Exploring Loneliness among people with Complex Emotional Needs (CEN) using Mixed Methods

孤独的人经历一种痛苦的主观状态，其特征是感知到现实与期望的社会互动模式之间的差异(1)。孤独与一系列广泛的心理健康问题有关；因此，针对孤独可以减轻痛苦和预防心理健康问题(1)。探索孤独和心理健康问题之间联系的研究已成为临床和政策的重大兴趣。提示诊断为“人格障碍”的特征在一般人群中很常见。这意味着转向使用一个更广泛的术语，比如CEN，来描述有“人格障碍”相关特征的人的重要性。“人格障碍”的诊断标签也被批评为污名化、厌恶女性、暗示人格缺陷(2)。有相关生活经历的人强调了这个词的贬义和无效性，并认为被诊断为“人格障碍”的人更应该被描述为CEN患者，因为他们的挣扎往往源于复杂的创伤经历(4)。鉴于“人格障碍”特征的普遍存在以及对诊断标签的强烈批评，我使用术语CEN来解决可能患有“人格障碍”诊断的人的需求。有CEN生活经验的人、专业人士和政策制定者一直强调提高护理质量和扩大干预措施的范围，包括以社会为重点的干预措施（15）。

Lonely people experience a painful subjective state characterized by a perceived discrepancy between actual and desired patterns of social interaction (1). Loneliness is linked to a wide range of mental health problems; thus, targeting loneliness could alleviate distress and prevent mental health issues (1). Research exploring the link between loneliness and mental health problems has become of great clinical and policy interest. Traits suggestive of a diagnosis of "personality disorder" are common in the general population. This signifies the importance of shifting towards employing a broader term, such as CEN, to describe people with "personality disorder" related traits. The diagnostic label "personality disorder" has also been criticized for being stigmatizing, misogynistic, and implying a defective personality (2). People with relevant lived experience emphasize the pejorative and invalidating nature of the term and suggest that people diagnosable with "personality disorder" are better described as people with CEN, on the basis that their struggles often originate from a history of complex traumatic experiences (4). In acknowledgement of the prevalence of "personality disorder" traits and the strong critiques regarding the diagnostic label, I employ the term CEN to address the needs of people who may have a "personality disorder" diagnosis. Improving quality of care and broadening the range of interventions offered, including socially focused interventions, has been emphasized by people with lived experience of CEN, professionals, and policymakers (15).