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Integrating Process and Structure in Borderline Personality Disorder

边缘性人格障碍的整合过程和结构

基本信息

批准号：
8585880
负责人：
WILLIAM W FLEESON
金额：
$ 28.93万
依托单位：
WAKE FOREST UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-07-01 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8585880
关键词：
Accounting Address Behavior Benchmarking Borderline Personality Disorder Boredom Categories Chronic Clinical Cognitive Data Dependency Development Diagnosis Disease Disease remission Distress Environment Etiology Frequencies Goals Health Care Costs Individual Judgment Knowledge Lead Measurement Measures Methodology Participant Pathway interactions Patient Self-Report Pattern Perception Personality Personality Disorders Persons Population Problem Solving Process Psychosocial Factor Qualifying Questionnaires Report (account)Reporting Research Research Proposals Risk Role Sampling Severities Social Perception Societies Staging Structure Suicide Symptoms Techniques Testing Time Treatment Efficacy base behavioral/social science clinical Diagnosis cost design effective therapy experience functional disability improved informant innovation insight longitudinal design public health relevance research clinical testing severe mental illness social stressor tool trait

项目摘要

DESCRIPTION (provided by applicant): Borderline Personality Disorder (BPD) is a serious mental illness, associated with severe functional impairment and significant costs to society. Two significant problems impede successful diagnosis and treatment of these debilitating disorders. First is an almost complete lack of direct, empirical knowledge about actual symptom expression, frequency, or severity. Clinical diagnosis relies on comparisons of individual's symptom levels to normal frequencies and severities, but there is no direct, empirical knowledge about actual levels of symptom expression in either a normal or abnormal population. This limitation in data availability to the clinician makes it difficult to determine whether a given individual's symptoms qualify for diagnosis, are being effectively treated, or are reduced to healthy levels. A second significant problem is that there is little information about the processes underlying BPD and associated problems. Without knowledge of the underlying causal mechanisms, it is difficult to optimize effective treatment of BPD. The following research proposal is tailored to simultaneously address both of these significant problems. In R01 MH70571, Stage 1, an innovative approach that is particularly suited to solving these problems was developed and successfully applied to the study of normal personality. This approach is characterized by two hallmarks: (1) measuring actual behavior to describe and explain personality, rather than relying on retrospective questionnaires; and (2) leveraging variability in behavior to identify the mechanisms underlying personality. Stage 1 verified the usefulness of this approach for arriving at new insights about personality and for explaining the mechanisms underlying personality. Stage 2 will use this approach to accomplish the same goals for BPD. Stage 2 will measure actual symptoms rather than rely on retrospective reports, and will leverage variability in those symptoms to test the mechanisms underlying BPD. Aim 1 is to obtain direct, empirical accounts of symptom frequencies, severities, and co-occurrences, to aid diagnosis, treatment, and termination decisions. Aim 2 is to propose and test several theoretical mechanisms for BPD. Aim 3 is to investigate the role of interpersonal perception processes in stressors and symptoms. Aim 4 is to chart trajectories and transactions of symptom frequencies, severities, and contingencies. Borderline Personality Disorder, like normal personality, is often considered chronic and untreatable. However, this is a serious mental illness, associated with severe functional impairment, high health-care costs, and significant suffering. The key to finding treatments and reducing these costs is to find an approach that unlocks the mechanism underlying the disorder. Stage 1 demonstrated such an approach for normal personality; Stage 2 will do the same for borderline personality disorder.

描述（由申请人提供）：边缘型人格障碍（BPD）是一种严重的精神疾病，与严重的功能障碍和社会的重大成本有关。两个重要的问题阻碍了这些衰弱性疾病的成功诊断和治疗。首先是几乎完全缺乏关于实际症状表现、频率或严重程度的直接经验知识。临床诊断依赖于将个体的症状水平与正常频率和严重程度进行比较，但对于正常或异常人群中症状表达的实际水平没有直接的经验知识。临床医生的数据可用性的这种限制使得难以确定给定个体的症状是否符合诊断条件，是否正在得到有效治疗，或是否降低到健康水平。第二个重要的问题是，几乎没有关于BPD和相关问题的基础过程的信息。如果不了解潜在的因果机制，就很难优化BPD的有效治疗。下面的研究建议是针对同时解决这两个重要问题。在R 01 MH 70571第1阶段中，开发了一种特别适合解决这些问题的创新方法，并成功应用于正常人格的研究。这种方法有两个特点：（1）测量实际行为来描述和解释人格，而不是依赖于回顾性问卷;（2）利用行为的可变性来识别人格背后的机制。第一阶段验证了这种方法的有用性，以达到对人格的新见解和解释人格的机制。第2阶段将使用这种方法来实现与BPD相同的目标。第2阶段将测量实际症状，而不是依赖于回顾性报告，并将利用这些症状的变化来测试BPD的潜在机制。目的1是获得直接的，经验的帐户症状的频率，严重程度和共同发生，以帮助诊断，治疗和终止决策。目的二是提出并验证BPD的几种理论机制。目的三是探讨人际知觉过程在应激源和症状中的作用。目标4是绘制症状频率、严重程度和突发事件的轨迹和交易。边缘型人格障碍，像正常人格一样，通常被认为是慢性和不可治愈的。然而，这是一种严重的精神疾病，伴随着严重的功能障碍、高昂的医疗费用和巨大的痛苦。找到治疗方法并降低这些费用的关键是找到一种方法，解开这种疾病的潜在机制。第一阶段展示了正常人格的这种方法;第二阶段将对边缘性人格障碍做同样的事情。