Rejection sensitivity and self-regulation in personality disorders

人格障碍中的拒绝敏感性和自我调节

• 批准号: 7352964
• 负责人: Geraldine A Downey
• 金额: $ 40.25万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-27 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7352964
• 关键词: Accounting; Address; Affect; Affective; Aggressive behavior; Alcohol or Other Drugs use; Anger; Attenuated; Basic Science; Behavior; Behavioral inhibition; Binge Eating; Borderline Personality Disorder; Bronchopulmonary Dysplasia; Cereals; Clinical; Cognitive; Communities; Cues; Daily; Data; Diagnosis; Diagnostic; Disease; Equilibrium; Exposure to; Fostering; Foundations; Fright; Funding; Goals; Health; Health Care Costs; Impulsive Behavior; Individual; Informal Social Control; Intervention; Interview; Knowledge; Laboratories; Life; Major Depressive Disorder; Methods; Modeling; Monitor; Moods; Ointments; Patient Self-Report; Personal Satisfaction; Personality; Personality Disorders; Persons; Prevention; Problem Solving; Procedures; Process; Process Assessment; Psyche structure; Punishment; Questionnaires; Reaction; Readiness; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Rewards; Risk; Role; Sampling; Self-Injurious Behavior; Societies; Specificity; Stress; Symptoms; System; Testing; Translational Research; Withdrawal; Work; base; clinically relevant; comparison group; coping; day; diaries; executive function; experience; functional disability; improved; in vivo; indexing; interest; prevent; response; sex; social

DESCRIPTION (provided by applicant): It is well known that healthy social relationships foster mental and physical health. Unfortunately, some people find relationships overwhelming and cope in self-defeating ways, extreme forms of which are captured in Borderline (BPD) and Avoidant (APD) Personality Disorders. BPD is characterized by volatile relationships involving angry, impulsive and self-injurious reactions to the threat of rejection. APD is characterized by pervasive and self-undermining avoidance of situations and roles entailing potential exposure to rejection. Our goal is to advance knowledge of processes that generate these debilitating disorders by building on basic personality research on two social-cognitive dispositions: (1) Rejection sensitivity (RS) is the disposition to anxiously expect, readily perceive, and intensely react to rejection. (2) Self-regulatory competency is the ability to effortfully override automatic reactions in favor of less dominant but more appropriate responses. Prior work shows that, in people high in RS, rejection cues rapidly and automatically prepare them to detect and to react intensely to forestall rejection. This potentially adaptive threat-response system can become maladaptive if activated indiscriminately in situations that require reflective, strategic behavior or when the threat is minimal. While both BPD and APD involve high RS, BPD alone is characterized by the dysregulating consequences of managing an intense need for social connection along with an intense fear of rejection. The proposed research examines how RS and regulatory competency interact to influence social threat processing dynamics and psychiatric symptoms in these disorders. Persons with BPD (n = 50) and APD (n = 50) recruited from the community and assessed with diagnostic interviews will be compared with two groups without personality disorders -- one group with Major Depression and one with no disorders. The research involves a unique combination of (a) experimental laboratory paradigms that enable fine-grained analyses of if & then processes underlying BPD and APD symptoms, and (b) a 21-day experience-sampling diary that will show how these processes relate to psychiatric symptoms in daily life. Aim 1 is to assess whether individuals with BPD or APD selectively attend to, perceive, and react to social cues in ways that reflect high RS. Aim 2 is to assess aspects of regulatory competency relevant to APD and BPD and to determine how they protect against the personal and interpersonal difficulties generated by RS. Borderline (BPD) and Avoidant (APD) Personality Disorders are serious disorders associated with severe functional impairment, and in the case of BPD, self-injurious urges and impulsive behaviors that often incur very high healthcare costs. By clarifying the specific processes by which the debilitating symptoms of these disorders emerge, this research will improve assessment procedures and provide a foundation for scientifically justified interventions intended to reduce the toll of these disorders on individuals and society.

描述（由申请人提供）：众所周知，健康的社会关系能促进身心健康。不幸的是，有些人发现人际关系势不挡，以自我挫败的方式应对，这种极端形式被边缘型人格障碍（BPD）和回避型人格障碍（APD）所捕获。BPD的特点是不稳定的人际关系，包括对拒绝的威胁做出愤怒、冲动和自残的反应。APD的特点是普遍的和自我破坏的回避可能导致潜在的拒绝暴露的情况和角色。我们的目标是通过对两种社会认知倾向的基本人格研究来推进对产生这些衰弱障碍的过程的认识：(1)排斥敏感性（RS）是一种焦虑地期待、容易感知和强烈反应拒绝的倾向。(2)自我调节能力是努力克服自动反应的能力，以支持不太主导但更适当的反应。先前的研究表明，在RS高的人群中，排斥信号会迅速而自动地让他们做好检测排斥的准备，并做出强烈的反应来预防排斥。如果在需要反思、战略行为或威胁最小的情况下不加选择地激活，这种潜在的自适应威胁-反应系统可能会变得不适应。虽然BPD和APD都涉及高RS，但BPD本身的特点是管理强烈的社会联系需求和强烈的拒绝恐惧的失调后果。本研究旨在探讨RS和调节能力如何相互作用，影响这些障碍的社会威胁加工动态和精神症状。从社区招募的BPD （n = 50）和APD （n = 50）患者，并通过诊断访谈进行评估，将与两组无人格障碍的患者进行比较-一组患有重度抑郁症，另一组没有障碍。该研究采用了一种独特的组合方式：(a)实验实验室范式，能够对BPD和APD症状背后的“如果&然后”过程进行细粒度分析；(b) 21天的经验抽样日记，将显示这些过程与日常生活中的精神症状之间的关系。目标1是评估BPD或APD患者是否以反映高RS的方式选择性地关注、感知和反应社会线索。目标2是评估与APD和BPD相关的调节能力方面，并确定他们如何防范RS产生的个人和人际困难。边缘型（BPD）和回避型（APD）人格障碍是与严重功能障碍相关的严重障碍，在BPD的情况下，自残的冲动和冲动行为往往会导致高昂的医疗费用。通过澄清这些疾病的衰弱症状出现的具体过程，这项研究将改进评估程序，并为旨在减少这些疾病对个人和社会造成的损失的科学合理干预提供基础。