Differentiating the everyday emotion dynamics of borderline personality disorder from major depressive disorder and bipolar disorder.
Differentiating the everyday emotion dynamics of borderline personality disorder from major depressive disorder and bipolar disorder.
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DOI：
10.1037/per0000255
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Furr RM
中科院分区：
文献类型：
--
作者：
Mneimne M;Fleeson W;Arnold EM;Furr RM
理解交界性人格障碍(BPD)的情绪动力学的一个主要障碍在于其与重度抑郁障碍(MDD)和双相情感障碍(BD)的严重共病。虽然BPD通常被描述为动态的情绪过程，包括不稳定、反应性和惰性，但它与MDD和BD的实质性共病使得很难辨别这些动态的特异性。为了区分BPD与MDD和BD的情绪动力学，对38名BPD参与者、15名MDD参与者、14名BD参与者和62名健康对照进行了一项经验抽样研究，在两周内每天五次报告人际挑战和情绪。人际关系的挑战包括拒绝、背叛、抛弃、冒犯、失望和自我形象挑战；情绪包括愤怒、兴奋、内疚、快乐、易怒和羞愧。多水平分析表明，内疚和羞耻的人际反应增强和羞耻的惰性增强是BPD的相对专一性。这些发现不能用当前MDD或BD的存在来解释。相比之下，愤怒和易怒的高度不稳定以及易怒的惰性似乎在很大程度上是跨诊断的。对临床评估、研究和理论的意义进行了讨论。
A major barrier to the understanding of emotion dynamics in borderline personality disorder (BPD) lies in its substantial comorbidity with major depressive disorder (MDD) and bipolar disorder (BD). While BPD has often been characterized in terms of dynamic emotional processes, including instability, reactivity, and inertia, its substantial comorbidity with MDD and BD makes it difficult to discern the specificity of these dynamics. To differentiate the emotion dynamics of BPD from those of MDD and BD, an experience sampling study of 38 participants with BPD, 15 participants with MDD, 14 participants with BD, and 62 healthy controls obtained reports of interpersonal challenges and emotions five times daily for two weeks. Interpersonal challenges included rejection, betrayal, abandonment, offense, disappointment, and self-image challenge; emotions included anger, excitement, guilt, happiness, irritability, and shame. Multilevel analyses revealed that heightened interpersonal reactivity of guilt and shame and heightened inertia of shame were relatively specific to BPD. These findings could not be accounted for by the presence of current MDD or BD. By contrast, heightened instability of anger and irritability and heightened inertia of irritability appeared to be largely transdiagnostic. Implications for clinical assessment, research, and theory are discussed.
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