边缘型人格障碍的欲求-压力分析

Need-pressure Triats of Borderline Personality Disorder in Thematic Apperception Test

目的:运用主题统觉测验(TAT)探索边缘型人格障碍(BPD)潜在的欲求-压力特点。方法:用人格诊断问卷(PDQ-4+)在3552名高校学生中筛出边缘型得分≥7者254人,由两名研究人员对他们进行人格障碍定式临床检查(SCID-Ⅱ)面谈,最后确诊BPD62人,从中按边缘型得分由高到低选取30名愿意参与本研究的为BPD组,在边缘型得分<2的学生中由高到低选取30名为对照组,施测主题统觉测验,对照两组的欲求-压力得分。结果:(1)BPD组的欲求和、压力和均高于对照组[(32.6±5.1)vs.(29.8±5.0),(36.9±5.0)vs.(32.2±6.3);均P<0.05],且BPD组的压力和高于欲求和(P<0.05)。(2)边缘型得分与欲求-压力系统的逐步回归方程:边缘型得分=-0.315C成就欲求+0.36X情绪变化欲求+0.329X灾害压力+0.313X情感压力+0.234X联想压力+0.204X丧失支持压力,多元回归系数为0.817,方程拟合度为0.668。结论:运用主题统觉测验的欲求-压力系统可解释BPD患者的内心感受模式和临床行为的驱动因素。

Objective： To explore the potential characteristic of need-pressure system in patients with borderline personality disorder （ BPD ） with the thematic apperception test （ TAT） . Methods： The need-pressure system of 30 BPD students were compared with that of 30 non-BPD students. Results： （ 1） The sums of needs and pressures of BPD were significantly more than that of non-BPD [ （ 32. 6 ± 5. 1 ） vs. （ 29. 8 ± 5.0 ）, （ 36. 9 ±5.0 ） vs. （ 32.2 ± 6. 3 ）, Ps 〈 0. 05 ] . In BPD gronp, the sum of press was significantly higher than the sum of needs （ P 〈 0. 05 ） . （2） Stepwise regression equations： the score of BPD = - 0. 315 x achievement need ＋ 0. 36x need of emotional change ＋ 0. 329 xpressure of physical danger ＋ 0. 313x emotional pressure ＋ 0. 234x associative pressure ＋ 0.204x loss of support pressure. Multiple Regression Coefficients was 0. 8171 and R2 was 0. 668. Conclusion： Need-press system of TAT can be used to explore the driving factors of experience mode and clinical behavior in BPD patients.