Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls.
Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls.
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DOI：
10.1037/a0035619
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发表时间：
2014-02
影响因子：
4.6
通讯作者：
Ebner-Priemer UW
中科院分区：
文献类型：
--
作者：
Santangelo P;Reinhard I;Mussgay L;Steil R;Sawitzki G;Klein C;Trull TJ;Bohus M;Ebner-Priemer UW
情感不稳定是边缘型人格障碍（BPD）的核心特征。使用先进的评估方法和适当的统计分析得出一致的结果，表明与健康对照组相比，BPD患者的不稳定性更高。然而，很少有研究调查了BPD患者情感不稳定与相关临床对照组的特异性。在这项研究中，43名BPD患者、28名创伤后应激障碍（PTSD）患者、20名神经性贪食症（BN）患者和28名健康对照者携带电子日记24小时，并在清醒时大约每15分钟对他们的瞬间情感状态进行评估。为了量化不稳定性，我们使用了3个最先进的指标：平方连续差异的多层次模型（ssd）、急性变化概率的多层次模型（PACs）和汇总逐点变化（APPCs）。与健康对照相比，BPD患者在情绪效价和痛苦方面表现出更高的情感不稳定性，无论具体的不稳定性指数如何。这些结果直接重复了早期的研究。然而，情感不稳定似乎并不是BPD患者所特有的。关于ssd、pac和appc， PTSD或BN患者表现出与BPD患者相似的情绪不稳定性（情绪效价和痛苦）。我们的结果提出了讨论，如果情感不稳定是一个跨诊断或障碍特异性机制。目前的证据无法回答这个问题，但研究日常生活中跨越障碍的精神病理机制是提高精神健康诊断的有效性和特异性的有希望的方法。
Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses.
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影响因子：
7.3
作者：
Farmer, RF;Nash, HM;Dance, D
通讯作者：
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影响因子：
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作者：
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影响因子：
4.6
作者：
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影响因子：
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作者：
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影响因子：
6.9
作者：
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