Rejection sensitivity and self-regulation in personality disorders

人格障碍中的拒绝敏感性和自我调节

• 批准号: 7892976
• 负责人: Geraldine A Downey
• 金额: $ 39.6万
• 依托单位: COLUMBIA UNIV NEW YORK MORNINGSIDE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-27 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7892976
• 关键词: Accounting; Address; Affect; Affective; Aggressive behavior; Alcohol or Other Drugs use; Anger; Attenuated; Basic Science; Behavior; Behavioral inhibition; Binge Eating; Borderline Personality Disorder; Bronchopulmonary Dysplasia; Cereals; Clinical; Cognitive; Communities; Cues; Data; Diagnosis; Diagnostic; Disease; Equilibrium; Exposure to; Fostering; Foundations; Fright; Funding; Goals; Health Care Costs; Impulsive Behavior; Individual; Informal Social Control; Intervention; Interview; Knowledge; Laboratories; Life; Major Depressive Disorder; Methods; Modeling; Monitor; Moods; Ointments; Patient Self-Report; Personality; Personality Disorders; Persons; Prevention; Problem Solving; Procedures; Process; Process Assessment; Psyche structure; Punishment; Questionnaires; Reaction; Readiness; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Rewards; Risk; Role; Sampling; Self-Injurious Behavior; Societies; Specificity; Stress; Symptoms; System; Testing; Translational Research; Withdrawal; Work; base; clinically relevant; comparison group; coping; diaries; executive function; experience; flexibility; functional disability; high risk; improved; in vivo; indexing; interest; physical conditioning; prevent; response; sex; social

DESCRIPTION (provided by applicant): It is well known that healthy social relationships foster mental and physical health. Unfortunately, some people find relationships overwhelming and cope in self-defeating ways, extreme forms of which are captured in Borderline (BPD) and Avoidant (APD) Personality Disorders. BPD is characterized by volatile relationships involving angry, impulsive and self-injurious reactions to the threat of rejection. APD is characterized by pervasive and self-undermining avoidance of situations and roles entailing potential exposure to rejection. Our goal is to advance knowledge of processes that generate these debilitating disorders by building on basic personality research on two social-cognitive dispositions: (1) Rejection sensitivity (RS) is the disposition to anxiously expect, readily perceive, and intensely react to rejection. (2) Self-regulatory competency is the ability to effortfully override automatic reactions in favor of less dominant but more appropriate responses. Prior work shows that, in people high in RS, rejection cues rapidly and automatically prepare them to detect and to react intensely to forestall rejection. This potentially adaptive threat-response system can become maladaptive if activated indiscriminately in situations that require reflective, strategic behavior or when the threat is minimal. While both BPD and APD involve high RS, BPD alone is characterized by the dysregulating consequences of managing an intense need for social connection along with an intense fear of rejection. The proposed research examines how RS and regulatory competency interact to influence social threat processing dynamics and psychiatric symptoms in these disorders. Persons with BPD (n = 50) and APD (n = 50) recruited from the community and assessed with diagnostic interviews will be compared with two groups without personality disorders -- one group with Major Depression and one with no disorders. The research involves a unique combination of (a) experimental laboratory paradigms that enable fine-grained analyses of if & then processes underlying BPD and APD symptoms, and (b) a 21-day experience-sampling diary that will show how these processes relate to psychiatric symptoms in daily life. Aim 1 is to assess whether individuals with BPD or APD selectively attend to, perceive, and react to social cues in ways that reflect high RS. Aim 2 is to assess aspects of regulatory competency relevant to APD and BPD and to determine how they protect against the personal and interpersonal difficulties generated by RS. Borderline (BPD) and Avoidant (APD) Personality Disorders are serious disorders associated with severe functional impairment, and in the case of BPD, self-injurious urges and impulsive behaviors that often incur very high healthcare costs. By clarifying the specific processes by which the debilitating symptoms of these disorders emerge, this research will improve assessment procedures and provide a foundation for scientifically justified interventions intended to reduce the toll of these disorders on individuals and society.

描述（由申请人提供）：众所周知，健康的社会关系可以促进身心健康。不幸的是，有些人发现人际关系难以承受，并以弄巧成拙的方式应对，其中极端形式表现为边缘型（BPD）和回避型（APD）人格障碍。边缘性人格障碍的特点是关系不稳定，涉及对拒绝威胁的愤怒、冲动和自残反应。 APD 的特点是普遍且自我破坏地回避可能遭受拒绝的情境和角色。我们的目标是通过建立对两种社会认知倾向的基本人格研究来增进对产生这些衰弱性疾病的过程的了解：（1）拒绝敏感性（RS）是一种焦急地期待、容易感知并对拒绝做出强烈反应的倾向。 (2) 自我调节能力是指努力克服自动反应，转而采取不太占主导地位但更适当的反应的能力。先前的研究表明，在 RS 水平高的人中，拒绝信号会迅速并自动地让他们做好检测并做出强烈反应以阻止拒绝的准备。如果在需要反思、战略行为或威胁最小的情况下不加区别地激活，这种潜在的自适应威胁响应系统可能会变得适应不良。虽然 BPD 和 APD 都涉及高 RS，但 BPD 本身的特点是管理对社交联系的强烈需求以及对拒绝的强烈恐惧所带来的失调后果。拟议的研究探讨了 RS 和监管能力如何相互作用，以影响这些疾病中的社会威胁处理动态和精神症状。从社区招募并通过诊断访谈进行评估的 BPD (n = 50) 和 APD (n = 50) 患者将与两组没有人格障碍的人进行比较——一组患有重度抑郁症，另一组没有人格障碍。该研究涉及 (a) 实验实验室范式的独特组合，可以对 BPD 和 APD 症状的 if & then 过程进行细粒度分析；(b) 21 天的经验采样日记，将显示这些过程与日常生活中的精神症状之间的关系。目标 1 是评估 BPD 或 APD 患者是否有选择性地关注、感知和反应社会线索，以反映高 RS。目标 2 是评估与 APD 和 BPD 相关的监管能力的各个方面，并确定它们如何防止 RS 产生的个人和人际困难。边缘型 (BPD) 和回避型 (APD) 人格障碍是与严重功能障碍相关的严重疾病，对于 BPD，自残冲动和冲动行为往往会产生非常高的医疗费用。通过阐明这些疾病的衰弱症状出现的具体过程，这项研究将改进评估程序，并为旨在减少这些疾病对个人和社会造成的损失的科学合理的干预措施提供基础。