본문 바로가기
KERD
논문KCI 등재

경계성인격장애 환자에서 임상적 특성과 마음헤아리기 능력의 연관성: 한국인 코호트 예비분석

The Association Between Clinical Characteristics and Mentalization Capacity in Patients With Borderline Personality Disorder: A Preliminary Analysis of a Korean Cohort

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objectives Several studies have reported an impairment of the mentalization capacity in borderline personality disorder (BPD). However, studies on the mentalization capacity in patients with BPD are scarce in Korea. The current study examined the clinical characteristics of BPD and its association with mentalization capacity. Methods Data from the study for developing a prospective clinical cohort and a Korean evidence- based treatment program for patients with BPD were analyzed. Fifty-nine participants (37 BPD patients, 22 healthy controls) were included in this study. The clinical characteristics, including depression and suicidality, adult attachment type, adverse childhood experiences, mentalization capacity, borderline personality symptom severity, resilience quotient, and temperament and character, were measured. An independent t-test, chi-square test, ranked ANCOVA, and multiple stepwise regression analysis were conducted for statistical analyses. Results Patients with BPD showed significant differences in mentalization capacity, adverse childhood experiences, attachment types, depression, and resilience profiles compared to the healthy control group. In this study, the impairment of mentalization capacity was significantly associated with temperament and character factors and borderline personality symptom severity. Conclusion The findings of this study suggest that mentalization capacity is associated with personality factors, including temperament and character, as well as the severity of personality psychopathology in Korean patients with BPD. Further analyses with a larger number of patients will be needed.

Abstract

Objectives Several studies have reported an impairment of the mentalization capacity in borderline personality disorder (BPD). However, studies on the mentalization capacity in patients with BPD are scarce in Korea. The current study examined the clinical characteristics of BPD and its association with mentalization capacity. Methods Data from the study for developing a prospective clinical cohort and a Korean evidence- based treatment program for patients with BPD were analyzed. Fifty-nine participants (37 BPD patients, 22 healthy controls) were included in this study. The clinical characteristics, including depression and suicidality, adult attachment type, adverse childhood experiences, mentalization capacity, borderline personality symptom severity, resilience quotient, and temperament and character, were measured. An independent t-test, chi-square test, ranked ANCOVA, and multiple stepwise regression analysis were conducted for statistical analyses. Results Patients with BPD showed significant differences in mentalization capacity, adverse childhood experiences, attachment types, depression, and resilience profiles compared to the healthy control group. In this study, the impairment of mentalization capacity was significantly associated with temperament and character factors and borderline personality symptom severity. Conclusion The findings of this study suggest that mentalization capacity is associated with personality factors, including temperament and character, as well as the severity of personality psychopathology in Korean patients with BPD. Further analyses with a larger number of patients will be needed.

참고문헌 (46)

  1. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
  2. Gunderson JG, "Borderline personality disorder", Nat Rev Dis Primers, 4, pp.18029~ (2018)
  3. Newton-Howes G, "Influence of personality on the outcome of treatment in depression : systematic review and meta-analysis", J Pers Disord, 28, pp.577~593 (2014)
  4. Temes CM, "The longitudinal course of borderline personality disorder", Psychiatr Clin North Am, 41, pp.685~694 (2018)
  5. Zanarini MC, "The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up", J Pers Disord, 19, pp.505~523 (2005)
  6. Zanarini MC, "Fluidity of the subsyndromal phenomenology of borderline personality disorder over 16 years of prospective follow-up", Am J Psychiatry, 173, pp.688~694 (2016)
  7. Linehan MM, "Dialectical behavior therapy for borderline personality disorder. Theory and method", Bull Menninger Clin, 51, pp.261~276 (1987)
  8. Bateman AW, "Treatment of personality disorder", Lancet, 385, pp.735~743 (2015)
  9. Bateman A, "8-year follow-up of patients treated for borderline personality disorder: mentalization-based treatment versus treatment as usual", Am J Psychiatry, 165, pp.631~638 (2008)
  10. Bateman AW, "Mentalization-based treatment of BPD", J Pers Disord, 18, pp.36~51 (2004)
  11. Levy KN, "The mechanisms of change in the treatment of borderline personality disorder with transference focused psychotherapy", J Clin Psychol, 62, pp.481~501 (2006)
  12. Kellogg SH, "Schema therapy for borderline personality disorder", J Clin Psychol, 62, pp.445~458 (2006)
  13. Gunderson JG, "Handbook of good psychiatric management for borderline personality disorder" (2014), American Psychiatric Publishing
  14. Gunderson J, "Good psychiatric management : a review", Curr Opin Psychol, 21, pp.127~131 (2018)
  15. Graham S, "A preliminary service evaluation of a personality disorder case management service", Personal Ment Health, 13, pp.65~74 (2019)
  16. Pugh R, "Borderline personality disorder: an evidence-based guide for generalist mental health professionals", Psychiatr Bull (2014), 38, pp.256~ (2014)
  17. Bateman AW, "Borderline personality disorder: an evidence-based guide for generalist mental health professionals" (2013), Oxford Univeristy Press
  18. Bateman A, "Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder", Am J Psychiatry, 166, pp.1355~1364 (2009)
  19. Bateman A, "Mentalization based treatment for personality disorders : a practical guide" (2016), Oxford University Press
  20. 최선우, "경계성 인격장애 환자의 마음헤아리기치료 효과 : 중간분석에 대한 예비보고", 신경정신의학, 59(1), pp.61~71 (2020), 대한신경정신의학회[DOI]
  21. 이주열, "우울증상 및 정신건강 보호-취약요인 선별평가를 위한 배터리 평가도구의 개발", 신경정신의학, 60(2), pp.143~157 (2021), 대한신경정신의학회[DOI]
  22. Brenner LA, "Encyclopedia of clinical neuropsychology", pp.1919~1921 (2011), Springer
  23. Kim JH, "Resilience-pleasant secrets changing adversity into fortune(Korean book)" (2011), Wisdom house
  24. Min BB, "Temperament and character inventory-revised-short" (2007), Maumsarang
  25. Jackson KM, "The factor structure of the personality assessment inventory-borderline features (PAI-BOR) scale in a nonclinical sample", J Pers Disord, 15, pp.536~545 (2001)
  26. Morey LC, "Personality assessment inventory" (1991), Psychological Assessment Resources
  27. Hong SH, "A validation study of the borderline personality disorder scale in Korean university students", Kor J Clin Psychol, 17, pp.259~271 (1998)
  28. Rutter M, "Resilience : some conceptual considerations", J Adolesc Health, 14, pp.626~631 (1993)
  29. Cloninger CR, "The temperament and character inventory (TCI) - A guide to its development and use" (1994), Center for Psychobiology of Personality, Washington University
  30. Cloninger CR, "A psychobiological model of temperament and character", Arch Gen Psychiatry, 50, pp.975~990 (1993)
  31. Svrakic DM, "Differential diagnosis of personality disorders by the seven-factor model of temperament and character", Arch Gen Psychiatry, 50, pp.991~999 (1993)
  32. Joyce PR, "Borderline personality disorder in major depression:symptomatology, temperament, character, differential drug response, and 6-month outcome", Compr Psychiatry, 44, pp.35~43 (2003)
  33. de la Rie SM, "Temperament, character, and personality disorders", J Pers Disord, 12, pp.362~372 (1998)
  34. Fossati A, "Temperament, character, and attachment patterns in borderline personality disorder", J Pers Disord, 15, pp.390~402 (2001)
  35. Stein MB, "Borderline pathology and the personality assessment inventory (PAI): an evaluation of criterion and concurrent validity", J Pers Assess, 88, pp.81~89 (2007)
  36. Watkins ER, "Depressive rumination and co-morbidity : evidence for brooding as a transdiagnostic process", J Ration Emot Cogn Behav Ther, 27, pp.160~175 (2009)
  37. Bolton JM, "Population-attributable fractions of Axis I and Axis II mental disorders for suicide attempts: findings from a representative sample of the adult, noninstitutionalized US population", Am J Public Health, 100, pp.2473~2480 (2010)
  38. Fonagy P, "What we have changed our minds about: part 1. Borderline personality disorder as a limitation of resilience", Borderline Personal Disord Emot Dysregul, 4, pp.11~ (2017)
  39. Zanarini MC, "Severity of reported childhood sexual abuse and its relationship to severity of borderline psychopathology and psychosocial impairment among borderline inpatients", J Nerv Ment Dis, 190, pp.381~387 (2002)
  40. Silk KR, "Borderline personality disorder symptoms and severity of sexual abuse", Am J Psychiatry, 152, pp.1059~1064 (1995)
  41. Lieb K, "Borderline personality disorder", Lancet, 364, pp.453~461 (2004)
  42. Josefsson K, "Associations of personality profiles with various aspects of well-being : a population-based study", J Affect Disord, 133, pp.265~273 (2011)
  43. 허연주, "경계선 성격장애 성향이 우울에 미치는 영향: 심리적 유연성의 매개효과 검증", Korean Journal of Clinical Psychology, 34(3), pp.747~767 (2015), 한국임상심리학회[DOI]
  44. Cloninger CR, "The psychological costs and benefits of being highly persistent : personality profiles distinguish mood disorders from anxiety disorders", J Affect Disord, 136, pp.758~766 (2012)
  45. Krause-Utz A, "Effectiveness of an emotional working memory training in borderline personality disorder : a proof-of-principle study", Psychother Psychosom, 89, pp.122~124 (2020)
  46. Scott KM, "Childhood maltreatment and DSM-IV adult mental disorders : comparison of prospective and retrospective findings", Br J Psychiatry, 200, pp.469~475 (2012)

관련 논문AI추천

이 간행물의 다른 논문 (11건)