Testing a Biosocial Model of Borderline Personality Features in Youth

项目摘要 交界性人格障碍(BPD)是一种复杂的、使人衰弱的疾病，与明显的 社会功能障碍，自杀行为频繁，治疗利用率高。虽然传统上 在成年期被诊断为BPD的著名模型将BPD的发育起源追溯到童年。 越来越多的证据表明，bpd的特征可能出现在儿童时期，预示着不良的功能结局。 除了更常见的儿童心理健康问题(例如，抑郁、焦虑、注意力-- 缺陷/多动障碍和品行问题)以及发展为BPD的高风险 青春期和成年期。然而，很少有工作研究BPD特征背后的神经机制。 青年，阻碍了确定和瞄准BPD风险最高的青年的努力。青少年患BPD的风险 在认知控制、依恋和从属关系的NIMH RDoC领域表现出缺陷。在自我- 在报告和行为水平上，患有BPD特征青少年在反应抑制方面表现出缺陷， 认知控制的一个方面，包括抑制强烈的行动冲动的能力。同样，还有 此外，在行为和自我报告层面，也有一些证据表明，社交处理方面的缺陷是 具有BPD特征的个体的依恋和联系困难。对社会排斥的敏感度是主要的 BPD干预的临床重点，尽管同时发生的情绪和焦虑困难也会导致 拒绝敏感度。新出现的研究表明，在社会接纳过程中 患有BPD的人，特别是在调节对接受提示的反应方面存在困难。回应中的赤字 在神经生理学水平上，抑制和社会接纳加工在年轻人中被可靠地诱发 使用来自脑电(EEG)的事件相关电位(ERP)，尽管他们没有 具体用于检查BPD特征的机制。重视神经生理机制 BPD的潜在风险可能为减轻BPD的社会和个人负担提供关键的见解。为了这个 在这项工作中，将从100名女孩(10-13岁)中抽样调查。大多数女孩(n=70)将从两个人中招募 临床多样化的门诊精神科诊所，而其余(n=30)女孩将是健康对照，没有 精神病理学史。反应抑制和社会接受的神经生理学评估 将进行处理，并测量反应抑制和社会接受处理 神经生理学水平将在6个月和12个月后作为BPD特征潜在的生长机制进行测试 初步评估。最后，我们将探讨严厉的父母教养和同伴伤害作为 反应抑制、社会接纳处理和BPD特征成长之间的关联。结果 这项工作将验证评估青少年BPD特征的效用，并为机制提供证据 这可以作为早期干预BPD高危青年的目标。

Project Summary Borderline personality disorder (BPD) is a complex and debilitating disorder associated with pronounced social dysfunction, frequent suicidal behavior, and high rates of treatment utilization. Although traditionally diagnosed in adulthood, prominent models of BPD trace the developmental origins of BPD back to childhood. There is mounting evidence that features of BPD may emerge in childhood, predicting poor functional outcomes beyond more commonly diagnosed childhood mental health problems (e.g., depression, anxiety, attention- deficit/hyperactivity disorder, and conduct problems) as well as high risk for the development of BPD into adolescence and adulthood. Yet, very little work has examined neural mechanisms underlying BPD features in youth, hindering efforts to identify and target those youth at highest risk for BPD. Youth at risk for BPD demonstrate deficits in the NIMH RDoC domains of Cognitive Control and Attachment and Affiliation. At the self- report and behavioral level, youth with BPD features have been shown to display deficits in response inhibition, one aspect of Cognitive Control, which involves the ability to suppress a prepotent urge to act. Similarly, there is also some evidence, at the behavioral and self-report level, that deficits in social processing are central to the Attachment and Affiliation difficulties of individuals with BPD features. Sensitivity to social rejection is a primary clinical focus in intervention for BPD, although co-occurring mood and anxiety difficulties also contribute to rejection sensitivity. Emerging work suggests unique alterations in social acceptance processing among individuals with BPD, particularly difficulties modulating responses to acceptance cues. Deficits in response inhibition and social acceptance processing have been reliably elicited in youth at the neurophysiological level using event-related potentials (ERPs) derived from the electroencephalogram (EEG), although they have not specifically been used to examine mechanisms of BPD features. Attention to neurophysiological mechanisms underlying risk for BPD may offer critical insight into reducing the societal and personal burden of BPD. For this work, a sample of 100 girls (ages 10-13) will be recruited. The majority of girls (n=70) will be recruited from two clinically diverse outpatient psychiatry clinics, while the remaining (n=30) girls will be healthy controls without a history of psychopathology. Neurophysiological assessments of response inhibition and social acceptance processing will be administered, and response inhibition and social acceptance processing measured at the neurophysiological level will be tested as mechanisms underlying growth in BPD features 6 and 12 months after the initial assessment. Lastly, harsh parenting and peer victimization will be explored as moderators of associations between response inhibition, social acceptance processing, and growth in BPD features. Results from this work will validate the utility of assessing BPD features in youth and provide evidence on mechanisms that can be targeted in early intervention for youth at high risk for the development of BPD.