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，反复自杀企图或手势，强烈和不稳定的关系）可能被视为应对这种核心缺陷的策略或后果。尽管情绪反应对BPD的概念至关重要，但令人惊讶的是，很少有研究直接研究BPD患者的情绪。一个例外是最近的调查生理指标的情绪反应，以愉快的，中性的，或不愉快的情绪效价标准化的图像。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的情绪高反应性。在这个建议中，我们认为，BPD患者会表现出情绪过度反应后，被激怒或触发一个突出的人际挑战。由此产生的愤怒，其特征是高唤醒和认知和行为去抑制，将改变对情绪线索的评价，并干扰其他完整的情绪能力。本提案的主要目的是进行必要的发展工作，以检查暴露于BPD中的个人相关挑战的情绪处理后果。我们建议从开放式的半结构化的叙事账户中产生最近感知到的违规经历的表意文字，并在实验室心理生理学（面部肌电图，心率和皮肤电导反应）之前和之后的表意挑战中检查情绪行为。第二个目标是开发一套情感唤起的刺激，是一致的人际图式假设是相关的BPD，这可以在未来的研究中使用。一个专家小组的BPD临床研究人员将选择这些集通过一个标准化的，基于计算机的排序程序。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，特别是人格障碍的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.