An fMRI Study of the Enhancement of Emotion Regulation in Borderline Patients

项目摘要 交界性人格障碍(BPD)是一种常见的精神障碍，大约2%到 6%的人口和20%的住院精神病患者。它的特点是激烈和迅速 情绪变化、自毁行为、助人为乐和动荡的关系。事实证明，很难做到 要么用药物治疗，要么用心理治疗。据报道，自杀率约为10%。在……里面 除了边缘患者和他们所爱的人所经历的痛苦的情感代价外，BPD 患者的功能水平通常大大低于智力相当的人，而且他们 消耗不成比例的心理健康资源。控制情绪的困难，如此核心 事实证明，这种疾病尤其难以治疗。目前的研究使用了最新的神经成像技术 在BPD上的发现为精神障碍的心理治疗创造了新的想法。 这个项目建立在我们之前的神经成像工作的基础上，这项工作表明，当BPD患者尝试 通过使用健康人经常使用的一种非常有效的方法来控制他们的情绪--采取一种 与令人心烦意乱的事情保持情感距离-BPD患者无法使他们大脑中 发出情绪警报信号。本研究的目的是确定是否给予bpd 患者使用这种健康的距离训练可以帮助他们提高他们的能力 调节他们的情绪，使他们的大脑活动恢复到更正常的模式。我们将通过使用fMRI来实现这一点 记录BPD受试者的大脑活动，试图通过疏远来减少他们对烦恼的情绪反应 在任何训练之前，让他们接受关于距离策略的具体训练。在这之后 训练我们将再次获得功能磁共振扫描，以确定他们的大脑激活模式是否已正常化 以及他们是否能够更好地减少对这些照片的负面反应。如果这是有效的，它 将表明，这样的培训可以帮助BPD患者更好地调节他们的情绪，并将支持一项计划 进一步发展并将疏远训练纳入BPD患者的心理治疗。 本研究的第二个目标是确定BPD患者是否倾向于 当再次经历负面情况时，对它们变得越来越敏感(如增加的 大脑情绪警报系统的活动)，会随着额外的暴露而减少，就像在患有 恐惧症，或将继续增加。了解这一点可以帮助治疗师计划如何在治疗中 探讨BPD患者心理治疗中的扰乱生活体验。 这个项目代表了脑成像研究的重要一步，因为它应用了所学到的信息 关于大脑活动模式的研究，以开发新的心理治疗方法。它解决了一个严重的、普遍存在的 而且很难治疗疾病。

Project Summary Borderline Personality Disorder (BPD) is a common psychiatric disorder found in approximately 2% to 6% of the population and 20% of hospitalized psychiatric patients. It is characterized by intense and rapid mood changes, self-destructive behavior, sucidality, and tumultuous relationships. It has proved very difficult to treat with either medications or psychotherapy. Suicide rates of approximately 10% have been reported. In additional to the emotional costs of the suffering experienced by borderline patients and their loved ones, BPD patients typically function at a level substantially below that of individuals with comparable intellect and they consume a disproportionate share of mental health resources. The difficulty controlling emotion, so central to the disorder, has proved a particularly difficult to treat. The present study utilizes the latest neuroimaging findings in BPD to generate new ideas for the psychotherapy of the disorder. This project builds upon our previous neuroimaging work, which has shown that when BPD patients try to control their emotions by employing a method that healthy people frequently use quite effectively -- taking an emotional distance from what is upsetting - BPD patients are not able to quiet down the part of their brain that sends out emotional alarm signals. The objective of the present study is to determine whether giving BPD patients special training in using this healthy distancing stragegy can help them to improve their ability to regulate their emotions and return their brain activity to a more normal pattern. We will do this by using fMRI to record brain activity as BPD subjects try to use distancing to reduce their emotional reactions to upsetting pictures before any training, then to have them receive specific training in the distancing strategy. After this training we will again obtain an fMRI scan to determine whether their pattern of brain activation has normalized and whether they have been able to better reduce their negative reactions to the pictures. If this is effective, it will show that such training may help BPD patients better regulate their emotions and would support a program to further develop and incorporate distancing training into the psychotherapy of BPD patients. A second objective of the present study is to determine whether the tendancy of BPD patients to become increasingly sensitized to negative situations when they are re-experienced (as shown by increased activity of the brain's emotional alarm system), will reduce with additional exposure, as it does in patients with phobias, or will continue to increase. Knowing this can help the therapist plan how to most therapeutically approach disturbing life experiences in the psychotherapy of BPD patients. This project represents an important step in brain imaging research since it applies information learned about brain activity patterns to develop new approaches to psychotherapy. It addresses a serious, prevalent and difficult to treat disorder.