邊緣性人格患者在情緒覺察與同理心之表現探討

The Performance of Emotional Awareness and Empathy in Patients with Borderline Personality Disorder

研究目的：邊緣性人格疾患為臨床上最常見的人格疾患種類，臨床特徵為情緒調適與人際關係困難，病因可能來自分離個體化歷程困難，而導致無法正確區辨自我與他人的情緒狀態，他們在理解他人想法與感受上有困難，錯誤解釋社會刺激因而產生不適當的行為反應，因此本研究以情緒覺察與同理心作為能力的指標進行探討，情緒覺察能力包括自我情緒與他人情緒的覺察，同理心則包括從他人角度瞭解推論他人感受與想法，感受他人情緒經驗並感同身受，本研究目的為排除情緒辨識及憂鬱指標的影響後，邊緣性人格患者組是否在情緒覺察及同理心與一般健康組有差異。研究方法：以31位經精神科醫師確立診斷之邊緣性人格疾患組與31位健康組，進行情緒臉孔與聲調綜合辨識、情緒覺察與同理心的評估。研究結果：邊緣性人格疾患者在情緒覺察方面，覺察自我或他人情緒皆表現較差，在情感同理心的反應較為強烈，而在認知同理心的表現較差，呈現出不對稱的同理心表現樣貌。研究結論：邊緣性人格患者無法區分自我與他人的情緒不同，加上觀點取替能力較弱，導致人際關係方面產生較高的個人受苦感，相關強化認知同理心的介入模式亦加以討論。

Purpose: Borderline personality disorder is the most common type of personality disorder identified in clinical practice. Affective dysregulation and disturbed relationships are the significant features of this disorder. Difficulty in separation-individuation processing might be the core psychopathology, which led to inappropriate perception the emotion state of self and others resulting disturbed personal relatedness. The present study explores the influence of borderline personality on the functions of emotional awareness and empathy. Emotional awareness is the ability to perceive one’s own and others’ emotions. Empathy is being able to interpret others’ feelings and thoughts from their perspective, feeling others’ emotional experiences, and obtaining the same feeling. Methods: Participants included 31 patients with borderline personality disorder diagnosed by a trained psychiatrist and 31 healthy individuals. Patients group had 29 females and 2 males with mean age of 30.32 years old, while the control group had also 29 females and 2 males with mean age of 30.32 year old. Emotional awareness, empathy, and emotional faces integrated with tone recognition tasks were assessed. Results: Patients with borderline personality had poor performance on the awareness of perceiving ones’ and others’ emotions. They also had poorer performance on the perspective-taking measure and higher scores on the personal distress measure than the control group. Conclusion: Inability to distinguish one’s own and others’ emotional status and impaired perspective-taking may lead to stronger feelings of personal suffering in patients with borderline personality disorder. The related intervention to improve cognitive
empathy is discussed.