Interpersonal Functioning and Emotion in Borderline Personality

描述（由申请人提供）：本提案是R01 MH56888工作的竞争性延续申请，现在标题为“边缘型人格中的人际功能和情感”。本研究的主要目的是对边缘型人格障碍（BPD）的人际功能进行多层次的详细评估（成人依恋类型、主要社会领域的功能、日常社会互动和社会认知）。我们建议将这项工作更明确地集中在一般假设上，即BPD的许多人际特征是由依恋系统的不适应功能引起的。由于依恋理论最好被理解为人际关系及其与情绪调节关系的理论，我们还增加了新的情绪反应和调节措施。我们的第一个具体目标是调查这样一个假设，即BPD患者的许多人际行为可以被理解为对依恋的沮丧（和令人沮丧的）请求。为了研究BPD、依恋中断和情绪反应和调节问题之间的假设联系，我们的第二个具体目标是用情绪信息处理动态时间过程的心理生理评估（瞳孔测量法）来补充我们目前的评估。我们的第三个具体目标是在一年的时间里，每季度对依恋、人际功能和情绪调节进行反复的纵向评估，以检查它们所显示的轨迹，并探索它们的相互影响。这项工作将以168名年龄在21岁至60岁之间的参与者为样本，接受多模式评估，包括临床访谈、自我报告问卷、心理生理评估、共识诊断会议，以及从最多三名举报人那里收集的信息。我们扩展了我们的抽样框架，在两组（精神病患者和社区居民）中使用三个层次（0-2、3-4和5个或更多诊断标准）来捕获BPD严重程度的全谱。这项工作将揭示成人潜在依恋、人际功能、情绪调节的重要机制，以及这些结构之间的关系。这种机制的识别是改进的最佳途径，以证据为基础的治疗可以在日常行为水平上解决BPD的人际功能和情绪调节障碍。

DESCRIPTION (provided by applicant): This proposal is a competing continuation application to extend the work of R01 MH56888, now titled "Interpersonal Functioning and Emotion in Borderline Personality." The primary goal of the work has been the detailed assessment of interpersonal functioning in borderline personality disorder (BPD) at multiple levels of resolution (adult attachment styles, functioning in major social domains, daily social interaction, and social cognition). We propose to focus this work more explicitly on the general hypothesis that many of the interpersonal features of BPD arise through maladaptive functioning of the attachment system. Since attachment theory is best understood as a theory of interpersonal relatedness and its relationship to emotion regulation, we have also added new measures of emotional reactivity and regulation. Our first specific aim is to investigate the hypothesis that many of the interpersonal behaviors of persons with BPD can be understood as frustrated (and frustrating) bids for attachment. To investigate hypothesized links between BPD, disruptions in attachment, and problems in emotional reactivity and regulation, our second specific aim is to supplement our current evaluations with psychophysiological assessments (pupillometry) of the dynamic time course of emotional information processing. Our third specific aim is to do repeated longitudinal assessment of attachment, interpersonal functioning, and emotion regulation over a one-year period at quarterly intervals in order to examine the trajectories they display and to explore their reciprocal influences. The work will be done with a sample of 168 participants aged 21 to 60 receiving a multimodal assessment battery including clinical interviews, self-report questionnaires, psychophysiological assessments, consensus diagnostic conferences, and information collected from up to three informants. We have expanded our sampling frame to capture the full spectrum of BPD severity using three strata (0-2, 3-4, and 5 or more diagnostic criteria) in two groups (psychiatric patients and community residents). The work will reveal important mechanisms in adults underlying attachment, interpersonal functioning, emotion regulation, and the relationships between these constructs. The identification of such mechanisms is the best way forward to improved, evidence-based treatments that can address impairments in interpersonal functioning and emotion regulation in BPD at the level of day-to-day behavior.