Preschooler emotion regulation in the context of maternal borderline personality disorder

母亲边缘型人格障碍背景下学龄前儿童的情绪调节

• 批准号: 9918460
• 负责人: Maureen Zalewski
• 金额: $ 82.03万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918460
• 关键词: 4 year old; Age; Anxiety; Attention; Behavioral; Borderline Personality Disorder; Characteristics; Child; Child Mental Health; Data; Development; Dialectical behavior therapy; Disadvantaged; Disease; Emotional; Emotions; Experimental Designs; Family; Fostering; Future; Growth; Income; Interpersonal Relations; Intervention; Knowledge; Laboratories; Life; Longevity; Measures; Mediator of activation protein; Mental Health; Mental disorders; Methods; Modeling; Moods; Mothers; Nursery Schools; Oregon; Outcome Measure; Pathway interactions; Pattern; Pennsylvania; Physiological; Preschool Child; Process; Public Health; Randomized Controlled Trials; Regulation; Risk; Sampling; Services; Sinus Arrhythmia; Socialization; Specificity; Temperament; Testing; Theoretical model; Time; Validation; base; biobehavior; clinically significant; design; emotion regulation; emotional experience; experience; improved; insight; novel; offspring; respiratory; response; severe mental illness; sex; skills; skills training; social skills; suicidal behavior; tool; transmission process

Borderline personality disorder is a serious mental illness characterized by extreme emotions, chaotic interpersonal relationships, suicidal behaviors, and a poor sense of self. Offspring of mothers with Borderline Personality Disorder (BPD) are at an elevated risk for developing mental illness across the lifespan. Difficulty managing emotions are a hallmark feature of BPD, and yet the ability to do so is necessary for responding effectively to childrens' emotions. This process is called maternal emotion socialization, which has a major impact on how children develop their own emotion regulation (ER) skills. ER develops rapidly during preschool and deficits in preschool ER are recognized as underlying future mental disorders. This proposal will test a model examining the extent to which maternal ER and emotion socialization impact child ER, which may be a significant pathway by which mental health problems are transmitted to offspring of mothers with BPD. This proposal will leverage Dialectical Behavior Therapy (DBT) Skills training, a robust and effective method for improving ER as a tool to change maternal ER in mothers with BPD. By completing multiple assessments of biobehavioral markers of child and mother ER, this study is poised to uncover a potentially modifiable pathway by which these offspring are at risk. Specifically, we propose to conduct a stratified randomized controlled trial of DBT Skills for mothers with BPD who have preschoolers. A total of 300 dyads (initial child age: 36-48 months) will be collected in Eugene, Oregon and Pittsburgh Pennsylvania, with 100 pairs in each of three groups: children who have mothers with BPD who receive DBT Skills, children who have mothers with BPD who receive Family Services as Usual, and children who have non-disordered mothers, matched on income, with this final group only participating in assessments (as to quantify normative ER growth). All children will be assessed 4 times every 4-months, with the first assessment occurring prior to treatment assignment. We will use a biobehavioral laboratory battery to measure child ER, assessing emotion understanding, strategy use, attention regulation and inhibitory control, and parasympathetic regulation. In mothers, we will employ a similar multi-method approach to assess emotion acceptance, strategy use, recognition, and parasympathetic regulation. Finally, during each laboratory assessment, we will observe mother's ability to effectively respond to children in the context of child negative emotions. Growth curve modeling will chart child ER trajectories for all 3 groups so that we can compare child ER growth as a function of: group status (DBT Skills vs. Family Services as Usual vs. income matched, non-disordered controls), changes in maternal ER, and changes in maternal emotion socialization. Findings from this proposal will identify a modifiable pathway by which offspring of mothers with BPD are at risk, determine the extent to which child ER can be restored by treating mothers, and will be the first DBT Skills trial to measure outcomes in offspring.

边缘性人格障碍是一种严重的精神疾病，其特征是极端情绪，混乱 人际关系，自杀行为和糟糕的自我意识。母亲的后代有边界 人格障碍（BPD）在整个生命周期中患精神疾病的风险较高。困难 管理情绪是BPD的标志性特征，但是这样做的能力对于响应是必要的 有效地表达儿童的情绪。这个过程称为母性情感社交化，它具有主要 影响孩子如何发展自己的情绪调节（ER）技能。 ER在学前班期间迅速发展 学龄前儿童的缺陷被认为是潜在的未来精神障碍。该建议将测试 模型检查了母体ER和情感社会化影响儿童的程度，这可能是一个 将心理健康问题传播到BPD母亲的后代的重要途径。这 提案将利用辩证行为疗法（DBT）技能培训，是一种强大而有效的方法 改善ER作为改变BPD母亲的母体ER的工具。通过完成多次评估 这项研究有望揭示儿童和母亲ER的生物行为标记 这些后代有风险。具体而言，我们建议进行分层的随机对照试验 具有学龄前儿童的BPD的母亲的DBT技能。共有300个二元组（初始儿童年龄：36-48 几个月）将在俄勒冈州的尤金和匹兹堡宾夕法尼亚州收集，三分是100对 小组：有母亲患有BPD的孩子接受DBT技能，有BPD母亲的孩子 像往常一样接受家庭服务的人和没有犯规母亲的孩子，与收入相匹配， 最终组只参与评估（以量化规范性ER增长）。所有孩子都会 每4个月评估4次，第一次评估在治疗分配之前进行。我们将 使用生物行为实验室电池来测量儿童ER，评估情绪理解，策略使用， 注意调节和抑制性控制以及副交感神经调节。在母亲中，我们将采用类似的 评估情绪接受，策略使用，认可和副交感神经的多方法方法 规定。最后，在每个实验室评估期间，我们将观察到母亲有效做出回应的能力 儿童在儿童负面情绪的背景下。成长曲线建模将绘制所有人的儿童ER轨迹 3个小组，以便我们可以将儿童ER成长与以下函数进行比较：小组状态（DBT技能与家庭 像往常一样与收入与收入相匹配的服务，非限制控制），孕产妇的变化以及变化 孕产妇的情感社交。该提案的发现将确定后代的可修改途径 BPD的母亲处于危险之中，确定可以通过治疗母亲来恢复孩子的程度 并将是第一个衡量后代成果的DBT技能试验。