人格障碍的诊断及治疗策略研究.ppt

* * * * * * * * DSM-III criteria adopted from Gunderson research criteria. Except the crucial criterion, tends to become psychotic in the transference. A certain loss of perspective occurred, patient seemed unable to distinguish between inner experience and reality. E.g., Neurotic/healthier pt: Are you experiencing me like your mother? You ARE exactly like my mother, stop it you bitch. DSM describes a very flamboyant, drmatic, hysetroid type of borderline. But intrapsychic processes will aply to most Axis II pts. * 精神动力学概述 人类行为下心理驱力的系统研究和系统理论，强调有意识动机和无意识动机的交互作用，以及情绪的功能性价值。 历史 研究 及认知神经基础 Locke ? ? ? Kant Pavlov ? ? Darwin Skinner ? ? ? Freud Behaviorism Systems Psychoanalytic Gordon, R.M.? (2008a) An Expert Look at Love, Intimacy and Personal Growth. Second edition. (Chapter 9 Integrating Theories) Not historical, Not developmental, Learned Historical , Structural, Gestalt, Developmental 历史 * 心智的动力学理解 * Morokoff (1985)Women highest on indexes of sex guilt showed more physiological arousal to erotic pictures, however, they denied being aroused. 反向形成的研究--无意识防御 * 无意识移情研究(Eagle, 1959) * Eric Kandel 神经-精神分析学 我们的大多数行为是无意识的。 Rudnstsky, P.L. (2008) “Nitty-Gritty Issues: An Interview with Eric R. Kandel” The American Psychoanalyst, 42,2, pp.6-7,15 and 16. 超我、自我和本我的冲突 Bechara, A., 2007. Decision-making, impulse control and loss of willpower to resist drugs: A neurocognitive perspective. Nature Neuroscience 8(11):1458-1463. VMPC A S 精神动力取向诊断系统 精神动力性诊断手册（PDM） 操作性动力性诊断手册（OPD-II） PDM的结构 多轴诊断 P轴（人格轴） M轴（心理功能轴） S轴（症状轴） 人格 人格是相对稳定的思考、感受、行动以及与他人联结的方式。 Healthy Neurotic Psychotic Borderline Level of personality organization Level Personality Style hysterical obsessional paranoid psychopathic etc. Healthy Neurotic Psychotic Borderline hysterical obsessional paranoid psychopathic Etc. Personality Style Borderline Personality Organization Affect Dysregulation Defenses based on Splitti