DISSOCIATION PREDICTS POOR RESPONSE TO DIALECTIAL BEHAVIORAL THERAPY IN FEMALE PATIENTS WITH BORDERLINE PERSONALITY DISORDER
DISSOCIATION PREDICTS POOR RESPONSE TO DIALECTIAL BEHAVIORAL THERAPY IN FEMALE PATIENTS WITH BORDERLINE PERSONALITY DISORDER
复制标题
DOI：
10.1521/pedi.2011.25.4.432
复制
发表时间：
2011-08-01
影响因子：
2.3
通讯作者：
Bohus, Martin
中科院分区：
文献类型：
--
作者：
Kleindienst, Nikolaus;Limberger, Matthias F.;Bohus, Martin
相当比例的边缘型人格障碍（BPD）患者在接受辩证行为疗法（DBT）治疗后，精神病理表现明显下降。为了进一步提高dbt应答率，识别与不满意应答相关的特征是有用的。由于DBT依赖于情绪学习，我们探索了分离——已知会干扰学习——是否预示着DBT的不良反应。对57例边缘型人格障碍（BPD）患者（DSM-IV）进行为期3个月的住院DBT计划的前瞻性观察。一般精神病理学（SCL-90-R）的改善是根据分离体验量表（DES）的基线分数，通过考虑基线精神病理学的回归模型来预测的。des评分高与术后改善差相关（beta = -0.017 +/- 0.006, p = 0.008）。数据没有证据表明，在预测dbt反应时，解离的某些方面比其他方面更重要。结果表明，在DBT期间，应密切监测边缘型患者的分离。在这一阶段，对分离治疗的研究（例如，特殊技能培训）是必要的。
A substantial proportion of Borderline Personality Disorder (BPD) patients respond by a marked decrease of psychopathology when treated with Dialectical Behavioral Therapy (DBT). To further enhance the rate of DBT-response, it is useful to identify characteristics related to unsatisfactory response. As DBT relies on emotional learning, we explored whether dissociation-which is known to interfere with learning-predicts poor response to DBT. Fifty-seven Borderline Personality Disorder (BPD) patients (DSM-IV) were prospectively observed during a three-month inpatient DBT program. Pre-post improvements in general psychopathology (SCL-90-R) were predicted from baseline scores of the Dissociative Experiences Scale (DES) by regression models accounting for baseline psychopathology. High DES-scores were related to poor pre-post improvement (beta = -0.017 +/- 0.006, p = 0.008). The data yielded no evidence that some facets of dissociation are more important in predicting DBT-response than others. The results suggest that dissociation in borderline-patients should be closely monitored and targeted during DBT. At this stage, research on treatment of dissociation (e.g., specific skills training) is warranted.