⭐今日精選 TOP Picks
Task-Based fMRI Reveals a Diagnosis-Dependent Amygdala Lateralization in Major Depressive Disorder, Borderline Personality Disorder, and Comorbidities.
Neuroscience bulletin · Task-Based fMRI Reveals a Diagnosis-Dependent Amygdala Lateralization in Major Depressive Disorder, Borderline Personality Disorder, and Comorbidities.
發現BPD患者顯示右側杏仁核過度活化，而MDD-BPD併存則呈雙側活化，提供神經生物學依據以區分BPD與MDD的病理機制，具重要鑑別診斷與治療定位價值。
P217名參與者，包括BPD seule、MDD seule、MDD-BPD併存及對照組
I情緒臉匹配任務中的任務功能fMRI
CBPD seule vs MDD seule vs MDD-BPD vs 健康對照組
OBPD seule顯示右側杏仁核過度活化，MDD-BPD併存組呈雙側杏仁核活化，情緒不穩與負自我概念為關鍵介因數
Analysis of brain volumetry and functional connectivity during resting state in patients with borderline personality disorder.
European archives of psychiatry and clinical neuroscience · Analysis of brain volumetry and functional connectivity during resting state in patients with borderline personality disorder.
發現BPD患者雙側島葉與前額葉迴灰質減少，且前額葉連結異常與童年虐待、症狀嚴重度及自傷行為相關，揭示結構-功能變化的發展模式。
P48名女性BPD患者（VBM）及41名（rs-fMRI），對照組54及51名健康女性
I結合 voxel-based morphometry (VBM) 與 resting-state fMRI
CBPD患者 vs 健康對照組
O島葉與中/上額frontal gyrus灰質減少；右中/上額frontal gyrus與額葉葉、顳葉、額極區連結增加；症狀嚴重度與自傷行為預測特定連結改變
Help-seeking patterns for non-suicidal self-injury across borderline symptom profiles in a large sample of university students.
Borderline personality disorder and emotion dysregulation · Help-seeking patterns for non-suicidal self-injury across borderline symptom profiles in a large sample of university students.
在1,476名瑞典大學生中發現，非自殺性自傷行為的求助行為隨BPD症狀類型無顯著差異，但他人鼓勵是求助行為最一致的預測因子，提示社會支持在早期干預中的關鍵作用。
P1,476名瑞典大學生（68.5%女性），經McLean篩選工具分類為四種BPD症狀 profiles
I無（橫斷面觀察）
CFull Spectrum、Internalizing、Externalizing、Asymptomatic 四種症狀類型間的求助行為差異
O求助行為在四個類型間無顯著差異；他人鼓勵是求助行為最一致相關因子；態度與來源無顯著差異
Low-Dose Clozapine Versus Aripiprazole in Borderline Personality Disorder: A Prospective Naturalistic Study.
Journal of clinical psychopharmacology · Low-Dose Clozapine Versus Aripiprazole in Borderline Personality Disorder: A Prospective Naturalistic Study.
低劑量氯氮平在解離與抑鬱症狀上較阿利匹胺優勢顯著，兩藥皆安全耐受，支持氯氮平作為重度、治療抵抗BPD患者的補充藥物選項。
P23名嚴重BPD患者（低劑量氯氮平n=9，阿利匹胺n=14）
I低劑量氯氮平 vs 阿利匹胺
C兩藥物組於入院、出院及3個月隨訪時的情緒失調、解離、抑鬱、衝動與生活品質變化
O兩組皆改善；氯氮平在出院時顯著降低解離，隨訪時降低抑鬱優於阿利匹胺；兩藥皆安全耐受
Possible Role and Function of AI Conversational Agents in Dialectical Behavior Therapy for Borderline Personality Disorder: Qualitative Interview Study.
JMIR mental health · Possible Role and Function of AI Conversational Agents in Dialectical Behavior Therapy for Borderline Personality Disorder: Qualitative Interview Study.
DBT臨床師視角下，AI對話代理被視為「苦行助手」— 可提供全天候支援，但懸念其可能強化依賴與安全行為，而非促進自主性，凸顯技術整合的倫理與臨床張力。
P17名瑞典DBT心理師（平均臨床經驗6.4年）
I半結構式訪談探索AI對話代理在DBT中的潛在角色
C無（質性研究）
O三大主題：(1)『我們在治療中是誰？』（AI定位為工具/團隊成員/主管/競爭者），(2)『苦行助手』（AI為理想助手的擴展），(3)『善意的適應者』（AI可能強化依賴與尋求安慰而非自主）
📚其他值得關注的文獻
Examining Change Using the MMPI-2-RF in a Multicenter RCT on BPD: Data from the BOOTS Project.
Journal of personality assessment
在多中心RCT中，MMPI-2-RF顯示BPD患者在內化 scale 上有中等至大的變化效應，支持其作為追蹤心理治療變化的工具。
Exploring Associations Between the MMPI-3 and Measures of Borderline Personality Disorder, Posttraumatic Stress Disorder, and Dissociation in a Sample of Incarcerated Women.
Journal of personality assessment
在監禁女性中，MMPI-3的EID、RC7、RC8等尺度與BPD、PTSD、解離症狀顯著相關，支持其在複雜創傷人群中的鑑別診斷實用性。
Borderline Personality Disorder in South Korea: A Narrative Review of Clinical Research and Future Directions.
Yonsei medical journal
南韓BPD顯著漏診，發病年齡較晚，功能受損與自殺風險高，強調需降低污名、提早干預並推廣證據基礎治療。
Right DLPFC repetitive transcranial magnetic stimulation in women with borderline personality disorder: A double-blind randomized sham-controlled trial.
Journal of affective disorders
右側DLPFC rTMS在BPD患者中未顯著優於假刺激，僅見短期自我報告抑鬱改善，提示需更大樣本與優化靶點以確認真實療效。
Dissociation as a marker of emotion dysregulation: An examination in adolescent psychiatric inpatients using ecological momentary assessment.
Journal of affective disorders
在青少年住院患者中，解離與負負情緒同步發生，但無預測性關聯；皮質醇與解離交互作用預測後續負情緒下降，部分支持解離作為短期調節機制。
Suicidal ideation covaries with depressive severity during six-month real-world esketamine treatment in a cohort enriched for borderline personality disorder.
Journal of affective disorders
未提供摘要，無法評估。
Does impulsivity predict treatment outcomes in PTSD with borderline personality disorder features? Results from a randomized clinical trial.
Journal of psychiatric research
基礎衝動性預測較高輟與CPT組PTSD改善較差，但DBT-PTSD組無關聯，提示DBT可能緩衝衝動性對治療的負面影響。
Localizing the structural and functional alteration networks associated with borderline personality disorder.
Journal of affective disorders
透過96篇文獻整合，定位BPD相關的三大腦網絡：結構（運動/皮質）、功能 salient 檢測（島殼/粒狀核）、靜止態預設模式網，並連結特定神經遞質系統。
Distress Intolerance: Dialectical Behavior Therapy Informed Communication for Serious Illness Care.
Journal of palliative medicine
DBT的痛苦 intolerance 技能與驗證策略可幫助嚴重疾病患者及其醫療團隊管理痛苦，提升照護品質與減少次級創傷。
Clinical and psychological characteristics of adolescents at risk of mood disorders compared with adolescents with suicidal behavior.
Journal of affective disorders
有自殺行為的青少年顯著較高絕望感、焦慮與BPD特徵，而情緒風險群則顯著較低憂鬱與焦慮，支持早期識別BPD特徵於自殺預防的重要性。
Mechanisms of vulnerability in borderline personality psychopathology: The role of childhood maltreatment, social cognition, and emotion dysregulation.
Journal of affective disorders
童年虐待嚴重度與社會認知缺損（特別是情緒識別與理論心智）共同預測BPD不良結果，即使未診斷BPD亦見此關聯，強調早期干預的預防價值。
Impulsivity in borderline personality disorder: A scoping review of affective, neurobiological and methodological findings.
Psychiatry research
BPD衝動性主要受負緊急性（negative urgency）影響，並在情緒唤起下顯現，而非靜態抑制控制缺陷，支持情境化、情緒導向的治療模型。
Trauma, Diagnosis, and Borderline Personality Disorder: The Need for Conceptual Clarity.
Social work
雖然童年創傷是BPD的重要風險因子，但非必要也不充分，警告避免將cPTSD視為BPD的亞型，強調需多因素模型與謹慎鑑別，以避免誤診與污名。
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
利用LLM分析自由文本發現，BPD個體在社交/個人關係與健康相關事件中自我評價與寧靜度反應顯著較低，且對負面事件的情緒反應性增強，顯示其對社會線索的過度敏感。
The salient role of childhood neglect in single and multiple suicide attempts among adult psychiatric inpatients.
European journal of psychotraumatology
情緒忽視是最常見童年創傷類型（93%），且與多次自殺試圖顯著相關，當與其他虐待共存時影響加倍，強調需全面創傷評估而非單一因子聚焦。
Suicidal attempts in young adults with borderline personality disorder: Examing factors in pathways to attempts.
Journal of affective disorders
情緒失調與衝動性是預測青年BPD患者自殺意圖與行為的關鍵，且18%嘗試自殺者無前期意圖或計畫，提示需評估非線性、衝動驅動的自殺風險。
From Childhood Emotional Abuse to Adolescent Dissociation: The Role of Borderline Personality Features.
Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)
童年情感虐待透過BPD特徵（特別是情緒不穩與身份問題）中介導致青少年解離，說明青春期是介入的關鍵窗口。
Absorption and Depersonalisation Derealisation Link Childhood Trauma to BPD Severity and Show Strong Independent Predictive Effects for Various BPD Symptom Domains.
Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD)
吸收型解離預測BPD九個領域中的八個（除自殺外），而去人格isation現實感解離則獨特預測自殺行為，支持區分解離亞型以指導臨床評估與治療。
Personality Traits in Borderline Personality Disorder: A Cluster Analysis Based on the Millon Test Scores.
Journal of clinical psychology
透過Million叢 cluster 分析識別出三種BPD特質模式：外向型（邊緣/衝動/ narcissistic）、內向型（依賴/迴避）及減弱型（低所有特徵），後者較多藥物治療，支持個性化治療。
Exploring Reasoning Biases Associated With Psychosis in Borderline Personality Disorder Using Self-Report and Objective Measures.
Journal of clinical psychology
BPD群體在證據迴避偏見（BADE）上較健康對照明顯高，但低於精神分裂症；在跳躍結論（JTC）任務中65%呈陽性，提示其在精神病樣症狀中的認知脆弱性。
Promoting self-compassion meditation with intranasal oxytocin in borderline personality disorder: a pilot study.
Psychiatry research
內源性催產素增強BPD患者在慈悲冥想中的想像維度表現，但未影響總分或身體體驗，提示其可能僅調節主觀體驗的特定面向。
Time to diagnosis and treatment for borderline personality disorder - opportunities and pitfalls during the consumer mental health journey.
Journal of psychiatric research
BPD症狀起始至診斷中位數延遲達13.5年，男性更長，診斷後至治療仍超過一年，凸顯系統性延遲與需改善溝通與服務連結的急迫性。
Intranasal esketamine in treatment-resistant depression with and without comorbid borderline personality disorder: A multicenter real-world longitudinal study.
Psychiatry research
伴BPD的治療抵抗憂鬱患者對鼻腔艾斯كس胺反應較好（月內起效），但六月緩解率無差異，提示BPD可能影響早期反應而非長期復原。
Risk factors associated with death by suicide in people diagnosed with borderline personality disorder in comparison with major depressive disorder: A descriptive study.
Journal of psychiatric research
BPD自殺死亡者較常見童年逆境、自傷史、近期關係斷裂與自傷方式改變；MDD則以生活事件與物質使用惡化為主，支持構建BPD特定自殺風險評估模型。
Peripheral inflammation is associated with emotional dysregulation, suicide attempts, and reduced microstructural integrity of white matter in young adults with borderline personality disorder.
Brain, behavior, and immunity
BPD年輕成人外周發炎（尤其GM-CSF）與情緒失調、自殺企圖及白質微結構損傷（ salient 網絡）相關，支持免疫-神經雙重病理模型。
Borderline personality features predicting depressive symptom trajectories among Chinese university students: The mediating role of difficulties in emotion regulation.
Journal of affective disorders
在中國大學生中，BPD特徵透過情緒調節困難中介預測遞增型憂鬱軌跡，男性與年長為高風險因子，支持早期情緒技能訓練作為預防策略。
Long-term stability of perceived childhood trauma in individuals with borderline personality disorder.
European journal of psychotraumatology
童年創傷問卷（CTQ）在BPD個體中顯示高度長期穩定性（ICC=0.82，4–11年），其變化與BPD症狀嚴重度同步變化，支持其作為可靠的回顧評估工具。
Long-term consequences of childhood sexual abuse: An umbrella review of diagnostic meta-analyses.
L'Encephale
童年性侵害顯著增加BPD風險（OR=5.96），與睡眠 disorder 並列為最常見精神後果，強調需納入創傷史評估於精神病檢查。
Prevalence, psychiatric comorbidity and treatment of multiple personality disorder in Germany: an analysis based on nationwide claims data, 2012-2021.
European journal of psychotraumatology
德國多重人格障礙（MPD）診斷率上升但仍低於流行病學估計，顯著共病焦慮與憂鬱，提示臨床上可能被漏診或誤診。
Linking childhood adversity with borderline and depressive symptoms: the role of reward processing.
European journal of psychotraumatology
童年逆境透過獎賞反應與學習維度影響BPD症狀，僅透過獎賞學習影響憂鬱，支持獎賞處理作為跨診斷治療標的。
The Role of Mothers' Psychiatric Symptoms, Practices of Emotion Socialization and Emotion Regulation among Children Diagnosed with Attention Deficit and Hyperactivity Disorder.
Child psychiatry and human development
母親的ADHD與BPD症狀透過其不支援的情緒社會化方式（懲罰與苦惱反應）間接影響孩子ADHD症狀的嚴重度，提示父母心理健康對孩子行為的間接影響。