的治疗反应。

IF 2 3区 医学 Q2 PSYCHIATRY
Alma M Bitran, Evan M Kleiman, Shireen L Rizvi
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引用次数: 0

摘要

目的:自杀沟通(SCs)——也被称为自杀威胁或“手势”,个人通过言语或行为表达自杀意图——对临床医生和亲人来说是一个严重的挑战,他们可能很难确定适当的反应水平。然而,很少有研究检查SCs的临床相关性,部分原因是操作不一致。确定维持神经干细胞的机制并澄清相关的自杀风险是至关重要的,特别是在边缘型人格障碍(BPD)患者中,神经干细胞相对常见。方法:108名成年BPD患者接受为期6个月的辩证行为疗法(DBT),报告其在入院、治疗中期和治疗结束时的SCs和其他自杀念头和行为(STBs)。参与者还完成了评估BPD严重程度、情绪失调和DBT技能吸收的测量。结果:接受终身SCs的参与者(53%)在基线时报告了更高的BPD严重程度和更严重的情绪失调。然而,dbt的剂量(概念为技能摄取和治疗时间长度)降低了SCs的发生率。在基线和治疗期间,终生SCs与其他stb的参与没有显著关联。结论:目前的研究结果支持SCs作为严重情绪失调的一种表达的概念,这种情绪失调可能通过DBT得到缓解。具体来说,DBT可以通过教授替代的、更具适应性的应对策略来防止SCs,即使在情绪失调加剧的情况下也是如此。最后,尽管结果表明SCs与其他STBs之间缺乏关联,但在提出临床建议之前,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Suicidal Communications in Adults with Borderline Personality Disorder: Clinical Correlates and Treatment Response to Dialectical Behavior Therapy.

Objective: Suicidal communications (SCs)-also known as suicide threats or "gestures," whereby an individual verbally or behaviorally signals suicidal intent-present a serious challenge to clinicians and loved ones, who may struggle to determine the appropriate level of response. Yet, few studies have examined clinical correlates of SCs, partly due to inconsistent operationalization. It is critical to identify mechanisms that maintain SCs and clarify associated suicide risk, especially among individuals with borderline personality disorder (BPD), among whom SCs are relatively common.

Method: Adults (N = 108) with BPD receiving a 6-month course of dialectical behavior therapy (DBT) reported on SCs and other suicidal thoughts and behaviors (STBs) at intake, mid-treatment, and end-of-treatment. Participants also completed measures assessing BPD severity, emotion dysregulation, and DBT skills uptake.

Results: Participants who endorsed lifetime SCs (53%) reported higher BPD severity and worse emotion dysregulation at baseline. However, dosage of DBT-conceptualized as both skills uptake and length of time in treatment-reduced the incidence of SCs. There were no significant associations between lifetime SCs and engagement in other STBs, both at baseline and during treatment.

Conclusion: Current findings support a conceptualization of SCs as an expression of severe emotion dysregulation, which may be alleviated by DBT. Specifically, DBT may protect against SCs by teaching alternative, more adaptive coping strategies, even in the presence of heightened emotion dysregulation. Finally, though results indicate a lack of association between SCs and other STBs, further researcher is needed before clinical recommendations can be made.

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来源期刊
CiteScore
6.10
自引率
7.10%
发文量
69
期刊介绍: Archives of Suicide Research, the official journal of the International Academy of Suicide Research (IASR), is the international journal in the field of suicidology. The journal features original, refereed contributions on the study of suicide, suicidal behavior, its causes and effects, and techniques for prevention. The journal incorporates research-based and theoretical articles contributed by a diverse range of authors interested in investigating the biological, pharmacological, psychiatric, psychological, and sociological aspects of suicide.
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