[{"data":1,"prerenderedAt":65},["ShallowReactive",2],{"q-nurse-114-3-psychiatric-community-016":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":35,"lastmod":64},"精神科與社區衛生護理學","psychiatric-community",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":26},"nurse-114-3-精神科與社區衛生護理學-016","nurse-114-3-psychiatric-community-016",114,3,16,"一位 22 歲女性，常瘋狂地逃避想像被男友拋棄、經常有空虛感、對人際關係極度敏感、情緒不穩定、有過度消費和割腕等自我傷害的衝動行為。這位病人最可能罹患下列何項人格障礙症？",{"A":14,"B":15,"C":16,"D":17},"自戀型人格障礙症（narcissistic personality disorder）","做作型人格障礙症（histrionic personality disorder）","反社會型人格障礙症（antisocial personality disorder）","邊緣型人格障礙症（borderline personality disorder）","D",null,[],"本題考點在於區辨四種人格障礙症的核心特徵。依 DSM-5 診斷準則,邊緣型人格障礙症以「瘋狂避免被拋棄、人際關係與自我形象不穩定、情緒起伏劇烈、慢性空虛感、衝動行為(揮霍、自傷或割腕)」為典型,個案的逃避被拋棄與反覆割腕自傷完全吻合,故選 D。A 自戀型核心是誇大自我、需要他人讚賞;B 做作型追求成為注目焦點、情感浮誇但少見自傷;C 反社會型以違反社會規範、缺乏悔意、侵犯他人權益為主,均與本題的空虛與自傷不符。","邊緣型的核心機轉是情緒調節失能與「分裂(splitting)」防衛,個案將他人非黑即白地擺盪在理想化與貶抑之間,導致人際關係劇烈起伏。記憶上可用「不穩定的三」:情緒不穩、關係不穩、自我認同不穩,再加上被拋棄恐懼與自傷衝動即成完整圖像。臨床常與情感性疾患共病,辯證行為治療(DBT)為主要實證心理治療。",[24,27,30,33],{"term":25,"count":26},"邊緣型人格障礙症",4,{"term":28,"count":29},"被拋棄恐懼",2,{"term":31,"count":32},"DSM-5 人格障礙症",1,{"term":34,"count":32},"分裂防衛機轉",[36,40,45,50,55,60],{"webId":37,"stem":38,"number":39,"year":9,"session":10},"nurse-114-3-psychiatric-community-017","有關自殺的概念，下列敘述何者最不適當？",17,{"webId":41,"stem":42,"number":43,"year":44,"session":29},"nurse-115-2-psychiatric-community-013","小蕙，21 歲，因嚴重幻聽和混亂行為，被診斷思覺失調症。有關影響疾病預後較好的因素，下列何者最適當？",13,115,{"webId":46,"stem":47,"number":48,"year":49,"session":32},"nurse-106-1-psychiatric-community-057","Green 等人於 1980 年提出之 PRECEDE（Predisposing, Reinforcing, and Enabling Causes in Educational Diagnosis and Evaluation）模式中，「流行病學診斷」的主要目的是：",57,106,{"webId":51,"stem":52,"number":53,"year":54,"session":29},"nurse-107-2-psychiatric-community-015","季節性鬱症發作病人，經常在特定季節感到情緒低落，此類病人較常在何季節發作？①春季 ②夏季 ③秋季 ④冬季",15,107,{"webId":56,"stem":57,"number":58,"year":59,"session":32},"nurse-109-1-psychiatric-community-059","衛生福利部國民健康署重視對民眾賦權（empowerment）的過程，透過三項策略來提升民眾的健康識能（health literacy），下列敘述何者錯誤？",59,109,{"webId":61,"stem":62,"number":43,"year":63,"session":29},"nurse-110-2-psychiatric-community-013","初次入住精神科急性病房的李先生，擔心醫院伙食被人下毒，有被害妄想不願意用餐，下列何者護理措施最適當？",110,"2026-09-04",1788510762826]