| Objective:Borderline personality disorder(BPD)is a kind of disorder in interpersonal relationship,self-image and emotional instability,accompanied by a general pattern of impulsiveness.According to epidemiological data,the proportion of BPD patients in population is 1% to 4%,and the proportion in the psychiatric outpatients is 10% to15%.The proportion of patients hospitalized with mental disorders is 20%.There are data showing that the suicide rate of BPD patients has reached 10%,which is bound to attract the attention of the medical community.Some scholars have suggested that the symptoms of personality disorder will have a gradual change.The two ends of the pedigree represent healthy personality and typical personality disorder symptoms.The analysis of personality and behavioral disorders in the early youth group has a certain range of adolescent groups.Not fully applicable to the diagnosis of personality disorder,but there is still a characteristic of personality deviation.This borderline personality deviation exhibited by children and adolescents is called borderline personality features(BPF)in this study.At present,the assessment,causes and intervention of BPF in China are still in their infancy.Early identification and treatment of BPD relies on a careful and accurate assessment of adolescent personality pathology.Tools with good reliability and good time cost help psychiatrists make more accurate clinical assessments.The exploration of the BPF in children and adolescents can provide a clinical basis for their prevention and treatment.Based on this,this study intends to achieve the following three research purposes: ? To evaluate the reliability and validity of the Chinese version of the Borderline personality feature scale-children(BPFS-C)in children and adolescents;? Delineate the critical value of BPFS-C and explore the risk factors of BPF in children and adolescents;? Explore the effect of structured group therapy on adolescents with BPF.Methods:1.Evaluation of the reliability and validity of BPFS-C.After the authorization of the author,BPFS-C is translated,back-translated and culturally debugged.The validity and expression of the content are verified by the expertgroup's repeated argumentation and small-scale test.The final form of the 24 item is finally formed.In the reliability and validity study,964 children and adolescents from3 high schools,1 junior high school and 1 elementary school in Shenyang were selected for sample collection(sample 1).All subjects were tested with BPFS-C Chinese version,CDI,MSI-BPD,UCLA,AQ-12 and the paranoia and interpersonal sensitivity subscales in SCL-90 were investigated.68 children and adolescents received a retest after 3 weeks.In the project analysis of the item,the correlation(R value)of each item's score with the total score of the dimension is calculated.Take the top 27% of the total scores for each dimension as the high group,and the last 27% for the low group.In each dimension,compare the average of the scores of the high and low groups in each item,and use the t value as the decision value of each item(CR value).Statistical analysis was performed using SPSS19.0 software.2.Delineation of the critical value of BPFS-C and evaluation of the risk factors of BPF in children and adolescents.A total of 195 patients aged 9-18 years in the psychological outpatients in general hospital were selected as the cut-off study subjects(sample 2).The BPD interview questionnaire in SCID-II was used as the external criterion.The ROC curve of BPFS-C was drawn by substituting 4 items of the 9 items with a score of 3 or more as a reference standard for determining the BPF.Calculate the area under the ROC curve(AUC)and the sensitivity(SEN)and specificity(SPE)corresponding to the critical value.The maximum value of the Yoden index(SEN+SPE-1)is used as the reference threshold.1 high school,1 junior high school and 1 primary school were selected for sample collection of regression analysis(sample 3).452 were included into the final analysis.Using the general information questionnaire,BPFS-C,SCID-II,IPPA-R to investigate,using binary logistic regression to explore the risk factors of BPF,using SPSS19.0 software for statistical analysis.3.Exploration of the effect of structural group therapy on the BPF of adolescents.A total of 84 adolescents with BPF in a psychological clinic in Shenyang in 2018(sample 4)were randomly divided into two groups,the experimental group and the control group.The experimental group was given an 8-week intervention using structural group therapy.BPFS-C,CDI,SCARED and 12-AQ were used before and after treatment to evaluate the effect of structural group therapy.Statistical analysis was performed using SPSS 19.0 software.Results:1.In the Chinese version of BPFS-C,the internal consistency reliability Cronbach ? coefficient is 0.853,and the test-retest reliability is 0.824.BPFS-C project analysis meets measurement requirements(P<0.05).The BPFS-C scores were moderately correlated with CDI,MSI-BPD,UCLA,12-AQ,SCL-90 and other scales,with a correlation coefficient of 0.590-0.676.The BPFS-C score was significantly different between boys(55.857±12.620)and girls(59.460±13.866)(P<0.001).2.According to the calculation results of the sample 2,the score of 76.5 corresponds to the maximum value of the Yoden index(0.849),the BPFS-C reference threshold is77,and the AUC is 0.973.In sample 1,the number of female BPF was 3.1 times that of male,and that of sample 2 was 2.4 times.Binary logistic regression statistics found that abuse experiences and poor parenting style and attachment relationships with parents and peers are risk factors of BPF.3.After the end of group therapy,the scores of BPFS-C,SCARED,CDI and AQ-12 in the experimental group were lower than those in the control group(p<0.05).The scores of BPFS-C,SCARED,CDI and12-AQ after treatment in the experimental group were also significantly lower than those before treatment.There were no significant differences in BPFS-C,SCARED,CDI,and 12-AQ scores before and after the end of group therapy in the control group(p>0.05).Conclusion:1.The Chinese version of BPFS-C has a good reliability and validity in children and adolescents.It is a reliable and effective tool for measuring BPF in children and adolescents.2.The BPFS-C threshold obtained by ROC curve analysis has a good sensitivity and specificity compared with the evaluation results of peer assessment evaluation.The incidence of BPF is significantly higher in female than in male in high school group,while the other two groups are not.The incidence of BPF and BPF in female showed an increasing trend with the increase of school age.Among the independent variables included in the regression analysis,the abused experience and poor attachment to parents and peers are important risk factors and poor parenting style for BPF.3.Structural group therapy played an important role in relieving the level of anxiety and depression,and reducing impulsive behavior of BPF among adolescents. |
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