McLean Study of Adult Development

麦克莱恩成人发展研究

• 批准号: 6924851
• 负责人: MARY C ZANARINI
• 金额: $ 42.85万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6924851
• 关键词: behavior prediction; behavioral /social science research tag; borderline personality disorder; clinical research; comorbidity; developmental psychology; functional ability; human subject; longitudinal human study; obesity; pathologic process; patient oriented research; social adjustment; social psychology

DESCRIPTION (provided by applicant): We propose a 5-year continuation of the McLean Study of Adult Development (MSAD), the first large-scale, prospective study of the long-term course of borderline personality disorder (BPD). We will obtain a minimum of 16 years of follow-up on 290 patients who met DIB-R and DSM-III-R criteria for BPD and 72 axis II comparison subjects who met DSM-III-R criteria for another personality disorder (and neither criteria set for BPD). After 10 years of follow-up, we are still following 93% of the surviving borderline patients (and 86% of the surviving axis II comparison subjects). During the years of follow-up, we have found that remissions of BPD are more common than expected and recurrences of BPD are quite rare. We have also found that a complex" model of borderline psychopathology best describes the course of the 24 symptoms of BPD that we are following. In this "complex" model, some symptoms are seen as acute as they resolve relatively rapidly and other symptoms are seen as temperamental as they resolve relatively slowly. Taken together, these findings suggest that BPD has a better prognosis than commonly thought. However, many borderline patients are now obese and suffering from a variety of obesity-related medical conditions. We believe that these findings warrant further investigation into the course of borderline psychopathology, psychosocial functioning, co-occurring axis I and II disorders, temperament, psychiatric treatment and medical conditions and medical treatments (AIM 1: Description). We also believe that these findings warrant further investigation into the predictors of five main outcomes: remission from BPD, recurrence of BPD, attainment of good psychosocial functioning, attempted suicide, and completed suicide (AIM 2: Prediction). Subjects will be assessed at two-year intervals by raters who are blind to all previously collected information. This proposed continuation will result in useful knowledge about the course of borderline psychopathology, with direct implications for patients, their families, and the clinicians treating them.

描述（由申请人提供）：我们提出了麦克莱恩成人发展研究（MSAD）的5年延续，这是对边界人格障碍（BPD）长期过程（BPD）的首个大规模的前瞻性研究。我们将对290名符合BPD的DIB-R和DSM-II-R标准的患者和72个Axis II比较受试者进行至少16年的随访。经过10年的随访，我们仍在遵循93％的尚存边缘患者（以及幸存的Axis II比较受试者的86％）。在随访的几年中，我们发现BPD的恢复比预期更普遍，而BPD的复发非常罕见。我们还发现，一个复杂的“边界心理病理学模型最能描述我们正在遵循的24种症状的过程。在这个“复杂”模型中，某些症状被认为是敏锐的，因为它们相对较快地解决，而其他症状则相对较慢地被视为较慢的态度，因为它们是相对缓慢的。但是，这些发现比常见的预测更好。我们认为，与肥胖相关的医疗状况。社会心理功能，自杀未遂并完成自杀（AIM 2：预测）。对所有先前收集的信息视而不见的评分者将以两年的时间间隔评估受试者。拟议的延续将导致有关边缘心理病理学进程的有用知识，对患者，他们的家人和临床医生对治疗的影响有直接的影响。