Preschooler emotion regulation in the context of maternal borderline personality disorder

边缘性人格障碍是一种以极端情绪、混乱为特征的严重精神疾病 人际关系、自杀行为和自我意识差。边缘母亲的后代 人格障碍(BPD)在一生中患精神疾病的风险增加。难度 管理情绪是BPD的一个标志性特征，但这样做的能力对于回应来说是必要的 有效地激发了孩子们的情绪。这个过程被称为母性情绪社会化，它有一个主要的 对孩子如何发展他们自己的情绪调节(ER)技能的影响。急诊室在学龄前发育迅速 学龄前ER缺陷被认为是潜在的未来精神障碍。这项提案将考验一项 检验母亲ER和情绪社会化对儿童ER的影响程度的模型，这可能是一个 精神健康问题向患有BPD的母亲的后代传播的重要途径。这 提案将利用辩证行为疗法(DBT)技能培训，这是一种强大而有效的方法 提高ER作为改变BPD母亲母体ER的工具通过完成多项评估 孩子和母亲ER的生物行为标记物，这项研究有望揭示一条潜在的可修改的途径 使这些后代处于危险之中。具体地说，我们建议进行分层随机对照试验。 为有学龄前儿童的患有BPD的母亲提供DBT技能。总共300个二元体(初始儿童年龄：36-48岁 月)将在俄勒冈州尤金和宾夕法尼亚州匹兹堡收集，每三个月各收集100双 小组：母亲患有BPD并接受DBT技能的儿童，母亲患有BPD的儿童 像往常一样接受家庭服务的人，以及母亲没有精神障碍、收入匹配的孩子， 最后一组只参加评估(以量化规范的ER增长)。所有的孩子都会 每4个月评估4次，第一次评估发生在治疗分配之前。我们会 使用生物行为实验室电池测量儿童ER，评估情绪理解，策略使用， 注意调节和抑制控制，以及副交感神经调节。对于母亲，我们将采用类似的 多方法评估情绪接受、策略使用、认知和副交感 监管。最后，在每次实验室评估中，我们将观察母亲有效应对 儿童在儿童负面情绪的背景下。生长曲线建模将为所有人绘制儿童ER轨迹 3组，以便我们可以比较儿童ER增长作为以下因素的函数：组状态(DBT技能与家庭 服务照常与收入匹配，非无序对照)，产妇ER的变化，以及 母性情感社会化。这项提案的发现将确定一种可修改的途径，即后代 患有BPD的母亲处于危险之中，确定通过治疗母亲可以在多大程度上恢复儿童ER， 这将是第一个衡量后代结果的DBT技能试验。

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.