Psychobiology of Suicidal Behavioral in BPD

边缘型人格障碍是一种精神疾病， 部分原因是反复的冲动和自杀行为。自杀率为 高达9.5%，BPD是最致命的精神疾病之一， 类似于情感和精神分裂症。这项研究 继续进行第一项前瞻性、多方面的临床研究， 自杀行为的心理社会和生物学危险因素 波士顿警局根据自杀的压力素质模型，我们评估预测的风险， 基线时的因素，并每年随访患者长达10年，评估 自杀行为，精神共病，物质使用障碍， 冲动攻击的发作，心理社会压力，治疗效果， 社会和临床结果。中枢多巴胺能调节在脑缺血中的作用 使用5 HT 2A特异性放射性配体研究冲动和自杀行为 [F-18]阿坦色林和PET神经成像。儿童时期的 虐待是根据自杀风险、冲动攻击行为和 测量中枢神经系统功能。压力源增加了 自杀行为包括与重度抑郁症或物质使用共病 疾病，最近的生活事件，以及社会支持不足。人格 冲动和攻击性等特征代表了慢性 自杀行为的脆弱性自杀者纵向随访 患者允许测试关于风险因素的预测假设， BPD患者自杀行为的生存分析。风险 预测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.