Mood and Reactivity in Borderline Personality Disorder

边缘性人格障碍的情绪和反应

• 批准号: 7330628
• 负责人: Lori N Scott
• 金额: $ 2.74万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-15 至 2010-08-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7330628
• 关键词: Affect; Affective; Arousal; Behavior; Benign; Biological; Biological Markers; Borderline Personality Disorder; Characteristics; Chronic; Clinical; Cognitive; Condition; Control Groups; DSM-IV; Development; Diagnosis; Dimensions; Disease; Distress; Elevation; Emotional; Endocrine; Environment; Event; Functional disorder; Goals; HPSE gene; Health; Hydrocortisone; Impulsivity; Individual; Interview; Invasive; Laboratories; Laboratory Procedures; Lead; Life; Matched Group; Measures; Medical; Mental Health Services; Mental disorders; Methods; Moods; Nature; Neurosecretory Systems; Numbers; Pain; Participant; Patients; Pattern; Perception; Physiological; Procedures; Process; Public Health; Range; Reaction; Recovery; Relative (related person); Reporting; Research; Saliva; Salivary; Sampling; Score; Social Environment; Speech; Standards of Weights and Measures; Stress; Structure; Sympathetic Nervous System; System; Testing; Time; Translations; Validation; alpha Amylase 2; alpha-amylase; biobehavior; biological adaptation to stress; comparison group; emotional stimulus; hypothalamic-pituitary-adrenal axis; indexing; innovation; loris; negative mood; programs; psychologic; psychopharmacologic; psychosocial; response; social; social cognition; social stress; stressor; suicidal behavior; therapy development; trait

DESCRIPTION (provided by applicant): The long-term goal of this research is to identify the specific mechanisms involved in the extreme emotional reactivity that characterizes Borderline Personality Disorder (BPD) and to apply these findings to the development and validation of both psychosocial and psychopharmacological treatments that directly target these mechanisms. The specific aim of the proposed research is to identify the characteristic patterns of physiological and phenomenological reactions in response to social perturbation in individuals with BPD as compared to two healthy comparison groups: 1) a temperamentally matched comparison group (scoring similarly to BPD patients on trait measures of negative affect and impulsivity); and 2) a non-temperamentally matched comparison group (scoring in the average range on these measures). All participants will be assessed for DSM-IV Axis I and II disorders with structured interviews and then will participate in a laboratory stress paradigm involving a speech and a verbal arithmetic task in front of three judges. Saliva samples will be collected at several time points in order to examine two physiological dimensions of the stress response: 1) salivary cortisol, reflecting reactivity of the limbic hypothalamic-pituitary-adrenal axis; and 2) alpha-amylase, reflecting activation of the autonomic (primarily sympathetic) nervous system. It is predicted that in response to the laboratory stress paradigm: 1) BPD patients, compared to both comparison groups, will show increased cortisol and alpha-amylase responses and slower return to baseline levels; and 2) BPD patients, compared to both comparison groups, will report greater subjective distress. It is also predicted that, compared to both comparison groups, BPD patients will report more malevolent perceptions of those with whom they have interacted during the experimental procedures. This research is important to public health because BPD is a highly prevalent, costly, painful, debilitating, and deadly disorder, and thus represents a serious clinical and public health concern. For individuals with BPD, subtle and benign events in the environment can evoke intense emotional responses that activate the stress response system and may rapidly spiral into behaviors that are life threatening and functionally debilitating. There are also serious health consequences to chronic elicitation of the stress response, and individuals with BPD are frequent users of both medical and mental health services. Understanding the physiological and psychological processes underlying these problematic features of BPD is imperative to the development of treatments aimed at reducing the burden of mental illness.

描述（由申请人提供）：这项研究的长期目标是确定表征边缘性人格障碍（BPD）的极端情感反应性的特定机制，并将这些发现应用于直接针对这些机制的心理社会和心理药理治疗的发展和验证。拟议研究的具体目的是与两个健康的比较组相比，鉴定BPD患者对社会扰动的响应生理和现象学反应的特征模式：1）与性别匹配的比较组（在负面影响和冲动性的特征测量中与BPD患者的分数相似）； 2）一个非匹配的比较组（在这些度量的平均范围内得分）。将对所有参与者进行结构化访谈的DSM-IV轴I和II疾病的评估，然后将参加三名法官面前的涉及语音和口头算术任务的实验室压力范式。将在几个时间点收集唾液样品，以检查应激反应的两个生理维度：1）唾液皮质醇，反映了边缘下丘脑 - 垂裂 - 肾上腺肾上腺轴的反应性； 2）α-淀粉酶，反映了自主神经（主要是交感神经）神经系统的激活。据预测，应响应实验室应力范式：1）与两个比较组相比，BPD患者将显示皮质醇和α-淀粉酶反应增加，并恢复较慢到基线水平； 2）与两个比较组相比，BPD患者将报告更大的主观困扰。还可以预测，与两个比较组相比，BPD患者将报告对与他们在实验程序中与之相互作用的人报告更多的恶意看法。这项研究对公共卫生很重要，因为BPD是一种高度普遍，昂贵，痛苦，使人衰弱和致命的混乱，因此代表了严重的临床和公共卫生问题。对于具有BPD的个体，环境中的微妙和良性事件可以唤起激活压力反应系统的强烈情绪反应，并可能迅速螺旋形成危及生命并在功能上使人衰弱的行为。长期引起压力反应也会严重健康，而患有BPD的人则是医疗和精神卫生服务的经常使用者。了解BPD这些有问题特征的生理和心理过程对于旨在减轻精神疾病负担的疗法的发展至关重要。