Components of Emotional Instability as Precursors of Borderline Personality

情绪不稳定的组成部分是边缘人格的前兆

基本信息

批准号：
9240663
负责人：
STEPHANIE D STEPP
金额：
$ 43.72万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-25 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9240663
关键词：
Adolescent Affect Affective Automobile Driving Behavior Biological Borderline Personality Disorder Child Child Rearing Clinic Clinical Conflict (Psychology)Development Developmental Course Diagnosis Dimensions Disease Early Intervention Ecological momentary assessment Emotional Emotions Ensure Environment Family Four-dimensional Fright Health system Impulsive Behavior Individual Longevity Mental Depression Mental Health Mental disorders Methods Modality Monitor Moods National Institute of Mental Health Nature Neurobiology Parents Pathogenesis Patient Self-Report Personality Prevention program Preventive Intervention Process Prospective Studies Protocols documentation Psychiatric Hospitals Recovery Recruitment Activity Research Risk Shapes Specific qualifier value Suicide Sum Testing Time Transact University Hospitals Validation Work Youth accomplished suicide aged biopsychosocial clinically relevant clinically significant conduct problem early adolescence experience follow up assessment girls indexing intervention program negative affect negative mood novel parental role prospective public health relevance response suicidal behavior theories time use tool

项目摘要

DESCRIPTION (provided by applicant): Borderline personality disorder (BPD) is extremely debilitating, with 75% of diagnosed individuals engaging in suicidal behavior and 5-10% completing suicide. Once the disorder emerges, it is difficult to treat and places an enormous burden on mental health systems. Thus, longitudinal research that begins in early adolescence is urgently needed to identify precursors of BPD features that can inform prevention and early intervention programs. Developmental theory postulates that emotional instability (EI) in the context of invalidating parenting behaviors underlies the development of BPD features, including suicide and other impulsive behaviors, abandonment fears, relationship volatility, and difficulties with identity formation. EI is specified as dimensions of variability in negative affective states, intensity of affect, and slow recovery following the onset of negative affect. However, the biological underpinnings of EI components and their predictive utility for BPD features are not known. Understanding how parenting behaviors and youth EI dampen or exacerbate each other over time as well as influence the development of BPD features is essential for the identification of clinically modifiable parent-youth transactions. Aims: The current application tests hypotheses about components of EI as precursors of BPD features and the developmental course of these features. Specifically, we will examine concurrent, prospective, unique and shared associations between components of EI, BPD features, and internalizing and externalizing problems within the parenting context. Thus, the proposal also examines reciprocal associations between parental response to emotion and youth EI and the potential moderating role of parental response to emotion on the development of BPD features. Approach: We will use a multi-modal, ecologically valid assessment battery of EI in young adolescents, emotion-focused parenting strategies, and parent-youth interactions. We will examine these processes in real-time (using an ecological momentary assessment protocol, observational ratings, and autonomic reactivity monitoring) as well as chart the course of their development with three assessments over 18 months. We will determine how specific EI components are related to near-neighbor internalizing and externalizing problems (e.g., depression, conduct problems), but we propose that the combination of these three EI components form a specific marker of subsequent BPD features, especially in the context of deleterious parenting strategies. Youth aged 11-13 years and primary caretakers (N=165 families; H50% girls) will be recruited from psychiatric clinics, and adolescents will be screened to ensure that we oversample severe and clinically significant levels of EI. In accordance with NIMH strategic priorities, the proposed work is a novel and critical step to identify who is at greatest risk and how to intervene with vulnerable youth and their families.

描述（由申请人提供）：边缘性人格障碍 (BPD) 会使人极度虚弱，75% 的诊断者有自杀行为，5-10% 的人完成自杀。这种疾病一旦出现，就很难治疗，会给精神卫生系统带来巨大的负担。因此，迫切需要从青春期早期开始进行纵向研究，以确定 BPD 特征的前兆，从而为预防和早期干预计划提供信息。发展理论假设，无效养育行为背景下的情绪不稳定（EI）是边缘性人格障碍特征发展的基础，包括自杀和其他冲动行为、被遗弃的恐惧、关系波动和困难随着身份的形成。 EI 被指定为负面情感状态的可变性维度，影响的强度，以及负面影响出现后恢复缓慢的情况。然而，EI 成分的生物学基础及其对 BPD 特征的预测效用尚不清楚。了解养育行为和青少年 EI 如何随着时间的推移相互抑制或加剧，以及如何影响 BPD 特征的发展，对于识别临床上可改变的父母-青少年交易至关重要。目标：当前的应用程序测试关于 EI 组件作为 BPD 特征的前身以及这些特征的发展过程的假设。具体来说，我们将研究 EI、BPD 特征以及养育环境中的内化和外化问题之间的并发、前瞻性、独特和共享关联。因此，该提案还研究了父母对情绪的反应与青少年 EI 之间的相互关联，以及父母对情绪的反应对 BPD 特征发展的潜在调节作用。方法：我们将在青少年中使用多模式、生态有效的情商评估、以情感为中心的养育策略以及亲子互动。我们将实时检查这些过程（使用生态瞬时评估方案、观察评级和自主反应性监测），并通过 18 个月内的三项评估来绘制其发展过程。我们将确定特定的 EI 成分如何与近邻内化和外化问题（例如抑郁、行为问题）相关，但我们建议这三个 EI 成分的组合形成后续 BPD 特征的特定标记，特别是在上下文中有害的养育策略。将从精神病诊所招募 11-13 岁的青少年和主要看护者（N = 165 个家庭；H50% 为女孩），并对青少年进行筛查，以确保我们对严重且具有临床意义的 EI 水平进行过采样。根据 NIMH 的战略重点，拟议的工作是确定谁面临最大风险以及如何对弱势青少年及其家人进行干预的新颖且关键的一步。