الگوی ساختاری آسیب کودکی، راهبردهای تنظیم شناختی هیجان و نشانه‌های شخصیت مرزی

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روانشناسی بالینی دانشگاه آزاد اسلامی واحد کرج، کرج، ایران

2 استادیار، گروه روانشناسی دانشگاه آزاد اسلامی واحد کرج، کرج، ایران

3 استادیار، گروه روانشناسی دانشگاه آزاد اسلامی واحد آستارا، آستارا، ایران

چکیده

مقدمه: قرار گرفتن در معرض وقایع آسیب زا، قبل و یا در دوران بلوغ پیامدهای منفی بر رشد شخصیت دارد  و عامل خطر مهمی برای ابتلا به اختلال شخصیت مرزی محسوب می­شود. هدف پژوهش حاضر تعیین نقش واسطه­ای راهبردهای مثبت و منفی تنظیم شناختی هیجان در رابطه بین آسیب کودکی و نشانه­های شخصیت مرزی بود.
روش: روش پژوهش حاضر توصیفی از نوع همبستگی بود. جامعه آماری پژوهش شامل تمام ساکنان منطقه هفت شهر کرج در تابستان سال ۱۳۹۶ بود. ۳۰۰ نفر با گزینش تصادفی انتخاب شدند. ابزار پژوهش شامل پرسشنامه آسیب کودکی(CTQ)؛ پرسشنامه تنظیم شناختی هیجان(CERQ) و سیاهه نشانه­های مرزی (BSL) بود. داده­های پژوهش با استفاده از مدل­یابی معادلات ساختاری تحلیل شدند.
یافته‌ها: شاخص­های برازندگی از برازش قابل قبول داده­ها با مدل حمایت کردند. یک ضریب مسیر کل بین آسیب کودکی و شخصیت مرزی (544/0=β، 01/0>P) مشاهده شد. یک ضریب مسیر مستقیم نیز بین راهبردهای منفی تنظیم شناختی هیجانی و شخصیت مرزی (513/0=β، 01/0>P) بدست آمد. یک ضریب مسیر غیرمستقیم هم بین آسیب کودکی و شخصیت مرزی (234/0=β، 01/0>P) آشکار شد.
نتیجه‌گیری: به نظر می­رسد آسیب­های دوران کودکی مانع از گسترش توانایی­های سالم تنظیم شناختی هیجانی می­شود. عاطفه منفی در افراد دچار اختلال شخصیت مرزی، آغاز­گر چرخه راهبردهای منفی تنظیم هیجان از جمله نشخوار فکری است و منجر به شدید­تر شدن تفکر خودسرزنش­گرانه و دگرسرزنش­گرانه می­شود که در نهایت نشانه­های اختلال شخصیت مرزی را منجر می­شوند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Structural Model of Childhood Trauma, Cognitive Emotion Regulation Strategies and Borderline Personality symptoms

نویسندگان [English]

  • H Homaeenejad, 1
  • A Karbalaeemohammadmeigouni, 2
  • S. Taghiloo, 3
1 -
2 karaj university
3 -
چکیده [English]

Introduction: Exposure to traumatic events prior to and/or during the puberty has negative consequences to personality development and is considered as an important risk factor for borderline personality disorder. The aim of this study was to determine the mediating role of positive and negative cognitive emotion regulation strategies in the relationship between childhood trauma and borderline personality symptoms.
Method: Applying a descriptive correlational method among the residents of Karaj 7th region in the summer 2017 a total sample of n=300 person were chosen on a randomly basis. The study tools included the Childhood Trauma Questionnaire (CTQ), Cognitive Emotion Regulation questionnaire (CERQ), and Borderline Symptom List (BSL). Data were analyzed using a Structural Equation Modeling (SEM).
Results: The obtained fitness indices supported an acceptable fitness to the model. A total path coefficient were observed for the childhood trauma and borderline personality symptoms (β=0.544, P<0.01). A direct path coefficient also revealed for the negative cognitive emotional regulation strategies and borderline personality symptoms as well (β=0.513, P<0.01). An indirect path coefficient was also evident for the childhood trauma and borderline personality symptoms (β=0.234, P<0.01).
Conclusion: It seems that childhood trauma prevent the development of healthy cognitive-emotional regulation capabilities. Negative affect in the borderline patients triggers the negative emotional strategies such as  rumination, which create severe self-blame and other-blame thinking that eventually leads to borderline symptoms.

کلیدواژه‌ها [English]

  • borderline
  • childhood trauma
  • cognitive regulation
  • emotion
1- Bassir Nia A, Eveleth MC, Gabbay JM, Hassan YJ, Zhang B, Perez-Rodriguez MM. Past, present, and future of genetic research in borderline personality disorder. Current Opinion in Psychology. 2018; 21: 60-8.
2- Ten Have M, Verheul R, Kaasenbrood A, van Dorsselaer S, Tuithof M, Kleinjan M, et al. Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2. BMC psychiatry. 2016; 16: 249.
3- American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. Arlington, VA: American Psychiatric Association. 2013.
4- Dalbudak E, Evren C, Aldemir S, Evren B. The severity of Internet addiction risk and its relationship with the severity of borderline personality features, childhood traumas, dissociative experiences, depression and anxiety symptoms among Turkish university students. Psychiatry research. 2014; 219(3): 577-82.
5- Calvo N, Valero S, Arntz A, Andión Ó, Matalí JL, Navascues V, et al. Validation of the Spanish version of the Borderline Personality Disorder Checklist (BPD Checklist) in a sample of BPD patients: Study of psychometric properties. The European Journal of Psychiatry. 2018; 32(1): 26-35.
6- Kienast T, Stoffers J, Bermpohl F, Lieb K. Borderline personality disorder and comorbid addiction: epidemiology and treatment. Deutsches Arzteblatt international. 2014; 111(16): 280-6.
7- Ntshingila N, Poggenpoel M, Myburgh CPH, Temane A. Experiences of women living with borderline personality disorder. Health SA Gesondheid. 2016; 21: 110-9.
8- Hall MA, Riedford KM. Borderline Personality Disorder: Diagnosis and Common Comorbidities. The Journal for Nurse Practitioners. 2017; 13(9): e455-e6.
9- Aaltonen KI, Rosenstrom T, Baryshnikov I, Karpov B, Melartin T, Suominen K, et al. Mediating role of borderline personality disorder traits in the effects of childhood maltreatment on suicidal behaviour among mood disorder patients. European psychiatry : the journal of the Association of European Psychiatrists. 2017; 44: 53-60.
10-   Selby EA, Anestis MD, Joiner TE. Understanding the relationship between emotional and behavioral dysregulation: emotional cascades. Behaviour research and therapy. 2008; 46(5): 593-611.
11- Selby EA, Joiner TE, Jr. Cascades of Emotion: The Emergence of Borderline Personality Disorder from Emotional and Behavioral Dysregulation. Review of general psychology : journal of Division 1, of the American Psychological Association. 2009; 13(3): 219.
12- Crowell SE, Beauchaine TP, Linehan MM. A biosocial developmental model of borderline personality: Elaborating and extending Linehan's theory. Psychological bulletin. 2009; 135(3): 495-510.
13- Mahmoodnejad M, Karbalaee Mohammad Meigouni A, Sabet M. Prediction of suicidal ideation and interpersonal violence among labor children based on childhood trauma, emotion regulation difficulties and callous-unemotional traits. Journal of Psychological Achievements. 2018; 25(1): 1-22.
14- Aftab R, Karbalaee Mohammad Meigouni A, Taghiloo S. The mediating role of emotion regulation strategies in relationship between borderline personality and conjugal violence. Journal of Applied Psychology. 2015; 8(32).
15- Nedaei, A, Paghoosh A, Sadeghi-Hosnijeh, A.H. Relationship between Coping Strategies and Quality of Life: Mediating Role of Cognitive Emotion Regulation Skills. Journal of Clinical Psychology. 2016; 8(4): 35-48.
16- Esmaily S, Tabatabaee SM, Afrooz Gh. Effectiveness of mindfulness-based cognitive-behavioral therapy on cognitive - emotion regulation and attentional control among addicted individuals. Journal of Applied Psycology Research. 2015; 6(3): 133-43.
17- Samani S, Sadeghi L. Psychometric Properties of the Cognitive Emotion Regulation Questionnaire. Scientific Journal Management System. 2010; 1(1): 51-62.
18- Garnefski N, Koopman H, Kraaij V, ten Cate R. Brief report: Cognitive emotion regulation strategies and psychological adjustment in adolescents with a chronic disease. Journal of adolescence. 2009; 32(2): 449-54.
19- Potthoff S, Garnefski N, Miklósi M, Ubbiali A, Domínguez-Sánchez FJ, Martins EC, et al. Cognitive emotion regulation and psychopathology across cultures: A comparison between six European countries. Personality and Individual Differences. 2016; 98: 218-24.
20- Nohi S, Hasani J. The Relationship between Cognitive Emotion Regulation Strategies and Defense Mechanisms with Borderline Personality Disorder. Thoughts and Behavior in Clinical Psychology. 2017; 11(43): 57-66.
21- Ghaffari M, Rezaei A. Study of relation of cognitive emotion regulation styles with impulsivity and borderline personality disorder among university students. Yafte Scientific Magazine 2014; 15(4): 61-72.
22- Aftab R, Karbalaee Mohammad Meigouni A, Taghiloo S. Gender differences in the structural model of borderline personality, emotional regulation strategies and domestic violence. Thoughts and Behavior in Clinical Psychology. 2015; 9(34): 7-16.
23- Elices M, Pascual JC, Carmona C, Martin-Blanco A, Feliu-Soler A, Ruiz E, et al. Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder. BMC psychiatry. 2015; 15: 180.
24- Bayes A, Parker G. Borderline personality disorder in men: A literature review and illustrative case vignettes. Psychiatry research. 2017; 257: 197-202.
25- Cattaneo A, Macchi F, Plazzotta G, Veronica B, Bocchio-Chiavetto L, Riva MA, et al. Inflammation and neuronal plasticity: a link between childhood trauma and depression pathogenesis. Frontiers in cellular neuroscience. 2015; 9: 40.
26- Carvalho Fernando S, Beblo T, Schlosser N, Terfehr K, Otte C, Lowe B, et al. The impact of self-reported childhood trauma on emotion regulation in borderline personality disorder and major depression. Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD). 2014; 15(4): 384-401.
27- Asgarpoor F, Karbalaee Mohammad Meigouni A, Taghiloo S. The mediating role of childhood trauma in the relationship between parenting styles and adaptive cognitive emotion regulation in child labor Journal of Applied Psychology. 2015; 1(9): 103-21.
28- Dixon-Gordon KL, Turner BJ, Zachary Rosenthal M, Chapman AL. Emotion Regulation in Borderline Personality Disorder: An Experimental Investigation of the Effects of Instructed Acceptance and Suppression. Behavior Therapy. 2017; 48(6): 750-64.
29- Izadpanah S, Schumacher M, Arens EA, Stopsack M, Ulrich I, Hansenne M, et al. Adolescent harm avoidance as a longitudinal predictor of maladaptive cognitive emotion regulation in adulthood: The mediating role of inhibitory control. Journal of adolescence. 2016; 52: 49-59.
30- Lotfi Kashani F, Vaziri Sh. The Effect of Dialectical Behavioral Therapy in Decreasing the Symptoms of Borderline Personality Disorder. Thoughts and Behavior in Clinical Psychology. 2013; 7(28): 27-36.
31- Meyers LS, Gamst G, Guarino AJ. Applied multivariate research, design and interpretation. London: Sage publication; 2006.
32- Delavar A. Theoretical and practical foundations of research in humanities and social sciences. 9th ed. Tehran: Growth. 2011.
33- Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American journal of psychiatry. 1994; 151(8): 1132-6.
34- Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences. 2001; 30(8): 1311-27.
35- Hasani J. The Psychometric Properties of the Cognitive Emotion Regulation Questionnaire (CERQ). Journal of Clinical Psychology. 2010; 2(3): 73-84.
36- Bohus M, Limberger MF, Frank U, Chapman AL, Kuhler T, Stieglitz RD. Psychometric properties of the Borderline Symptom List (BSL). Psychopathology. 2007; 40(2): 126-32.
37- Aftab R, Taghiloo S, Karbalaee Mohammad Meigouni A. The explanation of structural model of relationship between borderline personality traits, interpersonal difficulties and Internet addiction. Journal of Psychology Achievements 2017; 23(2): 113-36.
38- Kline RB. Principles and practice of structural equation modeling. New York & London: Guilford press. 2005.
39- Sanaeenasab, N, Sabri, V, Mohammadkhani, SH. Comparison of the Emotional Responses to Rorschach Test Among Individual with High and Low Emotion Regulation Difficulties. Journal of Clinical Psychology. 2018; 10(2): 41-50.
40- Halldorsdottir T, de Matos APS, Awaloff Y, Arnarson EO, Craighead WE, Binder EB. FKBP5 moderation of the relationship between childhood trauma and maladaptive emotion regulation strategies in adolescents. Psychoneuroendocrinology. 2017; 84: 61-5.
41- Huh HJ, Kim KH, Lee HK, Chae JH. The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies. Journal of affective disorders. 2017; 213: 44-50.
42- Besharat MA, Dehghani S, Masoudi M, Pourkhaghan F, Motahari S. Predicting Obsessive-Compulsive Disorder Symptoms on the Basis of Difficulties in Emotion Regulation, Impulsivity and Anger. Journal of Applied Psycology Research. 2015; 5(4): 29-49.
43- Burns EE, Jackson JL, Harding HG. Child Maltreatment, Emotion Regulation, and Posttraumatic Stress: The Impact of Emotional Abuse. Journal of Aggression, Maltreatment & Trauma. 2010; 19(8): 801-19.
44- Hebert M, Langevin R, Oussaid E. Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims. Journal of affective disorders. 2018; 225: 306-12.
45- Jang KI, Lee SH, Huh HJ, Chae JH. Influence of the 5-HT3A Receptor Gene Polymorphism and Childhood Sexual Trauma on Central Serotonin Activity. PloS one. 2015; 10(12): e0145269.
46- Mahmoodnejad M, Karbalaee Mohammad Meigouni A, Sabet M. Prediction of suicidal ideation and interpersonal violence among labor children based on childhood trauma, emotion regulation difficulties and callous-unemotional traits. Scientific Journal Management System. 2018; 25(1): 1-22.
47- Mulej Bratec S, Xie X, Schmid G, Doll A, Schilbach L, Zimmer C, et al. Cognitive emotion regulation enhances aversive prediction error activity while reducing emotional responses. NeuroImage. 2015; 123: 138-48.
48- Hasani J, Miraghaie AM. The relationship between strategies for cognitive regulation of emotions and suicidal ideation Contemporary Psychology. 2012; 7(1): 61-72.
49- Yarmohammadi Vasel M, Alipour F, Bastami M, Zolfagharinia M, Bazazzade N. The Mediating Role of Cognitive Emotion Regulation in the Relationship between Brain-Behavioral Systems and Impulsivity with Craving in Stimulant Addiction. Neuropsychology. 2015; 1(2): 51-67.
50- Haeri H, Shahnazari M. Investigating the role of positive thinking (optimism) and emotion regulation in life satisfaction of housewives in Tehran. Journal of Applied Psycology Research. 2015; 6(2): 133-46.
51- Ireland MJ, Clough BA, Day JJ. The cognitive emotion regulation questionnaire: Factorial, convergent, and criterion validity analyses of the full and short versions. Personality and Individual Differences. 2017; 110: 90-5.
52- Ullman SE, Peter-Hagene LC, Relyea M. Coping, emotion regulation, and self-blame as mediators of sexual abuse and psychological symptoms in adult sexual assault. Journal of child sexual abuse. 2014; 23(1): 74-93.
53- Saeidpoor, S, Kazemi-Rezai, S.A, Karbalaei-Esmaeil, E, Kazemi-Rezai, S.V, Ahmadi, F. Diagnostic role of cognitive emotion regulation strategies, cognitive fusion and thought control strategies in Obsessive-Compulsive disorder. Journal of Clinical Psychology. 2017; 9(3): 1-12.
54- Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. Journal of abnormal psychology. 1991; 100(4): 569-82.
55- Seligowski AV, Rogers AP, Orcutt HK. Relations among emotion regulation and DSM-5 symptom clusters of PTSD. Personality and Individual Differences. 2016; 92: 104-8.
56- Slater R, Holowka D, Schorr Y, Roemer L. Rumination, Dissociation, Self-Compassion, and Acceptance as Correlates of Posttraumatic Stress Symptoms.  Association of Behavioral and Cognitive Therapies. 2005.
57- Nolen-Hoeksema S, Wisco EB, Lyubomirsky S. Rethinking rumination. Perspectives on Psychological Science. 2008; 3(5): 400-24.
58- Salehi A, Mazaheri Z, Aghajani Z, Jahanbazi B. The Role of Cognitive Emotion Regulation Strategies in the Prediction of Depression. Knowledge & Research in Applied Psychology. 2015; 16(59): 108-17.
59- Borjali A, Aazami Y, Chopan H, Arab Quhistani D. Effectiveness of emotion regulation strategies for aggression control based on gross model in substance abusers. Iranian Journal of Rehabilitation Research in Nursing. 2015; 2(1): 53-65.
60- Law KC, Chapman AL. Borderline personality features as a potential moderator of the effect of anger and depressive rumination on shame, self-blame, and self-forgiveness. Journal of behavior therapy and experimental psychiatry. 2015; 46: 27-34.
61- McLean CP, Foa EB. Emotions and emotion regulation in posttraumatic stress disorder. Curr Opin Psychol. 2017; 14: 72-7.