State affective instability in borderline personality disorder assessed by ambulatory monitoring
State affective instability in borderline personality disorder assessed by ambulatory monitoring
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DOI：
10.1017/s0033291706009706
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发表时间：
2007-07-01
影响因子：
6.9
通讯作者：
Bohus, Martin
中科院分区：
文献类型：
--
作者：
Ebner-Priemer, Ulrich W.;Kuo, Janice;Bohus, Martin
背景资料。尽管情感不稳定是临界性人格障碍(BPD)的一个基本标准，但很少有报道将其作为结果标准。到目前为止，大多数使用纸笔日记评估BPD状态情感不稳定的研究都没有发现这种特征的迹象，而在其他研究中，发现是相互矛盾的。此外，BPD的不稳定模式尚未确定。我们使用电子日记对50例女性BPD患者和50例女性健康对照(HC)在日常生活24小时内的情感状态进行了评估。与以前的纸笔日记研究不同，情绪效价和痛苦情绪的高度不稳定在BPD组中明显表现出来，但在HC组中没有。以前论文中的不一致之处可以用计算不稳定性的方法来解释(见附录)。此外，我们能够在BPD组中识别出一种特定于组的不稳定模式，其特征是积极情绪状态突然大幅下降。此外，BPD患者从非常积极的情绪状态下降的48%是如此之大，以至于他们达到了负面的情绪状态。只有9%的HC患者出现这种情况，这表明BPD患者从非常积极的情绪状态波动到负面情绪状态所需的平均时间更短。未来的动态监测研究将有助于阐明哪些事件导致BPD患者的积极情绪突然下降。
Background. Although affective instability is an essential criterion for borderline personality disorder (BPD), it has rarely been reported as an outcome criterion. To date, most of the studies assessing state affective instability in BPD using paper-pencil diaries did not find indications of this characteristic, whereas in others studies, the findings were conflicting. Furthermore, the pattern of instability that characterizes BPD has not yet been identified.Method. We assessed the affective states of 50 female patients with BPD and 50 female healthy controls (HC) during 24 hours of their everyday life using electronic diaries.Results. In contrast to previous paper-and-pencil diary studies, heightened affective instability for both emotional valence and distress was clearly exhibited in the BPD group but not in the HC group. Inconsistencies in previous papers can be explained by the methods used to calculate instability (see Appendix). In additional, we were able to identify a group-specific pattern of instability in the BPD group characterized by sudden large decreases from positive mood states. Furthermore, 48 % of the declines from a very positive mood state in BPD were so large that they reached a negative mood state. This was the case in only 9 % of the HC group, suggesting that BPD patients, on average, take less time to fluctuate from a very positive mood state to a negative mood state.Conclusion. Future ambulatory monitoring studies will be useful in clarifying which events lead to the reported, sudden decrease in positive mood in BPD patients.