Emotional-Processing in Borderline Personality Disorder

描述(由申请人提供)：DSM-IV的强烈愤怒和情绪不稳定标准明确强调了BPD的情绪处理异常，而其他标准(如避免被遗弃的疯狂努力、反复的自杀企图或手势、紧张和不稳定的关系)可被视为应对这一核心缺陷或其后果的策略。尽管情绪反应是BPD概念的核心，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调查。在这些研究中，患有BPD的受试者对任何刺激类别都没有表现出更强烈的反应，未能支持BPD的情绪高反应。在这项建议中，我们认为BPD患者在受到显著的人际挑战的刺激或触发后，会表现出情绪上的高反应性。由此产生的愤怒，以高度唤醒、认知和行为去抑制为特征，将改变对情绪暗示的评估，并干扰原本完整的情绪能力。这项建议的主要目的是进行必要的发展工作，以检查在BPD中暴露于与个人相关的挑战的情绪处理后果。我们建议从开放式半结构化叙事账户中生成最近感知到的违规经历的表意文字，并在表意挑战之前和之后在实验室中从心理生理学角度(面部肌电、心率和皮肤电导反应)检查情绪行为。第二个目标是开发一套与假设与BPD相关的人际图式一致的情绪唤起刺激，以便在未来的研究中使用。BPD临床研究专家小组将通过标准化的、基于计算机的分类程序来选择这些集合。第三个目标是为研究生提供足够的知识和专业知识，以进行精神病理学中情绪处理的独立研究，特别是人格障碍。为了支持这些目标，我们建议从正在进行的人格障碍合作纵向研究(CLP)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学实验室测试情绪处理。

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.