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

项目摘要 边缘型人格障碍（BPD）是一种常见的精神疾病，在大约2%到3%的人中发现。 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、自我毁灭行为、放纵和混乱的关系。事实证明， 用药物或心理疗法治疗。据报道，自杀率约为10%。在 除了边缘患者及其亲人所经历的痛苦的情感代价外， 患者的功能水平通常大大低于具有可比智力的个体， 消耗了不成比例的心理健康资源。控制情绪的困难， 目前的研究利用了最新的神经成像技术， BPD的发现，为这种疾病的心理治疗提供新的思路。 这个项目建立在我们以前的神经影像学工作的基础上，这项工作表明，当BPD患者尝试 控制他们的情绪，采用一种健康人经常使用的非常有效的方法， 与令人不安的事情保持情感距离- BPD患者无法让他们大脑中的一部分安静下来， 会发出情绪警报信号本研究的目的是确定是否给予BPD 患者在使用这种健康的距离策略方面的特殊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。我们将使用功能性磁共振成像来实现这一点， 当BPD受试者试图用疏远来减少他们对心烦意乱的情绪反应时， 图片之前的任何培训，然后让他们接受具体的培训，在距离战略。在此之后 训练中，我们将再次获得功能性磁共振成像扫描，以确定他们的大脑激活模式是否正常化 以及他们是否能够更好地减少他们对图片的负面反应。如果这是有效的， 将表明这种训练可以帮助BPD患者更好地调节他们的情绪，并将支持一个项目， 进一步发展远程培训并将其纳入BPD患者的心理治疗中。 本研究的第二个目的是确定BPD患者是否倾向于 当再次经历消极情况时，对它们变得越来越敏感（如增加的 大脑的情绪警报系统的活动），将减少与额外的暴露，因为它在病人 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最有效地治疗 在BPD患者的心理治疗中接近令人不安的生活经历。 该项目代表了脑成像研究的重要一步，因为它应用了从研究中获得的信息。 研究大脑活动模式来开发新的心理治疗方法。它解决了一个严重的，普遍的 难以治疗的疾病。

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.