Physiological Correlates of Interpersonal Hypersensitivity in Borderline Personal

描述(申请人提供)：这项研究的长期目标是确定严重扰乱的人际关系中涉及的具体机制，这些机制是边缘人格障碍(BPD)的例证。这一长期目标的部分目的是使用一种转换研究方法来确定机制，该方法利用几个不同的分析水平：神经、生理、行为和现象学。这项拟议的研究旨在明确BPD患者与两个对照组：重度抑郁症患者和健康对照组相比，对人际拒绝的电生理、行为和现象学反应的特征模式。在参与两项关于社会排斥的研究之前，将在所有参与者中对DSM-IV轴I和II障碍进行评估。在第一个研究中，将使用惊吓探测范式来评估与拒绝相关的绘画的威胁性，而不是描绘接受或积极、消极和中性主题的绘画。惊吓反应将通过记录在左眼正下方的电极上的肌电图来评估。当看到对个体特别厌恶或威胁的刺激时，惊吓反应往往会升高，被认为反映了一种防御性动机系统的激活。在第二项研究中，受试者将玩一种电脑投球游戏，这是一种有效的操作方式，可以诱导社交拒绝体验，重点是应对人际压力。赛前、赛中和赛后将对脑电不对称性进行评估。参与者将完成对愤怒、对其他参与者的感知的自我报告，并完成一项衡量行为攻击性的任务。据预测，BPD和MDD参与者对拒绝主题的绘画都会表现出更高的惊吓反应，但对社会拒绝的反应会有几个不同：1)BPD患者会表现出更大的相对左额叶激活，2)会表现出更大的行为攻击性和对其他“玩家”的更恶毒的感知。这项拟议的研究对公共健康很重要，因为这种疾病非常普遍，并造成严重的精神健康负担。此外，焦虑不安的人际关系是BPD的一个突出而具体的特征，非常令人衰弱，但人们对此却知之甚少。对于患有BPD的人来说，微妙的、良性的人际关系事件会引发强烈的情绪反应、愤怒的爆发和不适应的、危及生命的行为。揭示BPD患者精神障碍相关的神经、生理和行为过程，对于指导心理治疗和药物治疗的发展，减轻心理健康负担具有重要意义。 公共卫生相关性：边缘人格障碍是一种严重的心理健康障碍，其特征是强烈的负面情绪、愤怒、攻击性、人际关系紊乱、对真实或感知到的抛弃以及自我伤害和自杀行为的适应不良反应。由于人际关系中的真实或感知事件与BPD的许多突出特征有关，包括攻击性行为、自残和自杀，因此了解这种骚扰的性质是很重要的。确定人际关系障碍的性质有助于找到治疗方法，减轻障碍的严重疼痛和痛苦，并显著改善工作和人际关系领域的功能，降低患有BPD的个人和公众的障碍成本。

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.