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Pathways to Alcohol Problems in Borderline PD via Acute Response to Alcohol

通过对酒精的急性反应导致边缘性 PD 酒精问题的途径

基本信息

批准号：
8936416
负责人：
Sarah L Pedersen
金额：
$ 17.74万
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：
2014-09-28 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8936416
关键词：
Accounting Acute Affect Affective Age Age-Years Alcohol abuse Alcohol consumption Alcohols Anti-Anxiety Agents Behavior Borderline Personality Disorder Cardiovascular system Characteristics Clinic Communities Comorbidity Diagnosis Disinhibition Education Event Female Foundations Future Gender Health Heavy Drinking Heterogeneity Impulsivity Individual Individual Differences Intervention Interview Laboratories Lead Link Literature Measures Modeling Moods National Institute on Alcohol Abuse and Alcoholism Participant Pathway interactions Patient Self-Report Population Prevalence Preventive Intervention Process Psychopathology Race Recruitment Activity Regulation Research Research Methodology Risk Risk Behaviors Self-Injurious Behavior Stress Structure Symptoms Testing TimeLine Translating Treatment outcome Unsafe Sex Work alcohol effect alcohol related problem alcohol response alcohol sensitivity alcohol use disorder base biological adaptation to stress clinical practice design drinking drinking behavior effective intervention experience follow-up indexing interpersonal conflict novel prospective response sobriety social stress suicidal behavior therapy design trait young adult

项目摘要

DESCRIPTION (provided by applicant): Borderline personality disorder (BPD) is extremely debilitating and costly to the individual and larger community. Additionally, BPD is highly comorbid with alcohol use disorder with prevalence estimates around 50% and an even higher percentage of individuals with BPD experiencing alcohol-related problems. This comorbidity significantly worsens treatment outcomes. To date very little research has examined mechanisms that may underlie both BPD and alcohol-related problems. The proposed project examines two hallmark features of BPD, affective instability and impulsivity/disinhibition, which have also been widely studied in relation to alcohol problems to test two pathways for why individuals with BPD engage in heavier alcohol use and experience more problems while drinking. Importantly, the disinhibition and anxiolytic/stress reducing effects of alcohol have been modeled successfully in the laboratory and our current proposal utilizes cutting edge research methodology to examine this important topic. Aims: The current application tests hypotheses about differences in response to alcohol both between groups comparing individuals with and without BPD and intra-individual differences in these responses as predictors of heavy alcohol use and alcohol-related problems. Specifically, we are hypothesizing that individuals with BPD will have heightened sensitivity to the anxiolytic effects of alcohol which in turn will increase their engagement in heavy drinking behaviors as a way to regulate their affective instability. We are also hypothesizing that individuals with BPD will be more sensitive to the disinhibiting effects of alcohol compared to individuals without BPD and that this acute response will partially account for the higher number of alcohol-related problems seen in this population. Further, by examining individual differences in response to alcohol we are able to examine a continuum of these constructs which takes into account the notable heterogeneity of individuals with and without BPD. Approach: We will use a tightly controlled within-subjects laboratory alcohol administration to model change in stress response and disinhibition from sober to intoxicated. Young adult drinkers (21-30 years of age; 50% female) with and without a diagnosis of BPD will be recruited to participate (N = 100; 50 BPD and 50 non-BPD) from both the community and treatment clinics. All participants will complete Axis I and Axis II semi-structured interviews, a control and alcohol lab session, and a three-month timeline followback interview to allow us to examine how lab-based response to alcohol relates prospectively to heavy alcohol use and alcohol-related problems. In accordance with NIAAA strategic priorities on identifying mechanisms of comorbidity the proposed work takes a critical step by increasing our understanding of why BPD and alcohol-related problems are highly linked and will ultimately inform future intervention efforts designed to decrease problematic drinking behaviors for this population.

描述（由申请人提供）：边缘型人格障碍（BPD）对个人和更大的社区来说是极其虚弱和昂贵的。此外，BPD与酒精使用障碍高度共病，患病率估计约为50%，BPD患者经历酒精相关问题的比例甚至更高。这种合并症显著恶化了治疗结果。迄今为止，很少有研究调查了BPD和酒精相关问题背后的机制。拟议的项目检查了BPD的两个标志性特征，情感不稳定性和冲动性/去抑制，这两个特征也被广泛研究与酒精问题有关，以测试为什么BPD患者会大量饮酒并在饮酒时遇到更多问题的两种途径。重要的是，酒精的去抑制和抗焦虑/减压作用已经在实验室中成功模拟，我们目前的建议利用尖端的研究方法来研究这一重要主题。目的：目前的应用测试了两组之间对酒精反应差异的假设，比较了有和没有BPD的个体，以及这些反应的个体内部差异，作为重度饮酒和酒精相关问题的预测因子。具体来说，我们假设BPD患者对酒精的抗焦虑作用更加敏感，这反过来又会增加他们大量饮酒行为的参与，作为一种调节他们情感不稳定的方式。我们还假设，与没有BPD的人相比，患有BPD的人对酒精的去抑制作用更敏感