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边缘型人格障碍负性情绪反应研究

发布时间:2018-05-31 21:53

  本文选题:边缘型人格障碍 + 负性情绪 ; 参考:《河北师范大学》2014年硕士论文


【摘要】:边缘性人格障碍(Borderline personality disorder,BPD)是以情感调节、冲动行为、人际关系、自我形象的不稳定为个性普遍模式的一种复杂而又严重的精神障碍。患者往往具有较大的社会功能损害,并存在10%的自杀率(高于普通人群50倍),这种障碍占普通人群中的1%-2%,门诊病人的10%,住院病人的20%,女性的发病率显著高于男性(70%比30%)。临床上,边缘型人格障碍的治疗非常困难,常常比其它精神障碍需要更多的心理健康资源。由于较高的自杀死亡率以及在治疗上的困难,BPD成为西方精神病学研究中的一个热点,但在我国边缘性人格障碍一直未进入我国精神障碍分类与诊断标准系统,在国内,关于边缘性人格障碍的研究还十分缺乏,仅有几篇介绍性的研究综述发表。 边缘型人格障碍患者比其他障碍的人群对环境刺激的反应更快更强,他们对情绪刺激高度敏感、具有强烈的情绪反应,进而加剧了情绪的唤起,导致情绪调节的困难。通常情况下,边缘型人格障碍患者的情绪恢复十分缓慢。这种情绪易感性特质影响边缘型人格障碍患者的情绪调节功能。在负性情绪方面,边缘型人格障碍患者体验的负性情绪不仅多,且波动性大。在负性情绪体验方面,已有理论表明边缘型人格障碍患者体验到的负性情绪要多于常人,且他们不知道如何控制调节负性情绪,这也解释了这类人格障碍患者的高自残、自杀率或其他冲动行为的出现原因。 本研究调查了河北医科大学附属第一医院精神卫生科及石家庄市第八医院(石家庄市心理危机干预中心)住院患者和门诊患者,经过人格诊断问卷第四版(PDQ-4+)问卷测量后进行初步筛选。再对边缘型人格障碍的得分在5分以上(含5分)的患者根据人格障碍的诊断问卷(SCID-II)进行半结构性访谈,将确诊为边缘型人格障碍的患者收入研究组。使用人格障碍诊断问卷(PDQ-4+)作为筛查量表,并使用人格障碍临床定式检测(SCID-II)作为访谈材料,进行边缘型人格障碍的筛查,最后由两名高年资精神科医师针对DSM-IV对于边缘型人格障碍的诊断标准进行确认。研究对照组选自PDQ-4+得分在2分以下的志愿者,并在年龄和性别上进行匹配。所有被试均排除幻觉妄想等严重精神病性症状的患者,以及脑器质疾病、记忆障碍及智力缺陷和重大内外科疾病史的患者。 本研究主要采用问卷调查法、访谈法和实验法。实验采用修订版的情绪Oddball实验范式比较边缘型人格障碍患者与正常对照者在负性情绪偏差刺激进行反应时的正确率和反应时差异,试图从负性情绪的效价强度和内容两个角度了解边缘型人格障碍对负性情绪刺激的反应特点。研究共分为两个实验,实验一考察负性情绪刺激效价强度(高负性、低负性、中性)对边缘型人格障碍患者负性情绪反应的影响。实验二考察负性情绪刺激内容(动物、环境、人物、)对边缘型人格障碍患者负性情绪反应的影响。实验材料选用中国情绪图片系统(Chinese Affective Picture System,CAPS)中的情绪图片,记录被试的反应时和正确率。 结果显示,实验一中边缘型人格障碍组与正常对照组对偏差刺激反应的正确率差异显著(F=9.001,p<0.01),边缘型人格障碍组的正确率明显低于正常对照组。从情绪效价强度来看,无论是边缘型人格障碍组还是正常对照组在高负性情绪刺激和低负性情绪刺激上的正确率均高于中性刺激,但边缘型人格障碍组在不同情绪效价强度上正确率差异不显著(F=0.833,p>0.05),正常对照组差异显著(F=10.978,p<0.001)。从反应时指标来看,组别有及其显著的主效应(F=332.470,p<0.001),边缘型人格障碍组反应时间显著长于正常对照组。情绪效价强度主效应不显著(F=2.070,P>0.05)。组别和情绪效价强度的交互作用不显著(F=1.704,P>0.05)。 实验二中,边缘型人格障碍患者和正常对照组反应正确率差异不显著(F=3.398,,p<0.05),但图片内容主效应显著(F=5.232,p<0.01),组别和情绪图片内容没有交互作用(F=1.199,P>0.05)。从反应时上看,边缘型人格障碍组被试反应时间显著长于正常对照组(F=147.266,p<0.001)。图片内容主效应不显著(F=2.204,P>0.05),组别和情绪图片内容的交互作用不显著(F=1.893,P>0.05)。 总之,与普通人群相比,在负性情绪刺激的影响下,边缘型人格患者的认知控制能力较差。此外,边缘型人格障碍患者对负性情绪的加工深度显著高于普通人群。边缘型人格障碍患者的对负性情绪的加工深度不受负性情绪效价强度的影响,但有可能受到负性情绪刺激内容的影响。
[Abstract]:borderline personality disorder ( bpd ) is a complex and serious mental disorder characterized by emotion regulation , impulsive behavior , interpersonal relationship and self - image instability .

Patients with borderline personality disorder are more responsive to environmental stimuli than others . They are highly sensitive to emotional stimuli and have a strong emotional response . In general , the emotional recovery of patients with borderline personality disorder is very slow . In the negative emotion experience , the negative emotion experienced by patients with borderline personality disorder is more and more volatile . In the negative emotion experience , there is a theory that the negative emotion experienced by the borderline personality disorder patients is more than that of the normal person , and they do not know how to control the regulation of negative emotion , which also explains the causes of the high self - mutilation , suicide rate or other impulsive behavior of the patients with personality disorder .

This study investigated the diagnosis of borderline personality disorders by using PDQ - 4 + as an interview material , and then matched them on age and sex .

The effect of negative emotion stimulation on negative emotional responses in patients with borderline personality disorder was studied by using the modified emotional Oddball experiment paradigm compared with normal controls .

The results showed that the correct rate of deviation stimulus response was significantly lower in the group of borderline personality disorder ( F = 9.001 , p < 0.01 ) , and the correct rate of borderline personality disorder group was significantly lower than that of normal control group ( F = 0.9833 , p > 0.05 ) . The reaction time was significantly longer than that of the normal control group ( F = 2.070 , P > 0.05 ) . The interaction of group and emotion valence was not significant ( F = 1.704 , P > 0.05 ) .

There was no significant difference ( F = 3.398 , p < 0.05 ) between the patients with borderline personality disorder and the normal control group ( F = 3.398 , p < 0.05 ) , but the main effect was significant ( F = 5.232 , p < 0.01 ) . There was no interaction between group and emotion picture content ( F = 1.199 , P > 0.05 ) . At the time of reaction , the reaction time of borderline personality disorder group was significantly longer than that in the normal control group ( F = 147.266 , p < 0.001 ) . The main effect of picture content was not significant ( F = 2.204 , P > 0.05 ) , and the interaction between group and emotion picture content was not significant ( F = 1.893 , P > 0.05 ) .

In conclusion , compared with the general population , the cognitive control ability of the borderline personality patients is poor under the influence of negative emotion stimulation . In addition , the processing depth of the negative emotion in the borderline personality disorder patients is obviously higher than that of the normal population . The processing depth of the negative emotion in the borderline personality disorder patients is not influenced by the negative emotion potency intensity , but it is possible to be influenced by negative emotion stimulation content .
【学位授予单位】:河北师范大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:B848

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