PDF(Pubmed)
Abstract：
This case study examines the complex relationship between childhood trauma, dissociation, and Borderline Personality Disorder (BPD) within the context of forensic psychiatry. It focuses on a young murder defendant named \"Paul,\" who has experienced various traumatic events, including childhood maltreatment and domestic violence. These experiences have led to dissociative states marked by high emotional intensity, particularly of an aggressive nature, and impaired impulse control, resulting in violent behavior during dissociative episodes. The study employs advanced assessment tools like Raven\'s Standard Progressive Matrices (SPM), the Millon Clinical Multiaxial Inventory-III (MCMI-III), and the Level of Service/Case Management Inventory (LS/CMI) to gain a comprehensive understanding of Paul\'s psychopathological condition, risk factors, and rehabilitation needs. The LS/CMI assessment highlights a high risk of recidivism, mainly influenced by family relationships, educational challenges, interpersonal connections, and aggressive tendencies. To address the multifaceted needs of individuals like Paul, the study emphasizes the importance of using transdiagnostic models for trauma and dissociation. This approach informs tailored treatment programs that include processing past traumatic experiences, improving self-identity, nurturing healthy relational patterns, and enhancing emotional regulation. Although this study is based on a single case, it serves as a model for integrating assessment tools and theoretical-clinical models in the field of forensic psychiatry. Understanding the intricate dynamics of childhood trauma, dissociation, and BPD is crucial for making informed decisions, conducting risk assessments, and developing rehabilitation programs within the justice system. Future research should expand the scope of cases and further validate assessment tools to advance our understanding of this complex relationship.
摘要：
本案例研究探讨了童年创伤之间的复杂关系，解离,以及法医精神病学背景下的边缘性人格障碍(BPD)。它集中在一个年轻的谋杀被告名叫“保罗，经历过各种创伤事件的人，包括儿童虐待和家庭暴力。这些经历导致了以高情感强度为标志的分离状态，特别是具有侵略性，冲动控制受损，导致分离事件期间的暴力行为。这项研究采用了先进的评估工具，如Raven的标准渐进矩阵(SPM)，米隆临床多轴库存-III(MCMI-III)，以及服务水平/病例管理清单(LS/CMI)，以全面了解保罗的精神病理学状况，危险因素，康复的需要。LS/CMI评估强调了重犯的高风险，主要受家庭关系的影响，教育挑战,人际关系，和侵略性倾向。为了解决像保罗这样的人的多方面需求，该研究强调了使用创伤和分离诊断模型的重要性。这种方法告知量身定制的治疗计划，包括处理过去的创伤经历，提高自我认同，培养健康的关系模式，加强情绪调节。尽管这项研究是基于一个案例，它是整合法医精神病学领域评估工具和理论临床模型的模型。了解童年创伤的复杂动态，解离,BPD对于做出明智的决定至关重要，进行风险评估，并在司法系统内制定康复计划。未来的研究应该扩大案例的范围，并进一步验证评估工具，以促进我们对这种复杂关系的理解。
