Testing a Biosocial Model of Borderline Personality Features in Youth

测试青少年边缘人格特征的生物社会模型

基本信息

批准号：
10302524
负责人：
Dara E Babinski
金额：
$ 25.79万
依托单位：
PENNSYLVANIA STATE UNIV HERSHEY MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10302524
关键词：
Adolescence Adolescent and Young Adult Adult Age Anxiety Attention Attention deficit hyperactivity disorder Back Behavior Behavioral Biological Process Biosocial Borderline Personality Disorder Child Mental Health Child Rearing Childhood Clinic Clinical Complex Cues Development Diagnosis Disease Early Intervention Early identification Electroencephalogram Electroencephalography Emergency department visit Emotional Environmental Risk Factor Event-Related Potentials Female Adolescents Functional disorder Growth Hospitalization Individual Individual Differences Intensive Care Intervention Measures Mental Depression Mental Health Methods Modeling Moods National Institute of Mental Health Outpatients Patient Self-Report Personality Prevention Process Prospective Studies Psychiatry Psychopathology Recording of previous events Research Research Domain Criteria Rewards Risk Sampling Signal Transduction Stigmatization Stimulus Suicide System Testing Time Woman Work Youth cognitive control conduct problem cost disorder risk experience follow-up functional outcomes girls high risk innovation insight neuromechanism neurophysiology peer peer victimization recruit relating to nervous system response social social deficits suicidal behavior

项目摘要

Project Summary Borderline personality disorder (BPD) is a complex and debilitating disorder associated with pronounced social dysfunction, frequent suicidal behavior, and high rates of treatment utilization. Although traditionally diagnosed in adulthood, prominent models of BPD trace the developmental origins of BPD back to childhood. There is mounting evidence that features of BPD may emerge in childhood, predicting poor functional outcomes beyond more commonly diagnosed childhood mental health problems (e.g., depression, anxiety, attention- deficit/hyperactivity disorder, and conduct problems) as well as high risk for the development of BPD into adolescence and adulthood. Yet, very little work has examined neural mechanisms underlying BPD features in youth, hindering efforts to identify and target those youth at highest risk for BPD. Youth at risk for BPD demonstrate deficits in the NIMH RDoC domains of Cognitive Control and Attachment and Affiliation. At the self- report and behavioral level, youth with BPD features have been shown to display deficits in response inhibition, one aspect of Cognitive Control, which involves the ability to suppress a prepotent urge to act. Similarly, there is also some evidence, at the behavioral and self-report level, that deficits in social processing are central to the Attachment and Affiliation difficulties of individuals with BPD features. Sensitivity to social rejection is a primary clinical focus in intervention for BPD, although co-occurring mood and anxiety difficulties also contribute to rejection sensitivity. Emerging work suggests unique alterations in social acceptance processing among individuals with BPD, particularly difficulties modulating responses to acceptance cues. Deficits in response inhibition and social acceptance processing have been reliably elicited in youth at the neurophysiological level using event-related potentials (ERPs) derived from the electroencephalogram (EEG), although they have not specifically been used to examine mechanisms of BPD features. Attention to neurophysiological mechanisms underlying risk for BPD may offer critical insight into reducing the societal and personal burden of BPD. For this work, a sample of 100 girls (ages 10-13) will be recruited. The majority of girls (n=70) will be recruited from two clinically diverse outpatient psychiatry clinics, while the remaining (n=30) girls will be healthy controls without a history of psychopathology. Neurophysiological assessments of response inhibition and social acceptance processing will be administered, and response inhibition and social acceptance processing measured at the neurophysiological level will be tested as mechanisms underlying growth in BPD features 6 and 12 months after the initial assessment. Lastly, harsh parenting and peer victimization will be explored as moderators of associations between response inhibition, social acceptance processing, and growth in BPD features. Results from this work will validate the utility of assessing BPD features in youth and provide evidence on mechanisms that can be targeted in early intervention for youth at high risk for the development of BPD.

项目概要边缘性人格障碍（BPD）是一种复杂且令人衰弱的疾病，与明显的社会功能障碍、自杀行为频繁、治疗利用率高。虽然传统上边缘性人格障碍（BPD）的著名模型在成年期被诊断出来，将边缘性人格障碍（BPD）的发育起源追溯到童年时期。越来越多的证据表明边缘性人格障碍的特征可能在儿童时期出现，预示着功能结果不佳除了更常见的儿童心理健康问题（例如抑郁、焦虑、注意力不集中）缺陷/多动障碍和行为问题）以及发展为 BPD 的高风险青春期和成年期。然而，很少有工作研究 BPD 特征背后的神经机制。青年人，阻碍了识别和针对边缘性人格障碍风险最高的青年人的努力。青少年面临边缘性人格障碍的风险表现出 NIMH RDoC 认知控制、依恋和归属领域的缺陷。在自我报告和行为水平，具有 BPD 特征的青少年已被证明表现出反应抑制缺陷，认知控制的一个方面，涉及抑制行动冲动的能力。同样，有还有一些证据表明，在行为和自我报告层面，社会处理缺陷是导致具有 BPD 特征的个体的依恋和归属困难。对社会排斥的敏感性是首要的尽管同时发生的情绪和焦虑困难也会导致边缘性人格障碍（BPD）的干预，但临床重点是拒绝敏感性。新兴的研究表明，社会接受过程发生了独特的变化患有 BPD 的人，尤其难以调节对接受线索的反应。应对措施不足青少年在神经生理学水平上可靠地引发了抑制和社会接受处理使用源自脑电图（EEG）的事件相关电位（ERP），尽管他们没有专门用于检查 BPD 特征的机制。关注神经生理机制边缘性人格障碍的潜在风险可能为减轻边缘性人格障碍的社会和个人负担提供重要的见解。为了这工作中，将招募 100 名女孩（10-13 岁）作为样本。大多数女孩（n = 70）将从两个临床多样化的精神科门诊，而其余 (n=30) 女孩将作为健康对照，无需精神病理学史。反应抑制和社会接受度的神经生理学评估将进行处理，并在该处测量反应抑制和社会接受处理神经生理学水平将在 6 个月和 12 个月后作为 BPD 特征生长的潜在机制进行测试初步评估。最后，严厉的养育和同侪受害将作为主持人进行探讨反应抑制、社会接受处理和 BPD 特征增长之间的关联。结果这项工作将验证评估青少年 BPD 特征的实用性，并提供机制证据可以针对边缘性人格障碍高危青少年进行早期干预。