A CONTINGENCY-ORIENTED APPROACH TO UNDERSTANDING BORDERLINE PERSONALITY DISORDER: SITUATIONAL TRIGGERS AND SYMPTOMS
A CONTINGENCY-ORIENTED APPROACH TO UNDERSTANDING BORDERLINE PERSONALITY DISORDER: SITUATIONAL TRIGGERS AND SYMPTOMS
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DOI：
10.1521/pedi.2015.29.4.486
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发表时间：
2015-08-01
影响因子：
2.3
通讯作者：
Furr, R. Michael
中科院分区：
文献类型：
--
作者：
Miskewicz, Kelly;Fleeson, William;Furr, R. Michael
本文从权变导向的角度检验了当下边缘型人格障碍（BPD）症状事件与当下触发因素之间的动态关系。一项对282名成年人的经验抽样研究，包括77名BPD患者，在两周内每天五次获得情景触发和BPD症状事件的报告。触发因素包括被拒绝、背叛、抛弃、冒犯和失望；自我概念受到威胁的；无聊的：处于无聊的境地；还有孤独。BPD与情境触发因素增加有关。多水平模型揭示了情境触发与BPD症状之间的显著个人内部关联，对于研究中的普通参与者来说，在触发-症状偶发的强度和方向上存在显著的个体差异。大多数触发-症状偶然性在具有更大的边缘性症状的个体中更强，这表明触发因素与BPD有意义的关系。这些发现强调了维持BPD的可能的近端机制，并有助于解释这种通常被描述为混乱和不可预测的疾病的病程。
This article tested a contingency-oriented perspective to examine the dynamic relationships between in-the-moment borderline personality disorder (BPD) symptom events and in-the-moment triggers. An experience sampling study with 282 adults, including 77 participants with BPD, obtained reports of situational triggers and BPD symptom events five times daily for 2 weeks. Triggers included being rejected, betrayed, abandoned, offended, and disappointed; having one's self-concept threatened; being in a boring situation; and being alone. BPD was associated with increased situational triggers. Multilevel models revealed significant within-person associations between situational triggers and BPD symptoms for the average participant in the study, with significant individual variance in the strength and direction of trigger-symptom contingencies. Most trigger-symptom contingencies were stronger for individuals with greater borderline symptomatology, suggesting that triggers are meaningfully related to BPD. These findings highlight possible proximal mechanisms that maintain BPD and help explain the course of a disorder often described as chaotic and unpredictable.