Interpersonal Functioning and Emotion in Borderline Personality

描述（由申请人提供）：该提案是一个竞争性的延续申请，以扩展R 01 MH 56888的工作，现在的标题是“边缘人格中的人际功能和情感”。“这项工作的主要目标是详细评估边缘型人格障碍（BPD）在多个解决水平（成人依恋风格，主要社会领域的功能，日常社会互动和社会认知）的人际功能。我们建议将这项工作更明确地集中在一般假设上，即BPD的许多人际特征是通过依恋系统的适应不良功能产生的。由于依恋理论最好理解为人际关系及其与情绪调节的关系的理论，我们还增加了情绪反应和调节的新措施。我们的第一个具体目标是调查这一假设，即BPD患者的许多人际行为可以被理解为对依恋的沮丧（和沮丧）出价。为了研究BPD，依恋中断和情绪反应和调节问题之间的假设联系，我们的第二个具体目标是补充我们目前的评估与情绪信息处理的动态时间过程的心理生理评估（瞳孔测量）。我们的第三个具体目标是在一年的时间里每季度对依恋、人际功能和情绪调节进行一次重复的纵向评估，以检查它们显示的轨迹，并探索它们的相互影响。这项工作将由168名年龄在21至60岁之间的参与者组成，他们接受了多模式评估组合，包括临床访谈，自我报告问卷，心理生理评估，共识诊断会议以及从最多三名知情者那里收集的信息。我们已经扩大了我们的抽样框架，以捕获BPD严重程度的全谱使用三个分层（0-2，3-4，和5个或更多的诊断标准）在两个组（精神病患者和社区居民）。这项工作将揭示重要的机制，在成人的基础依恋，人际功能，情绪调节，以及这些结构之间的关系。识别这些机制是改进循证治疗的最佳途径，可以在日常行为水平上解决BPD中人际功能和情绪调节的障碍。

DESCRIPTION (provided by applicant): This proposal is a competing continuation application to extend the work of R01 MH56888, now titled "Interpersonal Functioning and Emotion in Borderline Personality." The primary goal of the work has been the detailed assessment of interpersonal functioning in borderline personality disorder (BPD) at multiple levels of resolution (adult attachment styles, functioning in major social domains, daily social interaction, and social cognition). We propose to focus this work more explicitly on the general hypothesis that many of the interpersonal features of BPD arise through maladaptive functioning of the attachment system. Since attachment theory is best understood as a theory of interpersonal relatedness and its relationship to emotion regulation, we have also added new measures of emotional reactivity and regulation. Our first specific aim is to investigate the hypothesis that many of the interpersonal behaviors of persons with BPD can be understood as frustrated (and frustrating) bids for attachment. To investigate hypothesized links between BPD, disruptions in attachment, and problems in emotional reactivity and regulation, our second specific aim is to supplement our current evaluations with psychophysiological assessments (pupillometry) of the dynamic time course of emotional information processing. Our third specific aim is to do repeated longitudinal assessment of attachment, interpersonal functioning, and emotion regulation over a one-year period at quarterly intervals in order to examine the trajectories they display and to explore their reciprocal influences. The work will be done with a sample of 168 participants aged 21 to 60 receiving a multimodal assessment battery including clinical interviews, self-report questionnaires, psychophysiological assessments, consensus diagnostic conferences, and information collected from up to three informants. We have expanded our sampling frame to capture the full spectrum of BPD severity using three strata (0-2, 3-4, and 5 or more diagnostic criteria) in two groups (psychiatric patients and community residents). The work will reveal important mechanisms in adults underlying attachment, interpersonal functioning, emotion regulation, and the relationships between these constructs. The identification of such mechanisms is the best way forward to improved, evidence-based treatments that can address impairments in interpersonal functioning and emotion regulation in BPD at the level of day-to-day behavior.