Components of Emotional Instability as Precursors of Borderline Personality

情绪不稳定的组成部分是边缘人格的前兆

基本信息

批准号：
8754946
负责人：
STEPHANIE D STEPP
金额：
$ 48.82万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-07-25 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8754946
关键词：
Adolescent Affect Affective Automobile Driving Behavior Biological Borderline Personality Disorder Child Clinic Conflict (Psychology)Development Diagnosis Dimensions Disease Early Intervention Emotional Emotions Ensure Environment Family Four-dimensional Fright Health system Impulsive Behavior Individual Longevity Mental Depression Mental Health Mental disorders Methods Monitor Moods National Institute of Mental Health Nature Neurobiology Parenting behavior Parents Pathogenesis Patient Self-Report Personality Prevention program Preventive Intervention Process Prospective Studies Protocols documentation Recovery Recruitment Activity Research Risk Shapes Specific qualifier value Suicide Sum Testing Time University Hospitals Validation Work Youth accomplished suicide aged biopsychosocial clinically relevant clinically significant conduct problem early adolescence experience follow-up girls indexing intervention program negative mood novel parental role prospective public health relevance response suicidal behavior theories time use tool

项目摘要

DESCRIPTION (provided by applicant): Borderline personality disorder (BPD) is extremely debilitating, with 75% of diagnosed individuals engaging in suicidal behavior and 5-10% completing suicide. Once the disorder emerges, it is difficult to treat and places an enormous burden on mental health systems. Thus, longitudinal research that begins in early adolescence is urgently needed to identify precursors of BPD features that can inform prevention and early intervention programs. Developmental theory postulates that emotional instability (EI) in the context of invalidating parenting behaviors underlies the development of BPD features, including suicide and other impulsive behaviors, abandonment fears, relationship volatility, and difficulties with identity formation. EI is specified as dimensions of variability in negative affective states, intensity of affect, and slow recovery following the onset of negative affect. However, the biological underpinnings of EI components and their predictive utility for BPD features are not known. Understanding how parenting behaviors and youth EI dampen or exacerbate each other over time as well as influence the development of BPD features is essential for the identification of clinically modifiable parent-youth transactions. Aims: The current application tests hypotheses about components of EI as precursors of BPD features and the developmental course of these features. Specifically, we will examine concurrent, prospective, unique and shared associations between components of EI, BPD features, and internalizing and externalizing problems within the parenting context. Thus, the proposal also examines reciprocal associations between parental response to emotion and youth EI and the potential moderating role of parental response to emotion on the development of BPD features. Approach: We will use a multi-modal, ecologically valid assessment battery of EI in young adolescents, emotion-focused parenting strategies, and parent-youth interactions. We will examine these processes in real-time (using an ecological momentary assessment protocol, observational ratings, and autonomic reactivity monitoring) as well as chart the course of their development with three assessments over 18 months. We will determine how specific EI components are related to near-neighbor internalizing and externalizing problems (e.g., depression, conduct problems), but we propose that the combination of these three EI components form a specific marker of subsequent BPD features, especially in the context of deleterious parenting strategies. Youth aged 11-13 years and primary caretakers (N=165 families; H50% girls) will be recruited from psychiatric clinics, and adolescents will be screened to ensure that we oversample severe and clinically significant levels of EI. In accordance with NIMH strategic priorities, the proposed work is a novel and critical step to identify who is at greatest risk and how to intervene with vulnerable youth and their families.

描述（由申请人提供）：边界人格障碍（BPD）极度衰弱，有75％的诊断人从事自杀行为，5-10％的人完成自杀。一旦疾病出现，就很难治疗和对精神卫生系统造成巨大负担。因此，迫切需要在青春期开始的纵向研究，以识别可以为预防和早期干预计划提供依据的BPD特征的前体。发展理论假定在育儿行为无效的情绪不稳定（EI）是BPD特征的发展，包括自杀和其他冲动行为，遗弃恐惧，人际关系波动和困难与身份形成。 EI指定为负面情感状态的变异性维度，影响力强度，并在负面影响开始后缓慢恢复。但是，尚不清楚EI组件的生物基础及其对BPD特征的预测效用。了解育儿行为和青年EI如何随着时间的流逝而互相抑制或加剧，并影响BPD特征的发展对于识别临床上可修改的父母交易至关重要。目的：当前的应用程序测试对EI的组成部分作为BPD功能的前体和这些功能的发展过程。具体来说，我们将研究EI，BPD功能的组成部分之间的并发，潜在，独特和共享的关联，以及在育儿环境中的内部化和外部化问题。因此，该提案还研究了父母对情感与青年EI的反应与父母对情感反应对BPD特征发展的潜在调节作用之间的相互关联。方法：我们将在年轻的青少年中使用多模式，生态有效的EI评估电池，以情感为中心的育儿策略和父母 - 雅特的互动。我们将实时检查这些过程（使用生态瞬时评估方案，观察等级和自主反应性监测），并在18个月内通过三次评估来绘制其发展过程。我们将确定特定的EI组件与近邻邻化和外在化问题（例如抑郁症，进行问题）是如何相关的，但是我们建议这三种EI组件的组合构成了随后的BPD特征的特定标记，尤其是在有害父母的背景下。年龄在11-13岁之间的年轻人（N = 165个家庭； H50％的女孩）将从精神病诊所招募，并将筛选青少年，以确保我们过度地过度样本的严重和临床意义的EI水平。根据NIMH的战略重点，拟议的工作是确定谁处于最大风险以及如何干预弱势青年及其家人的新颖和关键步骤。