Korean Clinical Psychology Association

Current Issue

Korean Journal of Clinical Psychology - Vol. 39 , No. 4

[ Original Article ]
Korean Journal of Clinical Psychology - Vol. 39 , No. 4 , pp.257-273
ISSN: 2733-4538 (Online)
publication date 30 Nov 2020
Received 21 May 2020 Revised 06 Aug 2020 Accepted 24 Aug 2020
DOI: https://doi.org/10.15842/kjcp.2020.39.4.001

경계선 성격의 핵심증상 및 우울 증상과의 동반이환: 네트워크 분석
김민선 ; 최현정
1충북대학교 심리학과

Central Symptoms of Borderline Personality and Comorbidity with Depressive Symptoms: A Network Analysis
Minseon Kim ; Hyunjung Choi
1Department of Psychology, Chungbuk National University, Cheongju, Korea
Correspondence to : Hyunjung Choi, Department of Psychology, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Korea; E-mail: hchoi@chungbuk.ac.kr
This work is based on the master’s thesis of the first author.


© 2020 Korean Clinical Psychology Association

초록

경계선 성격장애(borderline personality disorder, BPD)는 정서, 인지, 행동 조절 문제와 정체감 및 대인관계 조절에 어려움을 특징으로 보이는 성격장애이다. BPD 증상은 서로 이질적이고 만성적이며 특히 주요우울장애와 공병률이 매우 높다. 이에 본 연구는 네트워크 분석을 사용하여 BPD 만성화에 영향을 미치는 핵심증상, 우울삽화 증상과 동반이환을 유발하는 연계증상 및 증상 예측도를 알아보았다. 네트워크 분석이란 정신장애를 이해하기 위해 새롭게 제안된 접근법으로, 증상 간 연결성을 시각적으로 나타내주는 분석방법이다. 비임상 성인표본 573명을 대상으로 성격평가질문지-경계선척도(PAI-BOR)와 환자건강질문지-9 (PHQ-9)를 사용하여 네트워크 분석을 실시하였다. 분석 결과, BPD 핵심증상은 ‘외로움’, ‘갑작스러운 기분변화’, ‘갑자기 격해지는 감정’ 이었으며, BPD와 우울삽화 증상의 연계증상은 ‘행복한 사람(역)’, ‘자해’, ‘자해충동 및 자살사고’, ‘저조한 기분 및 무망감’으로 나타났다. 이는 BPD에서 핵심증상은 정서조절 문제와 관련되며, 우울삽화와 부정적 정체감 문제를 통해 기분 및 자살 사고를 일으킬 가능성을 시사한다. 이어서 BPD 관련 기존 이론 및 범진단적 개념화를 통해 본 연구 결과에 대한 설명을 시도하고, 심리치료에 시사점을 논의하였다.

Abstract

Borderline personality disorder (BPD) is characterized by dysregulations in emotion, cognition, and behavior as well as disturbances in identity and interpersonal relationships. BPD shows a heterogeneous and chronic presentation, and a high comorbidity with major depressive disorder. This study used network analysis to identify the central symptoms affecting the chronicity of BPD, the bridge symptoms that may cause comorbid depressive symptoms, and the predictability of each symptom. Network analysis is a novel approach in understanding mental disorders, in that it delineates the core symptoms of a disorder as well as their inter-connectivity. We conducted a network analysis among 573 community samples using the Personality Assessment Inventory-Borderline Features Scale (PAI-BOR) and the Patient Health Questionnaire-9 (PHQ-9). Results indicated that loneliness, mood shift, and intense mood were central symptoms of BPD. Being a happy person (reverse), self-harm behavior, feeling depressed and hopeless, and self-harm and suicidality were symptoms of both BPD and depressive episodes. The findings suggest that the central symptoms of BPD are related to emotion regulation issues, and that depressive episodes are associated with negative identity issues, affecting mood issues and suicidality. We further explained the results by previous theories and transdiagnostic formulations of BPD and discussed their psychotherapeutic implications.


Keywords: borderline personality disorder, major depressive episode, network analysis, emotion dysregulation, transdiagnostic
키워드: 경계선 성격장애, 주요우울 삽화, 네트워크 분석, 정서조절문제, 범진단

Author contributions statement

Minseon Kim M.A., was a graduate student at Chungbuk National University, had conceived the research, analyzed data and prepared the manuscript. Hyunjung Choi Ph.D., assistant professor at Chungbuk National University, provided critical feedback and revised the manuscript. All authors approved the final submission.

Supplemental materials

Supplemental materials are available at https://doi.org/10.15842/kjcp.2020.39.4.001.


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