경계성 인격장애 환자의 마음헤아리기치료 효과 : 중간분석에 대한 예비보고
Effectiveness of Korean Mentalization Based Treatment in Patients with Borderline Personality Disorder : Preliminary Report on Interim Analysis
0
조회
0
다운로드
4
인용
0
참고문헌
초록
Objectives The treatment of borderline personality disorder (BPD) in Korea has been based mainly on individual psychopharmacotherapy and psychotherapy. No quantitative study has examined the effectiveness of group psychotherapy for patients with BPD in Korea. In the present study, the mentalization-based treatment (MBT) program developed from the Anna Freud Center in London was conducted in the author’s hospital. This article presents the results of a preliminary analysis of the treatment effects of the Korean MBT for BPD. Methods The recruited subjects are patients diagnosed with BPD at Gangnam Severance Hospital. A psychological assessment was conducted at baseline and every six months during the treatment. Statistical analysis was performed using the data of 62 people at the baseline assessment, and the treatment effectiveness was analyzed with the data from 21 people who participated in the treatment group over six months. Results Borderline personality features were positively correlated with depressive symptoms, anxious attachment, avoidant attachment, and novelty seeking trait, and negatively correlated with self-directedness. After the 12-month treatment, the depressive symptoms and self-disclosure scores were improved significantly. In addition, the self-directedness, cooperativeness factor scores of the temperament and character inventory, and the self-regulation ability score of the resilience scale were also improved significantly. Conclusion This study suggests that the Korean MBT can improve depressive symptoms and induce positive changes in personality functioning. Although the number of people who continued MBT over 12 months was very small due to the high dropout rate, this study is the first quantitative study on the effects of the Korean MBT for BPD patients.
Abstract
Objectives The treatment of borderline personality disorder (BPD) in Korea has been based mainly on individual psychopharmacotherapy and psychotherapy. No quantitative study has examined the effectiveness of group psychotherapy for patients with BPD in Korea. In the present study, the mentalization-based treatment (MBT) program developed from the Anna Freud Center in London was conducted in the author’s hospital. This article presents the results of a preliminary analysis of the treatment effects of the Korean MBT for BPD. Methods The recruited subjects are patients diagnosed with BPD at Gangnam Severance Hospital. A psychological assessment was conducted at baseline and every six months during the treatment. Statistical analysis was performed using the data of 62 people at the baseline assessment, and the treatment effectiveness was analyzed with the data from 21 people who participated in the treatment group over six months. Results Borderline personality features were positively correlated with depressive symptoms, anxious attachment, avoidant attachment, and novelty seeking trait, and negatively correlated with self-directedness. After the 12-month treatment, the depressive symptoms and self-disclosure scores were improved significantly. In addition, the self-directedness, cooperativeness factor scores of the temperament and character inventory, and the self-regulation ability score of the resilience scale were also improved significantly. Conclusion This study suggests that the Korean MBT can improve depressive symptoms and induce positive changes in personality functioning. Although the number of people who continued MBT over 12 months was very small due to the high dropout rate, this study is the first quantitative study on the effects of the Korean MBT for BPD patients.
참고문헌 (35)
- Gunderson JG, "Current overview of the borderline diagnosis", J Clin Psychiatry, 48, pp.5~14 (1987)
- American Psychiatry Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychaitry Association
- Zanarini MC, "Treatment histories of borderline inpatients", Compr Psychiatry, 42, pp.144~150 (2001)
- Bender DS, "Treatment utilization by patients with personality disorders", Am J Psychiatry, 158, pp.295~302 (2001)
- Skodol AE, "Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder", Am J Psychiatry, 159, pp.276~283 (2002)
- Sanislow CA, "Factor analysis of the DSM-III-R borderline personality disorder criteria in psychiatric inpatients", Am J Psychiatry, 157, pp.1629~1633 (2000)
- Fonagy P, "Attachment and borderline personality disorder. A theory and some evidence", Psychiatr Clin North Am, 23, pp.103~122 (2000)
- Fonagy P, "Affect regulation, mentalization and the development of the self" (2002), Other Press
- Bateman AW, "Handbook of mentalizing in mental health practice" (2012), American Psychiatric Publishing, Inc
- National Health and Medical Research Council, "Clinical practice guideline for the management of borderline personality disorder" (2012), National Health and Medical Research Council
- Bateman AW, "Mentalization-based treatment for borderline personality disorder: a practical guide" (2006), Oxford University Press
- Linehan MM, "Dialectical behavior therapy for borderline personality disorder. Theory and method", Bull Menninger Clin, 51, pp.261~276 (1987)
- Gunderson JG, "Handbook of good psychiatric management for borderline personality disorder" (2014), American Psychiatric Publishing
- 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)
- Kellogg SH, "Schema therapy for borderline personality disorder", J Clin Psychol, 62, pp.445~458 (2006)
- Hoffman PD, "Family connections : a program for relatives of persons with borderline personality disorder", Fam Process, 44, pp.217~225 (2005)
- Morey LC, "Personality assessment inventory professional manual" (1991), Psychological Assessment Resources
- Hong SH, "A validation study of the Borderline Personality Disorder Scale in Korean university students", Kor J Clin Psychol, 17, pp.259~271 (1998)
- Rush AJ, "The Inventory for Depressive Symptomatology(IDS) : preliminary findings", Psychiatry Res, 18, pp.65~87 (1986)
- 윤지호, "한국어판 우울증상평가척도의 신뢰도 및 타당도 연구", Mood and Emotion, 10(3), pp.131~151 (2012), 대한우울조울병학회
- Brennan KA, "Attachment theory and close relationships", pp.46~76 (1998), The Guilford Press
- Fraley RC, "An item response theory analysis of self-report measures of adult attachment", J Pers Soc Psychol, 78, pp.350~365 (2000)
- Kim SH, "Adaptation of the Experiences in Close Relationships-Revised Scale into Korean: Confirmatory Factor Analysis and Item Response Theory Approaches", pp.2004
- Reivich K, "He resilience factor: 7 Keys to finding your inner strength and overcoming life’s hurdles" (2003), Broadway Books
- Kim JH, "Resilience - a pleasant secret replacing hardship with fortune" (2011), Wisdomhouse
- Cloninger CR, "The Temperament and Character Inventory (TCI): a guide to its development and use" (1994), Center for Psychobiology of Personality, Washing-ton University
- Min BB, "Temperament and Character Inventory-Family Manual", pp.15~33 (2007), Maumsarang Co., Ltd
- Hausberg MC, "Is a self-rated instrument appropriate to assess mentalization in patients with mental disorders? Development and first validation of the mentalization questionnaire (MZQ)", Psychother Res, 22, pp.699~709 (2012)
- 송현주, "16-17세 한국 청소년의 정신화 척도 요인구조 탐색", Korean Journal of Clinical Psychology, 36(3), pp.391~401 (2017), 한국임상심리학회[DOI]
- 배성만, "한국 성인의 대인관계 유능성 척도의 개발과 타당화 연구", 상담학연구, 16(3), pp.51~65 (2015), 한국상담학회[DOI]
- Bateman AW, "Mentalization-based treatment for personality disorders. A practical guide" (2016), Oxford University Press
- Cornelius JR, "Disproportionate suicidality in patients with comorbid major depression and alcoholism", Am J Psychiatry, 152, pp.358~364 (1995)
- Oquendo MA, "Suicide : risk factors and prevention in refractory major depression", Depress Anxiety, 5, pp.202~211 (1997)
- Soloff PH, "Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder : a comparative study", Am J Psychiatry, 157, pp.601~608 (2000)
- Cloninger CR, "A psychobiological model of temperament and character", Arch Gen Psychiatry, 50, pp.975~990 (1993)