Emotional-Processing in Borderline Personality Disorder

描述（由申请人提供）：DSM-IV强烈愤怒和情感不稳定的标准明确强调了BPD的情绪处理异常，而其他（如疯狂的努力避免被遗弃，反复的自杀企图或手势，紧张和不稳定的关系）可能被视为应对这一核心缺陷的策略或后果。尽管情绪反应是BPD概念的中心，但令人惊讶的是，很少有研究直接检查BPD患者的情绪。一个例外是最近对具有愉快、中性或不愉快情绪效价的标准化图像的情绪反应的生理指标的研究。在这些研究中，BPD患者对任何刺激类别都没有表现出更强烈的反应，无法支持BPD患者的情绪超反应。在这个提议中，我们认为BPD患者在被一个显著的人际挑战激怒或触发后会表现出情绪过度反应。由此产生的愤怒，其特点是高唤醒和认知和行为解除抑制，将改变对情绪线索的评估，并干扰原本完好的情绪能力。本建议的主要目的是开展必要的发展工作，以检查BPD中暴露于个人相关挑战的情绪处理后果。我们建议从开放式半结构化叙述中生成最近感知到的侵犯经历的表意文字脚本，并在表意文字挑战之前和之后在实验室心理生理学（面部肌电图、心率和皮肤电导反应）中检查情绪行为。第二个目标是开发与BPD相关的人际图式相一致的情感唤起刺激，这些刺激可以用于未来的研究。由专家组成的BPD临床研究小组将通过标准化的、基于计算机的分类程序来选择这些组。第三个目标是为研究生提供足够的知识和专业技能，以便在精神病理学，特别是人格障碍方面进行情绪处理的独立研究。为了支持这些目标，我们建议从正在进行的人格障碍纵向合作研究（CLPS）中招募参与者，并在波士顿国家创伤后应激障碍中心的心理生理实验室检查情绪处理。

DESCRIPTION (provided by applicant): The DSM-IV criteria of intense anger and affective instability explicitly underscore emotional-processing abnormalities in BPD, while others (such as frantic efforts to avoid abandonment, repeated suicide attempts or gestures, intense and unstable relationships) may be viewed as strategies to cope with or consequences of this core deficit. Despite the centrality of emotional reactivity to the concept of BPD, surprisingly little research has directly examined emotions in individuals with BPD. An exception is the recent investigation of physiological indicators of emotional reactions to standardized images with pleasant, neutral, or unpleasant emotional valence. In these studies, subjects with BPD did not show more intense responses to any of the stimulus categories, failing to support emotional hyper-responsiveness in BPD. In this proposal, we argue that patients with BPD will show emotional hyper-reactivity after being provoked or triggered by a salient interpersonal challenge. The resultant anger, characterized by high arousal and cognitive and behavioral disinhibition will alter appraisal of emotional cues and interfere with otherwise intact emotional capabilities. The primary aim of this proposal is to conduct the necessary developmental work to examine the emotional-processing consequences of exposure to a personally relevant challenge in BPD. We propose to generate ideographic scripts of recent perceived violation experiences from open-ended semi-structured narrative accounts and examine emotional behavior in the laboratory psychophysiologically (facial EMG, heart rate, and skin conductance response) prior and subsequent to the ideographic challenge. A second aim is to develop sets of emotionally evocative stimuli that are consistent with interpersonal schemas hypothesized to be relevant to BPD, which can be used in future research. A panel of expert BPD clinical researchers will select these sets through a standardized, computer-based sorting procedure. A third aim is to provide a graduate student sufficient knowledge and expertise to conduct independent research in emotional-processing in psychopathology, especially personality disorders. To support these aims, we propose to recruit participants from the ongoing Collaborative Longitudinal Study of Personality Disorders (CLPS) and to examine emotional-processing at the psychophysiological laboratory at the National Center for PTSD in Boston.