Interpersonal Functioning and Emotion in Borderline Personality

描述（由申请人提供）：本提案是一份修订的竞争性续期申请，以扩展我们目前资助的项目，R01 MH056888，“边缘型人格中的人际功能和情感”。基于我们之前的研究结果，我们继续认为依恋理论是理解边缘型人格障碍（BPD）人际功能的最佳框架。在BPD中，焦虑、矛盾的依恋以一种独特的形式出现——对他人频繁的失望和愤怒导致一段时间的敌意退缩，随后是对分离的孤独和恐惧，产生新的接近和和解的尝试。直到下一个挫折和失望的插曲。在这个自我挫败的循环中，关键主题是(a)与愤怒作斗争，(b)无法与他人保持一致和舒适的人际距离。我们建议从二元视角来研究这些过程，这是人格障碍研究的一个创新的新步骤。我们将从患者和恋人的角度来评估这些过程，考虑到我们早期的发现，浪漫是BPD患者的高风险领域，这与我们关于依恋机制核心作用的假设是一致的。主要目的是通过在多个分析层面评估这些现象来增强我们对BPD中这些核心机制的理解。我们将使用三种方法（在不同的“粒度”级别和不同的时间尺度上）来实现这一点

DESCRIPTION (provided by applicant): This proposal is an amended competing renewal application to extend our currently funded project, R01 MH056888, "Interpersonal Functioning and Emotion in Borderline Personality." Based on our prior results, we continue to regard attachment theory as the best framework for understanding interpersonal functioning in borderline personality disorder (BPD) In BPD, anxious, ambivalent attachment takes a distinctive form- frequent disappointments and anger toward others lead to periods of hostile withdrawal, followed by loneliness and fears regarding separation, producing new attempts at approach and reconciliation, which continue until the next episode of frustration and disappointment. The key themes in this self-defeating cycle are (a) struggles with anger and (b) an inability to maintain a consistent and comfortable interpersonal distance from others. We propose to examine these processes from a dyadic perspective-an innovative, new step for research on personality disorders. We will assess these processes from the perspectives of both the patient and a romantic partner, given our earlier findings that romance is a high-risk domain for patients with BPD, consistent with our assumption about the central role of attachment mechanisms. The major objective is to enhance our understanding of these central mechanisms in BPD by assessing these phenomena at multiple levels of analysis. We will use three methods (at different levels of "granularity" and with different time scales) to achieve this objective. First, we will conduct a dyadic laboratory interaction involving a discussion of a currently troublesome and unresolved issue in the relationship. The interaction will be coded for both affect and behavior using the Specific Affect Coding System (SPAFF), and measures of peripheral psychophysiology will be recorded. Second, we will use a dyadic, ecological momentary assessment (EMA) protocol completed simultaneously by participant and partner for three weeks. Finally, we will include a social network analysis of the 25 most emotionally significant figures for the participant (and partner) during the past year. Our first specific aim s to document that patients with BPD (n = 55 dyads) have higher mean levels of anger, greater variability in anger, and a stronger association between threats to attachment and anger compared to patients with other PDs (OPD, n = 55 dyads) or no PD (n = 55 dyads). Our second specific aim is to document that patients with BPD display greater variability in interpersonal distance compared to patients with other PDs or no PD. Our third specific aim is to document that these effects regarding anger and interpersonal distance are moderated by the characteristics and behavior of partners, especially their own attachment anxiety. The work will be done with a total sample of 165 dyads consisting of men and women between the ages of 18 and 40. We believe that incorporating dyadic assessment (together with continued attention to the broader social networks in which both partners are embedded) is the best way forward to improved, evidence-based treatments that can address interpersonal functioning at the level of day-to-day transactions.