Psychobiology of Suicidal Behavioral in BPD

交界性人格障碍是一种精神障碍， 在一定程度上，是由于反复出现的冲动和自杀行为。自杀率为 高达9.5%的BPD是最致命的精神疾病之一， 可与情感障碍和精神分裂症相媲美。这项研究是 第一项前瞻性、多维度临床研究的继续， 精神分裂症患者自杀行为的心理社会和生物学危险因素 每桶。根据自杀的压力-素质模型，我们评估了预测的风险。 达到基线的因素，并每年对患者进行长达十年的随访，评估 自杀行为，精神共病，药物使用障碍， 冲动攻击性发作，社会心理压力，治疗效果， 社会和临床结果。中枢性5-羟色胺能调节在脑缺血中的作用 使用5HT2A特异性放射性配基研究脉冲和自杀行为 [F-18]Altanserin和PET神经成像。一段童年历史的影响 虐待是根据自杀风险、冲动攻击行为等进行评估的 中枢5-羟色胺能功能的测量。增加高血压风险的压力源 自杀行为包括与重度抑郁症或药物使用共病 精神障碍、最近的生活事件和糟糕的社会支持。人格 冲动和攻击性等特征代表慢性 自杀行为的易感性。自杀倾向的纵向随访 患者允许对有关风险因素的预测假设进行测试 应用生存分析研究BPD患者的自杀行为。风险 预测尝试的复发和医疗致命性的因素将允许 早期识别自杀风险最高的BPD患者并告知 治疗方面的努力。

Borderline Personality Disorder is a psychiatric disorder defined, in part, by recurrent impulsive and suicidal behaviors. With a suicide rate of up to 9.5 percent, BPD is among the most lethal of psychiatric disorders, comparable to affective and schizophrenic disorders. This study is the continuation of a first prospective, multidimensional study of the clinical, psychosocial and biological risk factors for suicidal behavior in patients with BPD. Following a stress-diathesis model of suicide, we assess predicted risk factors at baseline and follow patients annually for up to ten years, assessing for suicidal behavior, psychiatric co-morbidities, substance use disorders, episodes of impulsive-aggression, psychosocial stressors, treatment effects, social and clinical outcomes. The role of central serotonergic regulation in impulsive and suicidal behavior is studied using the 5HT2A specific radioligand [F-18] altanserin and PET neuroimaging. The effects of a childhood history of abuse are assessed on suicide risk, impulsive-aggressive behavior and on measures of central serotonergic function. Stressors increasing the risk of suicidal behavior include co-morbidity with Major Depression or Substance Use Disorders, Recent Life Events, and poor social support. Personality characteristics such as impulsivity and aggression represent chronic vulnerabilities to suicidal behavior. Longitudinal follow-up of suicidal patients allows testing of predictor hypotheses concerning risk factors for suicidal behavior in BPD through the application of survival analyses. Risk factors predicting recurrence and medical lethality of attempts will allow early identification of BPD patients at highest risk for suicide and inform treatment efforts.