Risk and Psychopathology Children Aged 4-6--Mothers BPD

4-6岁儿童的风险和精神病理学——BPD母亲

• 批准号: 7133445
• 负责人: JENNY A MACFIE
• 金额: $ 7.25万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7133445
• 关键词: behavioral /social science research tag; borderline personality disorder; caregivers; child abuse; child psychology; clinical research; developmental psychology; early diagnosis; early experience; family genetics; human subject; interview; mental disorder diagnosis; mental disorder prevention; mental health epidemiology; mother child interaction; mother deprivation; preschool child (1-5); psychopathology; psychosocial separation

DESCRIPTION (provided by applicant): Borderline Personality Disorder (BPD) is a severe and chronic disorder that involves self-destructive behavior, inappropriate displays of anger and high levels of help seeking. Because of this combination, In addition to the burden of individual distress, BPD imposes a severe burden on the health care system. In order to reduce this double burden of mental illness, successful preventive interventions are needed. Although BPD is not diagnosed until early adulthood there is theoretical and empirical support for its roots lying in part in the caregiving environment in early childhood. From a developmental psychopathology perspective, study of early child development in children at high risk of developing BPD, including children whose mothers have BPD, may inform the development of preventive interventions. These interventions would address developmental deviation and bring development back onto adaptive pathways. In this way, the likelihood that BPD will develop would decrease and the burden of mental illness be reduced. Such preventive interventions could then be extended to other children at high risk of developing BPD such as maltreated children. Prior to longitudinal study, a cross-sectional study of preschool-aged children whose mothers have BPD is proposed. N = 32 offspring of BPD mothers will be compared with both clinical and normative comparison groups. The aims of the study are to examine (1) whether BPD offspring are exposed to specific risk factors in the caregiving environment associated with BPD (maltreatment, separation/loss, problematic maternal caregiving); (2) whether BPD offspring's representations of this caregiving environment in their stories reflect developmental deviation suggestive of precursors to BPD (positive and negative self and other, fear of abandonment, and intrusion of traumatic material); and (3) an adult observer's assessment of current psychopathology. The current study will inform a longitudinal study of development of BPD offspring between 12 months and 5 years designed to examine processes and timing whereby risk factors result in deviations identified in the current study in order to design developmentally sensitive preventive interventions. The relevance of this proposed research to public health lies in its being the first step in informing the design of preventive interventions for BPD. Intervention would target developmental deviation in at risk children bringing development onto an adaptive pathway and thus reducing the risk of future BPD.

描述（由申请人提供）：边缘性人格障碍（BPD）是一种严重而慢性疾病，涉及自我毁灭行为，不适当地表现出愤怒和高水平的帮助寻求帮助。由于这种组合，除了个人困扰负担外，BPD还对医疗保健系统造成了严重负担。为了减轻这种精神疾病的双重负担，需要成功进行预防干预措施。尽管直到成年初才被诊断出BPD，但在幼儿时期的护理环境中，其根源部分存在理论和经验支持。从发育心理病理学的角度来看，研究患有BPD的儿童的早期儿童发育的研究，包括母亲患有BPD的儿童，可能会为预防干预的发展提供信息。这些干预措施将解决发展偏差，并将发展重新带入自适应途径。通过这种方式，BPD的发展可能会减少，并减轻精神疾病的负担。然后可以将这种预防干预措施扩展到其他患有BPD的高风险的儿童，例如虐待儿童。在进行纵向研究之前，提出了对母亲患有BPD的学龄前儿童的横断面研究。 n = 32个母亲的后代将与临床和规范比较组进行比较。该研究的目的是检查（1）在与BPD相关的护理环境中，BPD后代是否暴露于特定的危险因素（虐待，分离/损失，有问题的孕产妇护理）； （2）BPD后代在其故事中对这种护理环境的表现是否反映了发育偏差，暗示了BPD的前体（正面和消极的自我和其他，对遗弃的恐惧以及对创伤物质的侵犯）； （3）成人观察者对当前心理病理学的评估。当前的研究将为BPD后代在12个月至5年之间的发展提供纵向研究，旨在检查过程和时间安排，从而导致当前研究中确定的偏差，以设计发育敏感的预防性干预措施。这项拟议的研究与公共卫生的相关性在于它是告知BPD预防干预措施的第一步。干预措施将针对危险儿童的发展偏差，从而将发育带入适应性途径，从而降低未来BPD的风险。