Слабинский Владимир Юрьевич (dr_slabinsky) wrote,
Слабинский Владимир Юрьевич
dr_slabinsky

Ольга Бермант-Полякова: "Пограничник"

Из моих комментариев в сообществе ру_психолог:

Добрый день!
Видите ли, книги про бордерлайн (переводные) описывают наблюдения 1980-х годов. И пересказывать их спустя тридцать лет как новое слово в психодиагностике - значит рисковать. Я процитирую вам статью 2014 года, где о бордерлайн говорится как о неврологии, - то есть все "пограничные" имеют "лёгкую неврологию в анамнезе". И только. Сколько бы разговорных терапий вы не проводили с человеком, у которого анатомически две зоны мозга "тоньше", чем у основной популяции, мозг в этих местах не нарастает от разговоров.



http://www.ncbi.nlm.nih.gov/pubmed/24850076

Curr Top Behav Neurosci. 2014 May 22. [Epub ahead of print]
The Spectrum of Borderline Personality Disorder: A Neurophysiological View.
Stone MH.
Author information
Professor of Clinical Psychiatry, Columbia College of Physicians and Surgeons, 225 Central Park West, New York, NY, 10024, USA, michaelhstonemd@gmail.com.

Abstract

Borderline Personality Disorder (BPD) has been defined as a personality disorder in all editions of DSM since 1980; namely, DSM III through V. The criteria are a mixture of symptoms and traits; the etiology, a heterogeneous array of genetic, constitutional, and environmental factors. Until recently the diagnosis relied on clinical descriptions. In the last two decades, neurophysiological data, including MRIMRI and fMRI, have established correlates in various brain regions, particularly those involving the frontal lobes and various limbic structures, that show promise of providing a more substantial basis for diagnosis-relying primarily on (internal) brain changes, rather than on (external) clinical observation. Some of the changes in BPD consist of decreased volume in the orbitofrontal and dorsolateral prefrontal cortices and smaller volume in both the amygdala and hippocampus, though with heightened reactivity in the amygdala. Similar abnormalities have been noted in bipolar disorders (BDs) and in ADHD, both of which often accompany BPD and share certain clinical features. Persons with strong genetic predisposition to BDs can develop BPD even in the absence of adverse environmental factors; those with extreme adverse environmental factors (chiefly, early sexual molestation) can develop BPD in the absence of bipolar vulnerability. In some BPD patients, both sets of factors are present. As ideal treatment depends on careful analysis of these factors, neurophysiological testing may permit both more rational, brain-based diagnostic decisions and more appropriate therapeutic strategies.

Первыми обнаружили нейрофизиологические корреляты "пограничного расстройства личности" канадские учёные, их исследование повторили в разных университетах с тем же результатом. Пример немецкого:

http://www.ncbi.nlm.nih.gov/pubmed/24503371

Psychiatry Res. 2014 Mar 30;221(3):179-86. doi: 10.1016/j.pscychresns.2014.01.006. Epub 2014 Jan 23.
Reduced cortical and subcortical volumes in female adolescents with borderline personality disorder.
Richter J1, Brunner R2, Parzer P2, Resch F2, Stieltjes B3, Henze R4.
Author information
1Section Disorders of Personality Development, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital of Heidelberg, Heidelberg, Germany; Section Quantitative Imaging-Based Disease Characterization, Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
2Section Disorders of Personality Development, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital of Heidelberg, Heidelberg, Germany.
3Section Quantitative Imaging-Based Disease Characterization, Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
4Section Disorders of Personality Development, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital of Heidelberg, Heidelberg, Germany; Section Quantitative Imaging-Based Disease Characterization, Department of Radiology, German Cancer Research Center, Heidelberg, Germany. Electronic address: Romy.Henze@med.uni-heidelberg.de.

Abstract
Volumetric alterations in limbic structures have been detected in adults, but not in adolescents with borderline personality disorder (BPD). We examined adolescents in the early stages of BPD to provide a unique opportunity to investigate which parts of the brain are initially affected by the disorder before confounding factors such as long-term medication or chronicity can mask them. A group of 60 right-handed female adolescents between 14 and 18 years of age (20 patients with BPD, 20 clinical controls, and 20 healthy controls) underwent magnetic resonance imaging (MRI). Focus was on the examination of hippocampal and amygdalar volume differences. Furthermore, a cortical thickness analysis was conducted. FreeSurfer software detected significant group differences in the right and left hippocampus and in the right amygdala. Additionally, significant volume reductions in frontal (right middle frontal gyrus, orbital part of the inferior frontal gyrus bilaterally), and parietal regions (superior parietal gyrus bilaterally) were found in adolescents with BPD compared with controls. No group differences in cortical thickness were revealed.

KEYWORDS Amygdala; Borderline personality disorder; Cortical thickness; FreeSurfer; Hippocampus; Parietal cortex

Вот первая публикация, 2012 года, на эту тему, на сравнении 200 бордерлайн и 200 здоровых, канадская,

http://www.ncbi.nlm.nih.gov/pubmed/22507760

Psychiatry Res. 2012 Mar 31;201(3):245-52. doi: 10.1016/j.pscychresns.2012.02.012. Epub 2012 Apr 15.

1Department of Psychology, University of Toronto Scarborough, Toronto, Canada. aruocco@utsc.utoronto.ca

Amygdala and hippocampal volume reductions as candidate endophenotypes for borderline personality disorder: a meta-analysis of magnetic resonance imaging studies.
Ruocco AC1, Amirthavasagam S, Zakzanis KK.

Abstract

Borderline personality disorder (BPD) is a genetically influenced psychiatric illness with disruptions in neural systems supporting cognition and emotion regulation. Volumetric decreases of the hippocampus and amygdala may characterize BPD and serve as putative endophenotypes for the illness. The purpose of the present study was to evaluate whether the magnitude of these volume reductions and their associations with state-of-illness factors and psychiatric disorders which often co-occur with BPD warrant their consideration as potential endophenotypes. Volumetric magnetic resonance imaging results from 11 studies comprising 205 BPD patients and 222 healthy controls were quantitatively synthesized using meta-analytic techniques. Patients showed an average 11% and 13% decrease in the size of the hippocampus and amygdala, respectively. These volumetric differences were not attenuated in patients being treated with psychotropic medications. Comorbid depression, post-traumatic stress disorder, and substance use disorders were unrelated to volumetric decreases in either structure. These findings suggest modest volume reductions of the amygdala and hippocampus bilaterally in BPD which cannot be attributed to illness state or comorbid psychopathology. Decreased volumes of these key limbic structures may hold promise as candidate endophenotypes for BPD.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Оригинал взят у m_d_n в "Пограничник"


Владимир Слабинский: Благодарю уважаемую Ольгу Викторовну Бермант-Полякову за данный пост. А то уже устал с "новоявленными травмотерапевтами" разговоры разговаривать...
Tags: Бермант-Полякова, ПТСР, позитивная динамическая психотерапия, теория метода
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