检索历史 清除

目的 探索边缘型人格障碍(BPD)患者的心理防御机制,探讨心理防御机制与早年虐待的关系.方法 对142例BPD患者,63例其他人格障碍患者及20例无人格障碍的门诊就诊者就早年虐待和心理防御机制开展调查研究,进行多因素方差分析及Pearson相关分析.结果 BPD组患者较其他人格障碍患者及无人格障碍的就诊者在不成熟防御机制及部分中间型防御机制上得分较高,涉及投射(F=26.5,P＜0.05)、被动攻击(F=18.1,P＜0.05)、见诸行动(F=28.3,P＜0.05)、抱怨(F=16.7,P＜0.05)、幻想(F=16.3,P＜ 0.05)、分裂(F=28.8,P＜ 0.05)、退缩(F=8.3,P＜0.05)、躯体化(F=7.6,P＜0.05)、全能与贬低(F=9.2,P＜0.05)、隔离(F=4.7,P＜0.05)和同一化(F=10.0,P＜0.05),而成熟水平的升华(F=4.1,P＜0.05)和压抑(F=3.9,P＜0.05)得分较低.早年来自父母的精神虐待与不成熟的心理防御机制有显著正相关；早年经历躯体虐待较无躯体虐待者更多使用抱怨(F=6.9,P＜0.05)和否认(F=5.2,P＜0.05)的防御机制,而较少使用期望防御机制(F=4.6,P＜0.05),经历性虐待者较无性虐待者更多使用躯体化(F=4.4,P＜0.05)和隔离(F=3.6,P＜0.05)的防御机制.结论 BPD患者多使用不成熟水平以及部分中间水平的防御机制,较少使用成熟水平的防御机制.早年精神虐待、躯体虐待及性虐待与不成熟的心理防御机制及部分中间水平的防御机制存在一定相关性.早年父母养育方式,可减少或避免各种早年创伤性经历,对预防边缘型人格障碍的发生.

Objective To understnad the defense mechanisms of patients with borderline personality disorder (BPD) and to explore its relationship with childhood abuses.Methods One hundred and forty-two outpatients with BPD (group A),63 outpatients with other personality disorders (group B) and 20 outpatients without any Axis Ⅱ diagnoses (group C) were enrolled and completed Chinese versions of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the Defensive Style of Questionnaire (DSQ).Multivariate analysis of variance and Pearson correlation analysis were used for data analysis.Results Compared to group B and C,the score of defense mechanisms reported by group A were significantly increased in all eight premature defense mechanisms,such as projection(F =26.5,P ＜ 0.05),passive aggression (F =18.1,P ＜ 0.05),acting out (F =28.3,P ＜ 0.05),complaint (F =16.7,P ＜0.05),fantasy(F =16.3,P ＜ 0.05),splitting (F =28.8,P ＜ 0.05),withdrawal (F =8.3,P ＜ 0.05),somatization(F=7.6,P ＜ 0.05),and part of the middle defense mechanisms,such as omnipotence-devaluation(F =9.2,P ＜ 0.05),isolation(F =4.7,P ＜ 0.05) and identification (F =10.0,P ＜ 0.05).At the same time,the BPD patients got lower scores in the mature defense mechanisms,such as sublimation (F =4.1,P ＜ 0.05) and repression(F =3.9,P ＜ 0.05).Those who experienced physical abuse use more complaint (F =6.9,P ＜ 0.05),denial mechanisms (F =5.2,P ＜ 0.05) and less anticipation one (F =4.6,P ＜ 0.05).Those who experienced sexual abuse use more somatization (F =4.4,P ＜ 0.05) and isolation mechanism (F =3.6,P ＜ 0.05).Conclusions BPD patients would like to use more immature and middle defense mechanisms and less mature ones.Emotional,physical and sexual abuse from parents and other adult care takers have a correlation with immature defense mechanisms,which indicates the importance of care about parental rearing patterns and mental health of children.