The Feasibility and Acceptability of the Mediational Intervention for Sensitizing Caregivers for Mothers with Borderline Personality Disorder

项目摘要/摘要 现有数据表明，患有边缘性人格障碍(BPD)母亲的孩子尤其 各种不良心理社会结局的风险，部分原因是研究表明，患有 BPD很难与孩子形成安全的依恋关系。一种方法来中断 精神病理学从母亲到后代的代际传递是通过脚手架父母教养方式进行的 母亲们。虽然已经为大多数精神障碍制定了育儿计划，但人格病理学 已经落在后面了。敏感照顾者的调解干预(MISC)已被用于其他 受依恋中断影响的高危人群，并有望用于患有BPD的母亲。 然而，在MISC可以适用于患有BPD的母亲之前，首先要评估其可行性和 MISC对这一人群的可接受性。此应用程序的目标是使用Adapt-ITT模型来 评估MISC对患有BPD的母亲的可行性和可接受性，并确定应 将被纳入未来对患有BPD的母亲的MISC的适应。此应用程序的方法将 执行Adapt-ITT模型的前三个步骤。目标1(Adapt-ITT的步骤1)。量化评估 (第一阶段)将对100名患有BPD的母亲和100名患有BPD的母亲进行依恋和相关机制 没有BPD的母亲。将进行育儿和干预需求的定性评估(阶段2) 来自阶段1的15名患有BPD的母亲。目标2(Adapt-ITT模型的步骤2)。将MISC调整为 患有BPD的母亲将通过研究MISC对患有BPD的母亲的可行性来确定。目标3(第3步 适应-ITT模型)。未来适应MISC的具体干预目标和交付特征将是 通过让来自AIM 1-阶段2的15名参与者参与MISC的战区测试来确定。这个 应用中心假设如下。目标1：患有BPD的母亲会表现出父母养育的因素 他们的孩子面临着心理社会结果不佳的风险，他们将意识到需要父母的干预， 并将对治疗目标和交付具有特定的偏好。目标2：MISC适用于患有以下疾病的母亲 BPD，并适合于适应。目标3：BPD和关注反馈的母亲可以接受MISC 小组将确定对MISC的内容、材料和交付的具体改进，这些改进将需要 并入了《MISC》未来的改编。拟议的研究符合第三个战略目标。 在NIMH中，预防精神疾病。这项奖学金将作为未来F32或 K批准PI改编MISC材料，以供患有BPD的母亲使用。《MISC》成功改编- BPD将允许将基于依恋的实际干预引入人格领域 这可能会改善患有BPD的母亲及其子女的生活质量。最后， 获得这一奖学金将加强初级研究员的培训，因为她发展了一条独立的路线 无论她是否特别追求MISC，她都是翻译研究的专家。

Project Summary/Abstract Extant data suggest that the children of mothers with Borderline Personality Disorder (BPD) are at particular risk for a variety of poor psychosocial outcomes, in part because research has demonstrated that mothers with BPD have difficulty forming secure attachment relationships with their children. One avenue for interrupting the intergenerational transmission of psychopathology from mothers to offspring is through scaffolding parenting in mothers. While parenting programs have been developed for most psychiatric disorders, personality pathology has lagged behind. The Mediational Intervention for Sensitizing Caregivers (MISC) has been used in other high-risk populations impacted by attachment disruptions and holds promise for use with mothers with BPD. However, before MISC can be adapted for mothers with BPD, it is first important to evaluate the feasibility and acceptability of MISC for this population. The objective of this application is to use the ADAPT-ITT model to evaluate the feasibility and acceptability of MISC for mothers with BPD and to identify key elements that should be integrated in a future adaptation of MISC for mothers with BPD. The approach of this application will execute the first three steps of the ADAPT-ITT model. Aim 1 (Step 1 of ADAPT-ITT). Quantitative Assessment (phase 1) of attachment and related mechanisms will be conducted with 100 mothers with BPD and 100 mothers without BPD. Qualitative Assessment (phase 2) of parenting and intervention needs will be conducted with 15 mothers with BPD, from phase 1. Aim 2 (Step 2 of ADAPT-ITT model). The Decision to adapt MISC for mothers with BPD will be made by examining the feasibility of MISC for mothers with BPD. Aim 3 (Step 3 of ADAPT-ITT model). Specific intervention targets and delivery features for future Adaptation of MISC will be identified by having the 15 participants from Aim 1-phase 2 participate in theatre testing of MISC. The applications central hypotheses are as follows. Aim 1: Mothers with BPD will exhibit parenting factors which put their children at risk for poor psychosocial outcomes, will have a perceived need for a parenting intervention, and will have specific preferences for treatment targets and delivery. Aim 2: MISC is feasible for mothers with BPD and appropriate for adaptation. Aim 3: MISC is acceptable for mothers with BPD and feedback focus groups will identify specific refinements to MISC’s content, materials and delivery that will need to be incorporated into a future adaptation of MISC. The proposed research is in line with the third strategic objective of the NIMH, the prevention of mental illness. This fellowship will serve as preliminary data for a future F32 or K granted to the PI to adapt MISC materials for use with mothers with BPD. Successful adaptation of MISC- BPD would allow a practical attachment-based intervention to be introduced to the field of personality pathology, potentially improving the quality of life of mothers struggling with BPD and their children. Finally, receiving this fellowship will strengthen the training of a junior researcher as she develops an independent line of translational research, regardless of whether she pursues MISC in particular.