{"title":"边缘型人格障碍的因素结构及对情绪可预见性和问题解决系统训练的反应。","authors":"Donald W Black, Nancee Blum, Jeff Allen","doi":"10.1002/pmh.1538","DOIUrl":null,"url":null,"abstract":"<p><p>Differential response to the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program was compared in subgroups identified through latent class analysis (LCA). STEPPS is an evidence-based group treatment program for patients with borderline personality disorder (BPD). A reanalysis of data was conducted using data from a 20-week randomized controlled trial and 1-year follow-up. Subjects (n = 164) with DSM-IV BPD were assessed for comorbid Axis I and II disorders and selected clinical variables. Severity was assessed using the Zanarini Rating Scale for BPD (ZAN-BPD) and the Borderline Evaluation of Severity Over Time (BEST). Three- and four-class models were identified with the four-class model having the better fit. The latter included a high severity (HS) class (26%), an affective instability/substance abuse (AISA) class (16%), an empty/dissociation/identity disturbance (EDID) class (27%), and a low severity (LS) class (30%). High impulsiveness predicted membership in the HS class. Improvement was determined using a linear mixed-effects model. Those most likely to benefit were those in the HS group characterized by high symptom severity, Axis I and II comorbidity, problem relationships, abandonment fears, and intense anger. This work should help further efforts to match patients with treatments based on sociodemographic, diagnostic, and other illness characteristics.</p>","PeriodicalId":46871,"journal":{"name":"Personality and Mental Health","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Factor structure of borderline personality disorder and response to Systems Training for Emotional Predictability and Problem Solving.\",\"authors\":\"Donald W Black, Nancee Blum, Jeff Allen\",\"doi\":\"10.1002/pmh.1538\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Differential response to the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program was compared in subgroups identified through latent class analysis (LCA). STEPPS is an evidence-based group treatment program for patients with borderline personality disorder (BPD). A reanalysis of data was conducted using data from a 20-week randomized controlled trial and 1-year follow-up. Subjects (n = 164) with DSM-IV BPD were assessed for comorbid Axis I and II disorders and selected clinical variables. Severity was assessed using the Zanarini Rating Scale for BPD (ZAN-BPD) and the Borderline Evaluation of Severity Over Time (BEST). Three- and four-class models were identified with the four-class model having the better fit. The latter included a high severity (HS) class (26%), an affective instability/substance abuse (AISA) class (16%), an empty/dissociation/identity disturbance (EDID) class (27%), and a low severity (LS) class (30%). High impulsiveness predicted membership in the HS class. Improvement was determined using a linear mixed-effects model. Those most likely to benefit were those in the HS group characterized by high symptom severity, Axis I and II comorbidity, problem relationships, abandonment fears, and intense anger. This work should help further efforts to match patients with treatments based on sociodemographic, diagnostic, and other illness characteristics.</p>\",\"PeriodicalId\":46871,\"journal\":{\"name\":\"Personality and Mental Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2022-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Personality and Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/pmh.1538\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Personality and Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pmh.1538","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 1
摘要
通过潜在类分析(LCA)确定亚组,比较了对情绪可预测性和问题解决系统训练(STEPPS)计划的差异反应。STEPPS是一项针对边缘型人格障碍(BPD)患者的循证团体治疗方案。对20周随机对照试验和1年随访的数据进行再分析。对患有DSM-IV BPD的受试者(n = 164)进行共病I和II轴疾病和选定的临床变量评估。使用扎纳里尼BPD评定量表(Zanarini Rating Scale for BPD, ZAN-BPD)和严重程度随时间的边界评估(BEST)来评估严重程度。确定了三、四类模型,其中四类模型拟合效果较好。后者包括高严重性(HS)类(26%)、情感不稳定/药物滥用(AISA)类(16%)、空虚/分离/身份障碍(EDID)类(27%)和低严重性(LS)类(30%)。高冲动性预示着高中班的成员资格。使用线性混合效应模型确定改善程度。最有可能受益的是那些具有高症状严重程度、轴I和轴II合并症、问题关系、遗弃恐惧和强烈愤怒的HS组。这项工作将有助于进一步根据社会人口学、诊断和其他疾病特征为患者匹配治疗方案。
Factor structure of borderline personality disorder and response to Systems Training for Emotional Predictability and Problem Solving.
Differential response to the Systems Training for Emotional Predictability and Problem Solving (STEPPS) program was compared in subgroups identified through latent class analysis (LCA). STEPPS is an evidence-based group treatment program for patients with borderline personality disorder (BPD). A reanalysis of data was conducted using data from a 20-week randomized controlled trial and 1-year follow-up. Subjects (n = 164) with DSM-IV BPD were assessed for comorbid Axis I and II disorders and selected clinical variables. Severity was assessed using the Zanarini Rating Scale for BPD (ZAN-BPD) and the Borderline Evaluation of Severity Over Time (BEST). Three- and four-class models were identified with the four-class model having the better fit. The latter included a high severity (HS) class (26%), an affective instability/substance abuse (AISA) class (16%), an empty/dissociation/identity disturbance (EDID) class (27%), and a low severity (LS) class (30%). High impulsiveness predicted membership in the HS class. Improvement was determined using a linear mixed-effects model. Those most likely to benefit were those in the HS group characterized by high symptom severity, Axis I and II comorbidity, problem relationships, abandonment fears, and intense anger. This work should help further efforts to match patients with treatments based on sociodemographic, diagnostic, and other illness characteristics.
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.