Interpersonal Functioning and Emotion in Borderline Personality

描述(由申请人提供)：本提案是一个修订的竞争性续签申请，以扩展我们目前资助的项目，R01 MH056888，“边缘人格中的人际功能和情感”。基于我们之前的研究结果，我们仍然认为依恋理论是理解交界性人格障碍(BPD)人际功能的最佳框架。在BPD中，焦虑、矛盾的依恋以一种独特的形式出现--频繁的失望和对他人的愤怒导致敌意退缩，紧随其后的是孤独和对分离的恐惧，产生了新的接近和和解的尝试，这种尝试一直持续到下一次挫折和失望。在这个自我挫败的循环中，关键的主题是(A)与愤怒作斗争，以及(B)无法与他人保持一致和舒适的人际距离。我们建议从二元的角度来考察这些过程--这是人格障碍研究的一个创新的新步骤。我们将从患者和浪漫伴侣的角度来评估这些过程，因为我们之前的发现是，浪漫是BPD患者的高风险领域，这与我们关于依恋机制核心作用的假设是一致的。主要目标是通过在多个分析层面上评估这些现象，加强我们对业务连续性和可持续发展的这些核心机制的理解。我们将使用三种方法(在不同的“粒度”和不同的时间尺度上)来实现这一点 目标。首先，我们将进行一次二元实验室互动，讨论两国关系中目前令人头疼和悬而未决的问题。互动将使用特定情感编码系统(SPAFF)对情感和行为进行编码，并记录外周心理生理学的测量。其次，我们将使用由参与者和合作伙伴同时完成的为期三周的二元生态瞬时评估(EMA)方案。最后，我们将包括对参与者(和伴侣)在过去一年中最具情感重要性的25个人物的社交网络分析。我们的第一个明确目标是S证明，与其他人格障碍患者(门诊人格障碍，n=55对人格障碍)或没有人格障碍患者(n=55对人格障碍)相比，BPD患者(n=55对)的平均愤怒水平更高，愤怒的变异性更大，依恋威胁与愤怒之间的关联更强。我们的第二个具体目标是证明与其他PD或没有PD的患者相比，BPD患者在人际距离上表现出更大的变异性。我们的第三个具体目标是证明这些关于愤怒和人际距离的影响被伴侣的特征和行为所缓和，特别是他们自己的依恋焦虑。这项研究的样本总数为165对，包括年龄在18岁到40岁之间的男女。我们认为，纳入二元评估(同时继续关注双方所在的更广泛的社会网络)是改进循证治疗的最佳途径，可以在日常交易层面上解决人际功能问题。

DESCRIPTION (provided by applicant): This proposal is an amended competing renewal application to extend our currently funded project, R01 MH056888, "Interpersonal Functioning and Emotion in Borderline Personality." Based on our prior results, we continue to regard attachment theory as the best framework for understanding interpersonal functioning in borderline personality disorder (BPD) In BPD, anxious, ambivalent attachment takes a distinctive form- frequent disappointments and anger toward others lead to periods of hostile withdrawal, followed by loneliness and fears regarding separation, producing new attempts at approach and reconciliation, which continue until the next episode of frustration and disappointment. The key themes in this self-defeating cycle are (a) struggles with anger and (b) an inability to maintain a consistent and comfortable interpersonal distance from others. We propose to examine these processes from a dyadic perspective-an innovative, new step for research on personality disorders. We will assess these processes from the perspectives of both the patient and a romantic partner, given our earlier findings that romance is a high-risk domain for patients with BPD, consistent with our assumption about the central role of attachment mechanisms. The major objective is to enhance our understanding of these central mechanisms in BPD by assessing these phenomena at multiple levels of analysis. We will use three methods (at different levels of "granularity" and with different time scales) to achieve this objective. First, we will conduct a dyadic laboratory interaction involving a discussion of a currently troublesome and unresolved issue in the relationship. The interaction will be coded for both affect and behavior using the Specific Affect Coding System (SPAFF), and measures of peripheral psychophysiology will be recorded. Second, we will use a dyadic, ecological momentary assessment (EMA) protocol completed simultaneously by participant and partner for three weeks. Finally, we will include a social network analysis of the 25 most emotionally significant figures for the participant (and partner) during the past year. Our first specific aim s to document that patients with BPD (n = 55 dyads) have higher mean levels of anger, greater variability in anger, and a stronger association between threats to attachment and anger compared to patients with other PDs (OPD, n = 55 dyads) or no PD (n = 55 dyads). Our second specific aim is to document that patients with BPD display greater variability in interpersonal distance compared to patients with other PDs or no PD. Our third specific aim is to document that these effects regarding anger and interpersonal distance are moderated by the characteristics and behavior of partners, especially their own attachment anxiety. The work will be done with a total sample of 165 dyads consisting of men and women between the ages of 18 and 40. We believe that incorporating dyadic assessment (together with continued attention to the broader social networks in which both partners are embedded) is the best way forward to improved, evidence-based treatments that can address interpersonal functioning at the level of day-to-day transactions.