Physiological Correlates of Interpersonal Hypersensitivity in Borderline Personal

描述（由申请人提供）：本研究的长期目标是确定以边缘型人格障碍（BPD）为例的严重干扰人际关系的具体机制。这个长期目标的一部分是利用转化研究方法来确定机制，这种方法利用了几个不同层次的分析：神经、生理、行为和现象学。本研究旨在确定BPD患者在人际拒绝时的电生理、行为和现象反应的特征模式，并与两组对照组（重度抑郁症患者和健康对照组）进行对比。在参与两项社会排斥研究之前，将对所有参与者进行DSM-IV轴I和II障碍的评估。首先，将使用惊吓探针范式来评估与拒绝相关的绘画与描绘接受或积极，消极和中性主题的绘画相比的威胁性。惊吓反应将通过左眼下方电极记录的肌电图来评估。当看到对个人来说特别厌恶或威胁的刺激时，惊吓反应往往会升高，这被认为反映了防御动机系统的激活。在第二项研究中，参与者将玩一个电脑抛球游戏，该游戏已被证实是诱发社会拒绝体验的有效操作。将在比赛前、比赛中和比赛后评估脑电图不对称。参与者将完成愤怒的自我报告测量，对其他玩家的感知，并完成一项测量行为攻击的任务。结果表明，BPD和MDD受试者对拒绝主题绘画的惊吓反应均会升高，但对社会拒绝的反应存在以下差异：1)BPD患者表现出更大的相对左额叶激活；2)BPD患者表现出更大的行为攻击和对其他“参与者”更恶毒的看法。这项拟议的研究对公共卫生很重要，因为这种疾病非常普遍，并造成了严重的精神健康负担。此外，人际关系紊乱是BPD的一个突出和特殊的特征，它是高度衰弱的，但人们对它知之甚少。对于BPD患者来说，微妙的、良性的人际关系事件会引起强烈的情绪反应、愤怒爆发和适应不良、威胁生命的行为。揭示BPD中受干扰的相关性背后的神经、生理和行为过程对心理治疗和药物治疗的发展以及减轻心理健康负担至关重要。

DESCRIPTION (provided by applicant): The long-term goal of this research is to identify the specific mechanisms involved in severely disturbed interpersonal relationships that exemplify Borderline Personality Disorder (BPD). Part of this long-term goal is the aim to identify mechanisms using a translational research approach that utilizes several different levels of analysis: neural, physiological, behavioral and phenomenological. The proposed research is specifically aimed at identifying the characteristic patterns of electrophysiological, behavioral and phenomenological reactions to interpersonal rejection in individuals with BPD in contrast to two control groups: individuals with major depression and healthy controls. DSM-IV Axis I and II disorders will be assessed amongst all participants prior to participation in two studies of social rejection. In the first, a startle probe paradigm will be used to assess the threatening nature of rejection related paintings in contrast to paintings depicting acceptance or positive, negative and neutral themes. Startle response will be assessed by electromyography recorded from electrodes just below the left eye. When viewing stimuli that are particularly aversive or threatening to an individual, startle response tends to be elevated, thought to reflect the activation of a defensive motivational system. In the second study, focused on reactions to interpersonal stress, participants will play a computerized ball-toss game which has been validated as an effective manipulation to induce the experience of social rejection. EEG asymmetry will be assessed before, during and after the game. Participants will complete self-report measures of anger, perception of other players, and complete a task measuring behavioral aggression. It is predicted that both BPD and MDD participants will demonstrate elevated startle response to rejection themed paintings, but will show several differences in reactions to social rejection: 1) BPD patients will show greater relative left frontal activation, and 2) will demonstrate greater behavioral aggression and more malevolent perceptions of other "players". The proposed research is important to public health because the disorder is highly prevalent and poses a severe mental health burden. In addition disturbed interpersonal relatedness is a prominent and specific feature of BPD, is highly debilitating, and yet poorly understood. For individuals with BPD, subtle, benign interpersonal events can evoke intense emotional responses, angry outbursts and maladaptive, life threatening behaviors. Uncovering the neural, physiological and behavioral processes that underlie disturbed relatedness in BPD is essential for informing the development of psychotherapy and pharmacotherapy and reducing mental health burden. PUBLIC HEALTH RELEVANCE: Borderline Personality Disorder is a severe mental health disorder characterized by intense negative emotion, anger, aggression, disturbed interpersonal relationships, maladaptive responses to real or perceived abandonment and self-harm and suicidal behaviors. Because real or perceived events in interpersonal relationships are linked to many prominent features of BPD, including aggressive acts, self-harm and suicidality, it is important to understand the nature of this disturbance. Identification of the nature of disturbance in interpersonal relationships can help lead to therapies that can lessen the severe pain and distress of the disorder, and lead to significantly improved functioning in the realms of work and relationships, lessening the costs of the disorder to the individual with BPD and the public.