Preschooler emotion regulation in the context of maternal borderline personality disorder

母亲边缘型人格障碍背景下学龄前儿童的情绪调节

• 批准号: 9918460
• 负责人: Maureen Zalewski
• 金额: $ 82.03万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9918460
• 关键词: 4 year old; Age; Anxiety; Attention; Behavioral; Borderline Personality Disorder; Characteristics; Child; Child Mental Health; Data; Development; Dialectical behavior therapy; Disadvantaged; Disease; Emotional; Emotions; Experimental Designs; Family; Fostering; Future; Growth; Income; Interpersonal Relations; Intervention; Knowledge; Laboratories; Life; Longevity; Measures; Mediator of activation protein; Mental Health; Mental disorders; Methods; Modeling; Moods; Mothers; Nursery Schools; Oregon; Outcome Measure; Pathway interactions; Pattern; Pennsylvania; Physiological; Preschool Child; Process; Public Health; Randomized Controlled Trials; Regulation; Risk; Sampling; Services; Sinus Arrhythmia; Socialization; Specificity; Temperament; Testing; Theoretical model; Time; Validation; base; biobehavior; clinically significant; design; emotion regulation; emotional experience; experience; improved; insight; novel; offspring; respiratory; response; severe mental illness; sex; skills; skills training; social skills; suicidal behavior; tool; transmission process

Borderline personality disorder is a serious mental illness characterized by extreme emotions, chaotic interpersonal relationships, suicidal behaviors, and a poor sense of self. Offspring of mothers with Borderline Personality Disorder (BPD) are at an elevated risk for developing mental illness across the lifespan. Difficulty managing emotions are a hallmark feature of BPD, and yet the ability to do so is necessary for responding effectively to childrens' emotions. This process is called maternal emotion socialization, which has a major impact on how children develop their own emotion regulation (ER) skills. ER develops rapidly during preschool and deficits in preschool ER are recognized as underlying future mental disorders. This proposal will test a model examining the extent to which maternal ER and emotion socialization impact child ER, which may be a significant pathway by which mental health problems are transmitted to offspring of mothers with BPD. This proposal will leverage Dialectical Behavior Therapy (DBT) Skills training, a robust and effective method for improving ER as a tool to change maternal ER in mothers with BPD. By completing multiple assessments of biobehavioral markers of child and mother ER, this study is poised to uncover a potentially modifiable pathway by which these offspring are at risk. Specifically, we propose to conduct a stratified randomized controlled trial of DBT Skills for mothers with BPD who have preschoolers. A total of 300 dyads (initial child age: 36-48 months) will be collected in Eugene, Oregon and Pittsburgh Pennsylvania, with 100 pairs in each of three groups: children who have mothers with BPD who receive DBT Skills, children who have mothers with BPD who receive Family Services as Usual, and children who have non-disordered mothers, matched on income, with this final group only participating in assessments (as to quantify normative ER growth). All children will be assessed 4 times every 4-months, with the first assessment occurring prior to treatment assignment. We will use a biobehavioral laboratory battery to measure child ER, assessing emotion understanding, strategy use, attention regulation and inhibitory control, and parasympathetic regulation. In mothers, we will employ a similar multi-method approach to assess emotion acceptance, strategy use, recognition, and parasympathetic regulation. Finally, during each laboratory assessment, we will observe mother's ability to effectively respond to children in the context of child negative emotions. Growth curve modeling will chart child ER trajectories for all 3 groups so that we can compare child ER growth as a function of: group status (DBT Skills vs. Family Services as Usual vs. income matched, non-disordered controls), changes in maternal ER, and changes in maternal emotion socialization. Findings from this proposal will identify a modifiable pathway by which offspring of mothers with BPD are at risk, determine the extent to which child ER can be restored by treating mothers, and will be the first DBT Skills trial to measure outcomes in offspring.

边缘型人格障碍是一种严重的精神疾病，其特征是极端的情绪，混乱， 人际关系，自杀行为，以及自我意识差。边缘型母亲的后代 人格障碍（BPD）在整个生命周期中患精神疾病的风险很高。困难 情绪管理是BPD的一个标志性特征，然而，这样做的能力是回应的必要条件。 有效地影响孩子的情绪。这一过程被称为母亲的情感社会化， 影响儿童如何发展自己的情绪调节（ER）技能。ER在学龄前发育迅速 而学前ER的缺陷被认为是潜在的未来精神障碍。该提案将测试A 模型检查母亲ER和情绪社会化影响儿童ER的程度，这可能是一个 这是一个重要的途径，精神健康问题通过这一途径传播给患有BPD的母亲的后代。这 建议将利用辩证行为疗法（DBT）技能培训，一个强大的和有效的方法， 改善ER作为改变BPD母亲ER的工具。通过完成多项评估， 儿童和母亲ER的生物行为标志物，这项研究准备揭示一个潜在的可修改的途径 这些后代处于危险之中。具体来说，我们建议进行分层随机对照试验 为有学龄前儿童的BPD母亲提供DBT技能。共300对夫妇（初始儿童年龄：36-48岁 将在俄勒冈州的尤金和宾夕法尼亚州的匹兹堡收集100对 组：母亲患有BPD并接受DBT技能的儿童，母亲患有BPD的儿童 接受家庭服务的儿童，以及母亲没有疾病的儿童，收入相匹配， 最后一组仅参与评估（以量化标准ER生长）。所有儿童都 每4个月评估4次，第一次评估发生在治疗分配之前。我们将 使用生物行为实验室电池来测量儿童ER，评估情绪理解，策略使用， 注意力调节和抑制控制，以及副交感神经调节。在母亲中，我们将使用类似的 多方法方法评估情绪接受，策略使用，识别和副交感神经 调控最后，在每次实验室评估期间，我们将观察母亲有效应对的能力 在儿童负面情绪的背景下。生长曲线建模将绘制所有儿童的ER轨迹 3组，以便我们可以比较儿童ER生长作为一个功能：组状态（DBT技能与家庭 服务与收入匹配，非疾病对照），孕产妇ER的变化， 母亲情感社会化这项提案的发现将确定一种可改变的途径， 的BPD母亲有风险，确定通过治疗母亲可以恢复儿童ER的程度， 这将是第一个DBT技能试验，以衡量后代的结果。