Rejection sensitivity and self-regulation in personality disorders

描述（由申请人提供）：众所周知，健康的社会关系促进身心健康。不幸的是，有些人发现人际关系难以承受，并以弄巧成拙的方式科普，其中的极端形式表现为边缘型（BPD）和回避型（APD）人格障碍。BPD的特点是不稳定的关系，包括愤怒，冲动和自我伤害的反应，拒绝的威胁。APD的特点是普遍和自我破坏的情况和角色，需要潜在的拒绝暴露回避。我们的目标是通过对两种社会认知倾向的基本人格研究来促进对产生这些衰弱性疾病的过程的认识：（1）拒绝敏感性（RS）是焦虑地期待，容易感知和强烈反应拒绝的倾向。(2)自我调节能力是一种努力克服自动反应的能力，有利于不那么主导但更适当的反应。先前的研究表明，在RS高的人中，拒绝线索迅速自动地使他们做好准备，以检测并做出强烈反应来阻止拒绝。这种潜在的适应性威胁反应系统，如果在需要反思的情况下被不加选择地激活，战略行为或威胁最小时，可能会变得适应不良。虽然BPD和APD都涉及高RS，但BPD的特点是管理对社会联系的强烈需求沿着对拒绝的强烈恐惧的失调后果。拟议的研究探讨RS和监管能力如何相互作用，影响社会威胁处理动态和精神症状，这些疾病。从社区招募的BPD（n = 50）和APD（n = 50）患者将与两组无人格障碍的患者进行比较，一组为重度抑郁症患者，另一组为无人格障碍患者。该研究涉及（a）实验室范例的独特组合，可以对BPD和APD症状的if & then过程进行细粒度分析，以及（B）21天的经验采样日记，将显示这些过程如何与日常生活中的精神症状相关。目的1是评估BPD或APD患者是否以反映高RS的方式选择性地注意，感知和反应社会线索。目的2是评估与APD和BPD相关的监管能力方面，并确定它们如何防止RS产生的个人和人际关系困难。边缘型（BPD）和回避型（APD）人格障碍是与严重功能障碍相关的严重疾病，在BPD的情况下，自我伤害的冲动和冲动行为往往会导致非常高的医疗费用。通过澄清这些疾病的衰弱症状出现的具体过程，这项研究将改善评估程序，并为旨在减少这些疾病对个人和社会的影响的科学合理的干预措施提供基础。

DESCRIPTION (provided by applicant): It is well known that healthy social relationships foster mental and physical health. Unfortunately, some people find relationships overwhelming and cope in self-defeating ways, extreme forms of which are captured in Borderline (BPD) and Avoidant (APD) Personality Disorders. BPD is characterized by volatile relationships involving angry, impulsive and self-injurious reactions to the threat of rejection. APD is characterized by pervasive and self-undermining avoidance of situations and roles entailing potential exposure to rejection. Our goal is to advance knowledge of processes that generate these debilitating disorders by building on basic personality research on two social-cognitive dispositions: (1) Rejection sensitivity (RS) is the disposition to anxiously expect, readily perceive, and intensely react to rejection. (2) Self-regulatory competency is the ability to effortfully override automatic reactions in favor of less dominant but more appropriate responses. Prior work shows that, in people high in RS, rejection cues rapidly and automatically prepare them to detect and to react intensely to forestall rejection. This potentially adaptive threat-response system can become maladaptive if activated indiscriminately in situations that require reflective, strategic behavior or when the threat is minimal. While both BPD and APD involve high RS, BPD alone is characterized by the dysregulating consequences of managing an intense need for social connection along with an intense fear of rejection. The proposed research examines how RS and regulatory competency interact to influence social threat processing dynamics and psychiatric symptoms in these disorders. Persons with BPD (n = 50) and APD (n = 50) recruited from the community and assessed with diagnostic interviews will be compared with two groups without personality disorders -- one group with Major Depression and one with no disorders. The research involves a unique combination of (a) experimental laboratory paradigms that enable fine-grained analyses of if & then processes underlying BPD and APD symptoms, and (b) a 21-day experience-sampling diary that will show how these processes relate to psychiatric symptoms in daily life. Aim 1 is to assess whether individuals with BPD or APD selectively attend to, perceive, and react to social cues in ways that reflect high RS. Aim 2 is to assess aspects of regulatory competency relevant to APD and BPD and to determine how they protect against the personal and interpersonal difficulties generated by RS. Borderline (BPD) and Avoidant (APD) Personality Disorders are serious disorders associated with severe functional impairment, and in the case of BPD, self-injurious urges and impulsive behaviors that often incur very high healthcare costs. By clarifying the specific processes by which the debilitating symptoms of these disorders emerge, this research will improve assessment procedures and provide a foundation for scientifically justified interventions intended to reduce the toll of these disorders on individuals and society.