Testing a Biosocial Model of Borderline Personality Features in Youth

项目摘要 边缘型人格障碍（BPD）是一种复杂的、使人衰弱的障碍，与明显的 社会功能障碍、频繁的自杀行为和高治疗利用率。虽然传统上 在成年期诊断，BPD的突出模型将BPD的发育起源追溯到童年。 越来越多的证据表明，BPD的特征可能出现在儿童时期，预测不良的功能结果 除了更常见的儿童心理健康问题（例如，抑郁焦虑注意力 缺陷/多动障碍和行为问题）以及BPD发展为 青春期和成年期。然而，很少有工作研究BPD特征的神经机制， 这阻碍了识别和针对BPD风险最高的青年的努力。有患BPD风险的青少年 在NIMH RDoC领域的认知控制和依恋和归属证明赤字。在自我- 报告和行为水平，具有BPD特征的青年显示出反应抑制的缺陷， 这是认知控制的一个方面，它涉及到抑制一种占优势的行动冲动的能力。之类似的还有 还有一些证据，在行为和自我报告的水平上，社会处理的缺陷是核心， 具有BPD特征的个体的依恋和归属困难。对社会排斥的敏感性是 BPD干预的临床重点，虽然同时发生的情绪和焦虑困难也有助于 抑制灵敏度新的研究表明，在社会接受过程中， BPD患者，特别是难以调节对接受线索的反应。应对赤字 在神经生理学水平上，抑制和社会接受过程在青年中被可靠地引出 使用来自脑电图（EEG）的事件相关电位（ERP），尽管他们没有 专门用于检查BPD功能的机制。注意神经生理机制 BPD的潜在风险可能为减少BPD的社会和个人负担提供重要的见解。为此 工作，将招募100名女孩（10-13岁）的样本。大多数女孩（n=70）将从两个 临床多样化的精神病门诊，而其余（n=30）女孩将是健康对照，没有 精神病理学史反应抑制和社会接纳的神经生理学评估 处理将被管理，并在反应抑制和社会接受过程中进行测量。 神经生理学水平将作为BPD特征生长的潜在机制进行测试，6和12个月后 初步评估。最后，严厉的父母和同伴受害将被探讨为调节器， 反应抑制、社会接受处理和BPD特征增长之间的关联。结果 这项工作将验证评估青年BPD特征的实用性，并提供有关机制的证据 这可以在早期干预中针对处于BPD发展高风险的青少年。

Project Summary Borderline personality disorder (BPD) is a complex and debilitating disorder associated with pronounced social dysfunction, frequent suicidal behavior, and high rates of treatment utilization. Although traditionally diagnosed in adulthood, prominent models of BPD trace the developmental origins of BPD back to childhood. There is mounting evidence that features of BPD may emerge in childhood, predicting poor functional outcomes beyond more commonly diagnosed childhood mental health problems (e.g., depression, anxiety, attention- deficit/hyperactivity disorder, and conduct problems) as well as high risk for the development of BPD into adolescence and adulthood. Yet, very little work has examined neural mechanisms underlying BPD features in youth, hindering efforts to identify and target those youth at highest risk for BPD. Youth at risk for BPD demonstrate deficits in the NIMH RDoC domains of Cognitive Control and Attachment and Affiliation. At the self- report and behavioral level, youth with BPD features have been shown to display deficits in response inhibition, one aspect of Cognitive Control, which involves the ability to suppress a prepotent urge to act. Similarly, there is also some evidence, at the behavioral and self-report level, that deficits in social processing are central to the Attachment and Affiliation difficulties of individuals with BPD features. Sensitivity to social rejection is a primary clinical focus in intervention for BPD, although co-occurring mood and anxiety difficulties also contribute to rejection sensitivity. Emerging work suggests unique alterations in social acceptance processing among individuals with BPD, particularly difficulties modulating responses to acceptance cues. Deficits in response inhibition and social acceptance processing have been reliably elicited in youth at the neurophysiological level using event-related potentials (ERPs) derived from the electroencephalogram (EEG), although they have not specifically been used to examine mechanisms of BPD features. Attention to neurophysiological mechanisms underlying risk for BPD may offer critical insight into reducing the societal and personal burden of BPD. For this work, a sample of 100 girls (ages 10-13) will be recruited. The majority of girls (n=70) will be recruited from two clinically diverse outpatient psychiatry clinics, while the remaining (n=30) girls will be healthy controls without a history of psychopathology. Neurophysiological assessments of response inhibition and social acceptance processing will be administered, and response inhibition and social acceptance processing measured at the neurophysiological level will be tested as mechanisms underlying growth in BPD features 6 and 12 months after the initial assessment. Lastly, harsh parenting and peer victimization will be explored as moderators of associations between response inhibition, social acceptance processing, and growth in BPD features. Results from this work will validate the utility of assessing BPD features in youth and provide evidence on mechanisms that can be targeted in early intervention for youth at high risk for the development of BPD.