Mood and Reactivity in Borderline Personality Disorder

边缘性人格障碍的情绪和反应

• 批准号: 7330628
• 负责人: Lori N Scott
• 金额: $ 2.74万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-15 至 2010-08-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7330628
• 关键词: Affect; Affective; Arousal; Behavior; Benign; Biological; Biological Markers; Borderline Personality Disorder; Characteristics; Chronic; Clinical; Cognitive; Condition; Control Groups; DSM-IV; Development; Diagnosis; Dimensions; Disease; Distress; Elevation; Emotional; Endocrine; Environment; Event; Functional disorder; Goals; HPSE gene; Health; Hydrocortisone; Impulsivity; Individual; Interview; Invasive; Laboratories; Laboratory Procedures; Lead; Life; Matched Group; Measures; Medical; Mental Health Services; Mental disorders; Methods; Moods; Nature; Neurosecretory Systems; Numbers; Pain; Participant; Patients; Pattern; Perception; Physiological; Procedures; Process; Public Health; Range; Reaction; Recovery; Relative (related person); Reporting; Research; Saliva; Salivary; Sampling; Score; Social Environment; Speech; Standards of Weights and Measures; Stress; Structure; Sympathetic Nervous System; System; Testing; Time; Translations; Validation; alpha Amylase 2; alpha-amylase; biobehavior; biological adaptation to stress; comparison group; emotional stimulus; hypothalamic-pituitary-adrenal axis; indexing; innovation; loris; negative mood; programs; psychologic; psychopharmacologic; psychosocial; response; social; social cognition; social stress; stressor; suicidal behavior; therapy development; trait

DESCRIPTION (provided by applicant): The long-term goal of this research is to identify the specific mechanisms involved in the extreme emotional reactivity that characterizes Borderline Personality Disorder (BPD) and to apply these findings to the development and validation of both psychosocial and psychopharmacological treatments that directly target these mechanisms. The specific aim of the proposed research is to identify the characteristic patterns of physiological and phenomenological reactions in response to social perturbation in individuals with BPD as compared to two healthy comparison groups: 1) a temperamentally matched comparison group (scoring similarly to BPD patients on trait measures of negative affect and impulsivity); and 2) a non-temperamentally matched comparison group (scoring in the average range on these measures). All participants will be assessed for DSM-IV Axis I and II disorders with structured interviews and then will participate in a laboratory stress paradigm involving a speech and a verbal arithmetic task in front of three judges. Saliva samples will be collected at several time points in order to examine two physiological dimensions of the stress response: 1) salivary cortisol, reflecting reactivity of the limbic hypothalamic-pituitary-adrenal axis; and 2) alpha-amylase, reflecting activation of the autonomic (primarily sympathetic) nervous system. It is predicted that in response to the laboratory stress paradigm: 1) BPD patients, compared to both comparison groups, will show increased cortisol and alpha-amylase responses and slower return to baseline levels; and 2) BPD patients, compared to both comparison groups, will report greater subjective distress. It is also predicted that, compared to both comparison groups, BPD patients will report more malevolent perceptions of those with whom they have interacted during the experimental procedures. This research is important to public health because BPD is a highly prevalent, costly, painful, debilitating, and deadly disorder, and thus represents a serious clinical and public health concern. For individuals with BPD, subtle and benign events in the environment can evoke intense emotional responses that activate the stress response system and may rapidly spiral into behaviors that are life threatening and functionally debilitating. There are also serious health consequences to chronic elicitation of the stress response, and individuals with BPD are frequent users of both medical and mental health services. Understanding the physiological and psychological processes underlying these problematic features of BPD is imperative to the development of treatments aimed at reducing the burden of mental illness.

描述（由申请人提供）：本研究的长期目标是确定涉及边缘型人格障碍（BPD）特征的极端情绪反应的具体机制，并将这些发现应用于直接针对这些机制的心理社会和心理药理学治疗的开发和验证。本研究的具体目的是通过与两个健康对照组（1）气质匹配的对照组）进行比较，确定BPD个体对社会干扰的生理和现象学反应的特征模式（在消极情感和冲动的特质测量上与BPD患者评分相似）;和2）非气质匹配的对照组（在这些测量的平均范围内得分）。所有参与者将通过结构化访谈评估DSM-IV轴I和II障碍，然后将参与实验室压力范例，包括在三名法官面前进行演讲和口头算术任务。将在几个时间点采集唾液样本，以检查应激反应的两个生理维度：1）唾液皮质醇，反映边缘系统下丘脑-垂体-肾上腺轴的反应性;和2）α-淀粉酶，反映自主（主要是交感）神经系统的激活。预测响应于实验室应激范例：1）与两个比较组相比，BPD患者将显示出增加的皮质醇和α-淀粉酶反应，并且更慢地恢复到基线水平;以及2）与两个比较组相比，BPD患者将报告更大的主观痛苦。还预测，与两个对照组相比，BPD患者将报告对在实验过程中与他们互动的人的更多恶意感知。这项研究对公共卫生很重要，因为BPD是一种非常普遍、昂贵、痛苦、衰弱和致命的疾病，因此代表了严重的临床和公共卫生问题。对于患有BPD的人来说，环境中微妙和良性的事件可以引起强烈的情绪反应，激活压力反应系统，并可能迅速演变成危及生命和功能衰弱的行为。长期诱发应激反应也会对健康造成严重后果，BPD患者经常使用医疗和心理健康服务。了解BPD这些问题特征背后的生理和心理过程对于开发旨在减轻精神疾病负担的治疗方法至关重要。