Vogel Alecia C, Geselowitz Ben, Tillman Rebecca, Barch Deanna M, Luby Joan L, Whalen Diana J
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
Department of Psychological and Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA.
Dev Psychopathol. 2023 Jun 21:1-16. doi: 10.1017/S0954579423000627.
Difficulties with emotion regulation are integral to borderline personality disorder (BPD) and its hypothesized developmental pathway. Here, we prospectively assess trajectories of emotion processing across childhood, how BPD symptoms impact these trajectories, and whether developmental changes are transdiagnostic or specific to BPD, as major depressive (MDD) and conduct disorders (CD) are also characterized by emotion regulation difficulties. This study included 187 children enriched for those with early symptoms of depression and disruptive behaviors from a longitudinal study. We created multilevel models of multiple components of emotional processing from mean ages 9.05 to 18.55 years, and assessed the effect of late adolescent BPD, MDD, and CD symptoms on these trajectories. Linear trajectories of coping with sadness and anger, and quadratic trajectories of dysregulated expressions of sadness and anger were transdiagnostic, but also exhibited independent relationships with BPD symptoms. Only inhibition of sadness was related to BPD symptoms. The quadratic trajectories of poor emotional awareness and emotional reluctance were also independently related to BPD. Findings support examining separable components of emotion processing across development as potential precursors to BPD, underscoring the importance of understanding these trajectories as not only a marker of potential risk but also potential targets for prevention and intervention.
情绪调节困难是边缘型人格障碍(BPD)及其假定的发展途径的一个组成部分。在此,我们前瞻性地评估儿童期情绪加工的轨迹、BPD症状如何影响这些轨迹,以及发展变化是跨诊断的还是BPD特有的,因为重度抑郁(MDD)和品行障碍(CD)也具有情绪调节困难的特征。本研究纳入了187名来自纵向研究的儿童,这些儿童中富含具有抑郁早期症状和破坏性行为的儿童。我们建立了从平均年龄9.05岁到18.55岁的情绪加工多个组成部分的多层次模型,并评估了青少年晚期BPD、MDD和CD症状对这些轨迹的影响。应对悲伤和愤怒的线性轨迹,以及悲伤和愤怒失调表达的二次轨迹是跨诊断的,但也与BPD症状表现出独立关系。只有抑制悲伤与BPD症状有关。情绪意识差和情绪抵触的二次轨迹也与BPD独立相关。研究结果支持将发展过程中情绪加工的可分离成分作为BPD的潜在先兆进行研究,强调了理解这些轨迹的重要性,它们不仅是潜在风险的标志,也是预防和干预的潜在目标。