The construct of effortful control: An approach to borderline personality disorder heterogeneity
The construct of effortful control: An approach to borderline personality disorder heterogeneity
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DOI：
10.1159/000084815
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发表时间：
2005-01-01
期刊：
影响因子：
3.6
通讯作者：
Levy, KN
中科院分区：
文献类型：
--
作者：
Hoermann, S;Clarkin, JF;Levy, KN
背景：本研究根据努力控制的结构来探究《精神疾病诊断与统计手册》第四版（DSM - IV）中边缘性人格障碍（BPD）诊断的异质性。我们基于努力控制假设了BPD患者的3个亚组，并且这些亚组在功能的其他方面也会有所不同，比如症状、人际关系和人格组织。
抽样与方法：通过半结构化访谈，47名临床转诊个体被可靠地诊断为符合DSM - IV的BPD标准。使用自我报告问卷对努力控制、症状学、人际功能和人格组织进行评估。
结果：进行了聚类分析和剖面分析，并确定了3个亚组。第1亚组努力控制水平高，在症状、人际功能和人格组织方面表现出的问题最少。第3亚组努力控制评分低，在这些方面问题最多，第2亚组在努力控制的某些方面水平高但在其他方面水平低，介于第1亚组和第3亚组之间。
讨论：研究结果表明注意机制与边缘性人格病理的临床表现之间存在关联。努力控制是识别BPD患者亚组的一个有价值的结构，从而有助于理解BPD的异质性。本研究的局限性包括仅使用自我报告来评估努力控制，以及样本量较小。未来的研究应进一步探究神经认知与边缘性病理的关联，以及针对不同BPD亚组的不同治疗方法。
版权所有（C）2005 S. 卡尔格股份公司，巴塞尔
Background: The present study investigated the heterogeneity of DSM-IV borderline personality disorder (BPD) diagnosis as a function of the construct of effortful control. We hypothesized 3 subgroups of BPD patients based on effortful control, that would also differ in other areas of functioning, such as symptoms, interpersonal relations and personality organization. Sampling and Methods: Forty-seven clinically referred individuals were reliably diagnosed as meeting DSM-IV criteria for BPD using semistructured interviews. Effortful control, symptomatology, interpersonal functioning and personality organization were assessed using self-report questionnaires. Results: Cluster and profile analyses were performed and identified 3 subgroups. Subgroup 1, with high effortful control, exhibited the fewest problems in symptoms, interpersonal functioning and personality organization. Subgroup 3, with low ratings of effortful control, had the most problems in these areas, and subgroup 2, a group high in some aspects of effortful control but low in others, ranged midway between groups 1 and 3. Discussion: The findings indicate a relationship between attentional mechanisms and the clinical expression of borderline personality pathology. Effortful control is a valuable construct for identifying subgroups of BPD patients, thus helping to understand the heterogeneity in BPD. Limitations of the study include the exclusive use on self-report of effortful control, as well as the small sample size. Future research should further investigate the associations of neurocognition and borderline pathology, as well as different approaches to treatment of the different BPD subgroups. Copyright (C) 2005 S. Karger AG, Basel.