Developing mixed-latent-state-trait-models to analyse the temporal characteristics of affect and self-esteem in borderline personality disorder

情感不稳定被认为是边缘性人格障碍(BPD)患者的核心病理，ICD-10甚至将BPD列为情绪不稳定人格障碍的类别。令人惊讶的是，最近使用电子日记评估随着时间推移的情感的工作并没有揭示情感不稳定是一种特定于障碍的机制，就像其他障碍确实会被类似的不稳定所打动一样。因此，有人假设，对情感和自尊之间的动态相互作用进行静态建模对于区分跨诊断机制和障碍专有机制是必要的。更详细地说，为了更好地了解BPD患者日常生活中的情绪不稳定，我们必须动态模拟情绪和自尊随时间的变化，此外还考虑到情绪变化事件、对这些事件的反应性以及特定的情绪调节机制，如自残行为。因此，统计模型是必要的，它允许：a)分解随机和真实的可变性，b)同时对情感过程的多个子成分进行建模，c)在情感反应和调节过程中对受试者和群体特定的差异进行建模，以及d)能够对心理测量学特性和所使用的抽样策略的适当性进行估计。因此，我们的资助方案遵循两个主要策略：临床目标是同时对情感和自尊的动态特征进行建模，包括它们的相互作用和具体的调节机制。我们将使用电子日记来评估125名BPD患者、125名焦虑症患者以及125名健康对照的情绪、自尊和日常生活中特定的调节策略。我们确实假设，情感和自尊的协变是BPD特有的，而且自残行为是通过同步增加的负面情绪和降低的自尊来预测的。由于目前的统计模型对这类分析的限制，我们的第二个主要目标是开发和系统地测试先进的统计模型。具体地说，我们将把普通的混合潜伏态特质模型扩展到multigroup-multitrait-mixed-autoregressive-latent-state-trait-growth-curve-models.除此之外，我们将使用蒙特卡罗模拟研究来调查在哪些前提条件下这些模型在非卧床评估研究中是卓有成效的。

Affective instability is hypothesized to be the core pathology in patients with borderline personality disorder (BPD) and the ICD-10 even lists BPD under the category of emotionally unstable personality disorders. Surprisingly, recent work using e-diaries to assess affect over time did not reveal affective instability as a disorder-specific mechanism, as other disorders did impress by similar instability. Accordingly, it has been hypothesized that statically modeling the dynamic interplay between affect and self-esteem is necessary to discriminate between transdiagnostic and disorder-specific mechanisms. In more details, to better understand affective instability in daily life in patients with BPD we have to dynamically model affect and self-esteem over time, taking additionally into account affect-changing events, reactivity to these events, as well as specific affect regulation mechanisms, like self-mutilating behavior. Therefore statistical models are necessary which allow: a) decomposing random from true variability, b) modeling multiple subcomponents of affective processes at the same time, c) modeling between-subject and group-specific differences in affective response and regulation processes, as well as d) enabling estimations on psychometric properties and the appropriateness of the sampling strategies used.Accordingly our grant proposal follows two main strategies: The clinical goal is to simultaneously model the dynamical characteristics of affect and self-esteem including their interplay and specific regulation mechanisms. We will use electronic diaries to assess affect, self-esteem, and specific regulation strategies in everyday life in 125 patients with BPD, 125 patients with anxiety disorders, as well as 125 healthy controls. We do hypothesize that the covariation of affect and self-esteem is specific for BPD as well as that self-mutilating behavior is predicted by a synchronous increasing negative affect and decreasing self-esteem. As current statistical models are limited for this kind of analyses, our second main goal is to develop and systematically test advanced statistical models. In details, we will expand ordinary mixed-latent-state-trait-models to multigroup-multitrait-mixed-autoregressive-latent-state-trait-growth-curve-models. Beyond that, we will use Monte Carlo simulations studies to investigate under which preconditions these models are fruitful usable in ambulatory assessment research.