INTRANASAL OXYTOCIN TREATMENT OF BORDERLINE PERSONALITY DISORDER

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 研究中心，而研究中心不一定是研究者所在的机构。 精神障碍诊断和统计手册（第4版）（DSM IV-TR 2000）将BPD分类为轴II群集B人格障碍。 BPD的DSM IV标准包括情感不稳定、冲动冒险行为、不适当和强烈的愤怒、在理想化和贬值之间迅速转变的不稳定关系、不稳定的自我形象、空虚感、解离体验、自我伤害行为，如浅表皮肤切割或烧伤，以及多次自杀企图（DSM IV-TR 2000）。 将BPD指定为轴II型人格障碍反映了历史概念，即人格障碍是心理和发展根源，而不是生物学基础和遗传决定的，如轴I障碍。最近，BPD和人格障碍的替代概念已经出现，为BPD治疗中使用药物提供了理论依据。本提案的目的是通过为期6周的随机安慰剂对照试验，在40名成年受试者中确定鼻内催产素作为治疗边缘型人格障碍（BPD）的一线单药治疗的疗效。 假设： 主要治疗假设： 1. 根据ZAN-BPD和CGI-I测量，催产素在治疗BPD的总体严重程度方面上级安慰剂。 次要治疗假设： 1. 催产素在其他治疗结果指标方面上级安慰剂。 2. 催产素在改善功能障碍方面上级安慰剂，如通过希恩残疾量表测量的。 探索性假设： 1. 我们将试点使用事件相关记录（ECR），以自然的方式评估BPD成人治疗过程中情绪和社会功能的变化。 挑战假设： 1. 催产素在增强情绪调节和情绪处理能力方面上级安慰剂，如情绪调节任务、对接受/拒绝的注意偏向任务和对动态情绪表达的感知任务所证明的。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The Diagnostic and Statistical Manual of Mental Disorders (4th Edition) (DSM IV-TR 2000) classifies BPD as an Axis II Cluster B Personality Disorder. DSM IV criteria for BPD include affective instability, impulsive risk taking behavior, inappropriate and intense anger, unstable relationships that rapidly shift between idealization and devaluation, unstable self image, feelings of emptiness, dissociative experiences, self injurious behavior such as superficial skin cutting or burning, and multiple suicide attempts (DSM IV-TR 2000). The designation of BPD as an Axis II personality disorder reflects the historical conceptualization that personality disorders are psychologically and developmentally rooted, rather than biologically based and genetically determined such as the Axis I disorders. More recently, alternative conceptualizations of BPD and personality disorders have arisen, lending theoretical rationale for the use of medications in the treatment of BPD. The goal of this proposal is to determine the efficacy of intranasal oxytocin as a first-line monotherapy in the treatment of Borderline Personality Disorder (BPD), via a 6-week, randomized, placebo-controlled trial in 40 adult participants over a two year period. Hypothesis: Primary Treatment Hypothesis: 1. Oxytocin will be superior to placebo in treating global severity of BPD, as measured by the ZAN-BPD and the CGI-I. Secondary Treatment Hypotheses: 1. Oxytocin will be superior to placebo in other treatment outcome measures. 2. Oxytocin will be superior to placebo in improving functional disability, as measured by the Sheehan Disability Scale. Exploratory Hypothesis: 1. We will pilot the use of Event Contingent Recording (ECR) to assess changes in mood and social functioning over the course of treatment in adults with BPD in a naturalistic fashion. Challenge Hypotheses: 1. Oxytocin will be superior to placebo in enhancing emotional regulation and emotional processing capacity, as evidenced by the Emotion Regulation Task, the Attentional Bias to Acceptance/Rejection Task, and the Perception of Dynamic Emotion Expressions Task.