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

基本信息

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
项目类别：
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

项目摘要

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、自杀行为和自我意识差。边缘性母亲的后代人格障碍 (BPD) 在一生中患精神疾病的风险较高。困难管理情绪是 BPD 的一个标志性特征，但这样做的能力对于做出反应是必要的有效地调动孩子的情绪。这个过程被称为母性情绪社会化，它有一个重要的作用：影响儿童如何发展自己的情绪调节（ER）技能。学前阶段 ER 发展迅速学龄前 ER 缺陷被认为是未来潜在的精神障碍。该提案将测试模型检查母亲 ER 和情绪社会化对儿童 ER 的影响程度，这可能是一个患有 BPD 的母亲将心理健康问题传播给后代的重要途径。这该提案将利用辩证行为疗法（DBT）技能培训，这是一种稳健有效的方法改善 ER 作为改变 BPD 母亲的 ER 的工具。通过完成多项评估儿童和母亲 ER 的生物行为标志物，这项研究有望揭示一个潜在的可修改途径这些后代面临危险。具体来说，我们建议进行分层随机对照试验为有学龄前儿童的 BPD 母亲提供 DBT 技能。共300对（初始儿童年龄：36-48岁）月）将在俄勒冈州尤金和宾夕法尼亚州匹兹堡收集，三个地区各收集 100 双群体：患有 BPD 的母亲接受 DBT 技能的孩子、母亲患有 BPD 的孩子照常接受家庭服务的人，以及母亲健康状况良好的儿童，收入匹配，最后一组仅参与评估（以量化规范 ER 增长）。所有的孩子都会每 4 个月评估 4 次，第一次评估发生在治疗分配之前。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、注意力调节和抑制控制，以及副交感神经调节。对于母亲，我们将采用类似的多种方法来评估情绪接受、策略使用、识别和副交感神经规定。最后，在每次实验室评估期间，我们都会观察母亲有效应对的能力孩子处于负面情绪的背景下。生长曲线模型将为所有儿童绘制 ER 轨迹图 3 组，以便我们可以将儿童 ER 增长作为以下函数进行比较：组状态（DBT 技能与家庭照常服务与收入匹配、无序控制）、孕产妇 ER 的变化以及母性情感社会化。该提案的结果将确定一个可修改的途径，通过该途径，后代患有 BPD 的母亲面临风险，确定通过治疗母亲可以在多大程度上恢复儿童 ER，这将是第一个衡量后代结果的 DBT 技能试验。