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Machine learning reveals a multimodal, transdiagnostic signature of emotion dysregulation vulnerability across patients, offspring, and controls.
Molecular psychiatry · Machine learning reveals a multimodal, transdiagnostic signature of emotion dysregulation vulnerability across patients, offspring, and controls.
透過多模態資料(MRI、免疫、神經營養)與機器學習識別出情緒調節功能失調的跨診斷生物標誌,BPD 高危兒代表現中間表型,具早期預警與干預潛力。
P97 名情緒調節失調相關障礙患者(含 BPD)、67 名其子女、73 名健康對照
I無介入(橫斷式多模態評估:臨床評估、dMRI、fMRI、血清免疫與神經營養指標)
C健康對照組 vs. 患者組 vs. 高危子女群
O識別出兩個關鍵多模態成分:一與海馬動態功能連接和高情緒調節失調相關(子女群呈中間表型);一與全身性炎症相關(僅見於患者);RF 模型區分對照與高危群達 80.3% 平衡準確率;多模態非臨床特徵可預測情緒調節症狀(p < 0.01)
Contextual insights from large language models in ambulatory assessment: Differential reactivity of affect and self-esteem to daily events in borderline personality disorder.
Journal of psychopathology and clinical science · Contextual insights from large language models in ambulatory assessment: Differential reactivity of affect and self-esteem to daily events in borderline personality disorder.
使用 LLM 分析 10,844 篇自由文本事件描述,發現 BPD 群在社交/個人關係與健康相關事件中,對落ち着き與自尊的反應顯著較弱,且情緒反應性較高,顯示其對日常線索的過度敏感。
P265 名女性(131 名 BPD 患者,134 名健康對照),進行 4 天高頻率莊體評估(每日 12 次)
ILLM 自動管線:將自由文本事件分為 5 類(日常routine、休閒、社交關係、工作、健康與福祉)並評估情感傾向
CBPD 群 vs. 健康對照群,於事件類別與情感傾向互項下分析瞬間平靜感、情感價值、自尊
OBPD 群在社交/個人關係與健康福祉事件中,平靜感與自尊顯著低於對照;負面情感傾向在 BPD 群中對平靜感、情感價值、自尊的反應較強(p < 0.05);正面情感傾向與所有三項結果正相關
Characterizing brain structural and functional abnormalities in borderline personality disorder by seed-based d mapping approach.
Brain imaging and behavior · Characterizing brain structural and functional abnormalities in borderline personality disorder by seed-based d mapping approach.
透過種子基礎 d 對映(SDM)對 26 份研究進行多模態(sMRI、fMRI、DTI、rs-fMRI)整合 meta 分析,發現 BPD 患者在前額葉、海馬、前 cingulate 及島葉等區域結構與功能異常一致,解釋情緒調節與人際功能障礙的神經基礎。
PBPD 患者 vs. 健康對照(HC),來自 26 份符合納入標準的神經影像研究
ISeed-based d mapping (SDM) 軟體進行座標基礎 meta 分析(CBMA),整合四種影像模態
CBPD 群 vs. 健康對照群,於結構與功能影像端點
O前額葉灰質減少、海馬體積異常、前 cingulate 皮質厚度減弱、島葉功能連接異常;DTI 顯示前額葉-邊緣系統白質完整性降低;rs-fMRI 顯示默認模式網絡與額葉控制網絡連接失調
Does Dialectical Behaviour Therapy for adolescents affect suicidal ideation and use of coping skills in adulthood? A 12.4-years follow-up study of a Randomized Trial using Ecological Momentary Assessment.
Behaviour research and therapy · Does Dialectical Behaviour Therapy for adolescents affect suicidal ideation and use of coping skills in adulthood? A 12.4-years follow-up study of a Randomized Trial using Ecological Momentary Assessment.
青少年接受 DBT-A 後,12.4 年隨訪顯著降低成年自殺念頭發生率(OR=0.16),且對特定應對技能的使用與負面情緒之間的動態關聯具有調節效應,證明其長期保護作用。
P54 名曾參與 RCT(DBT-A vs. Enhanced Usual Care)的青少年,12.4 年後隨訪
I青少年期辯證行為療法(DBT-A)
CDBT-A 群 vs. Enhanced Usual Care (EUC) 群
ODBT-A 群報告任何自殺念頭的 odds 降低 84%(OR=0.16,95% CI: .02–.89),獨立於共病 BPD 或主要憂鬱;特定應對技能使用與當時負面情緒之間具有顯著內人交互作用,僅 EUC 群顯示技能使用增加時負面情緒升高
Machine learning reveals a multimodal, transdiagnostic signature of emotion dysregulation vulnerability across patients, offspring, and controls.
Molecular psychiatry · Machine learning reveals a multimodal, transdiagnostic signature of emotion dysregulation vulnerability across patients, offspring, and controls.
(與 Rank 1 重複,此為系統誤實際應為 Rank 5 以下新增論文,但原始資料中無更多高臨床實用性論文,故調整為次高價值論文)
📚其他值得關注的文獻
Trauma, Diagnosis, and Borderline Personality Disorder: The Need for Conceptual Clarity.
Social work
探討創傷與 BPD 的關係,認為創傷非必要也不充分條件,主張多因子模型,並批判 cPTSD 作為獨立診斷的臨床實用性與風險。
Manual therapists and people living with borderline personality disorder (BPD): a commentary on building safety, trust, and therapeutic effectiveness in physical care.
Chiropractic & manual therapies
指出手動治療師常遇 BPD 患者但缺乏創傷知照培訓,建議以 NICE 指引為基礎整合安全邊界、合作與續航性,避免無意傷害。
Long-term stability of perceived childhood trauma in individuals with borderline personality disorder.
European journal of psychotraumatology
CTQ 在 BPD 群體中顯示出高長期穩定性(ICC=0.82,4–11 年),且創傷感知變化與 BPD symptom 嚴重度正相關,支持其作為可靠回溯工具。
Neuroimaging insights into Borderline Personality Disorder patients with and without suicide attempts: A multi-modal structural MRI study.
Journal of psychiatric research
發現有自殺嘗試史的 BPD 患者(BPD-SA)在海馬、前額葉及胼鬝體顯示更嚴重的白質異常,與童年創傷負相關,提示神經發育風險的生物標誌。
Effects of Short-Term Versus Long-Term Mentalization-Based Therapy on Psychiatric Symptoms in Outpatients With Borderline Personality Disorder: Exploratory Results From a Randomized Clinical Trial.
Personality and mental health
隨訪 16 個月後,短期(5 個月)與長期(14 個月)MBT 在精神症狀(SCL-90-R)上無顯著差異,提示療程長度可能非精神症狀改善的關鍵因子。
Two operationalizations of a single construct: Overlap between borderline personality disorder and the level of personality functioning.
Personality disorders
發現 BPD 與 LPF(人格功能水準)具有高度共享變異(一般因子主導),但 BPD 仍保留獨特的外向性特徵,支持將資源轉向維度模型而非類別診斷。
A Qualitative Exploration of Trainee Nurse Practitioners' Experiences and Readiness to Provide Care for Borderline Personality Disorder in Primary Care.
International journal of mental health nursing
初階護士從業者報告感覺 unprepared 面對 BPD 患者,主要因培訓不足、時間限制、路徑不明確與系統障礙,強調需加強精神內容導師制與危機管理培訓。
A scoping review of programmes that address the daily living functioning of people diagnosed with borderline personality disorder.
The Australian and New Zealand journal of psychiatry
雖有 44 項跨國計畫涵蓋日常生活功能域(健康、家庭、責任等),但無單一項目涵蓋全部域,凸顯需建立全面、循證的康復計畫以促進功能復原。