Enhancing transdiagnostic mechanisms of cognitive dyscontrol using computer-based training

使用基于计算机的训练增强认知失调的跨诊断机制

• 批准号: 10283150
• 负责人: Jessica Bomyea
• 金额: $ 63.12万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10283150
• 关键词: Address; Adult; Affect; Anxiety; Behavioral; Benchmarking; Brain; Cellular Phone; Clinical; Cognition; Cognitive; Data; Disease; Distress; Dose; E-learning; Environment; Executive Dysfunction; Exercise; Foundations; Frequencies; Functional Magnetic Resonance Imaging; Goals; Individual; Intervention; Knowledge; Memory; Mental Depression; Mission; Modeling; Moods; National Institute of Mental Health; Neurobehavioral Manifestations; Neurobiology; Neurosciences; Outcome; Participant; Performance; Phase; Population; Post-Traumatic Stress Disorders; Public Health; Randomized; Randomized Controlled Trials; Research; Research Priority; Resources; Role; Sampling; Short-Term Memory; Symptoms; System; Task Performances; Testing; Therapeutic; Thinking; Training; Training Programs; Training Technics; Traumatic Stress Disorders; adverse outcome; associated symptom; base; clinical effect; cognitive enhancement; cognitive function; cognitive performance; cognitive system; cognitive task; cognitive testing; cognitive training; computerized; confirmatory trial; cost; design; disability; emotional functioning; emotional symptom; executive function; experience; improved; innovation; mHealth; mood symptom; negative mood; neuroimaging; novel; portability; primary outcome; psychologic; reduce symptoms; relating to nervous system; standard care; stem; suicidal risk; tool; treatment program

Mood, anxiety, and traumatic stress disorders are common psychiatric conditions - affecting over 40 million U.S. adults - and are leading causes of disability worldwide. People with these conditions are commonly plagued by difficulty controlling distressing personal thoughts and memories, collectively referred to as repetitive negative thinking symptoms. Models suggest that repetitive negative thinking is driven by executive functioning deficits, such that cognitive resources are insufficient to downregulate unwanted thoughts. Executive functioning deficits could be a promising treatment target but are not typically addressed with existing interventions. The long-term goal advanced by this proposal is to develop effective, mechanistic cognitive training programs that can improve cognition and reduce symptoms associated with mood, anxiety, and traumatic stress disorders. The objectives of this proposal are first to determine the optimal dose of a cognitive training program designed to improve executive functioning in this population using behavioral and neural outcomes (R61). If the cognitive training tested in the R61 successfully improves executive functioning (go/no-go decision), we will evaluate the relationship between change in executive functioning and change in clinical symptoms (R33). Our central hypothesis is that repeated training exercises will enhance executive functioning and will lead to a reduction of repetitive negative thinking in mood, anxiety, and traumatic stress disorders. The hypothesis will be tested by pursing two specific aims: Aim 1 is to identify the cognitive effects and optimal dose of cognitive training. Aim 2 is to evaluate the clinical effects of the optimized cognitive training program relative to a sham condition. We will also conduct an exploratory aim to determine generalization of cognitive training to real-world cognitive performance. The R61 phase will test Aim 1 by randomizing participants with depression, anxiety, and/or traumatic stress disorders to one of two doses of cognitive training or a no-treatment control condition. We will examine executive functioning change with cognitive task performance and functional neuroimaging assessments. The R33 phase will randomize participants to the dose decided by the R61 or a sham condition. The R33 intends to replicate the impact on executive functioning and assess the relationship between change in executive functioning and clinical symptoms. We will explore how cognitive training helps people in their daily lives by including assessments given with a smartphone mobile cognitive testing app. The research proposed is innovative because it aims to address symptoms by intervening on a cognitive target thought to generate symptoms across multiple disorders, thus explicitly testing the interactions of cognitive and emotional symptoms. Outcomes derived from the proposed research will include a novel treatment program and information about its utility for reducing clinical symptoms. Knowledge from this proposal will advance our treatment options by targeting a specific cognitive system, providing a foundation for neuroscience-based therapeutic alternative for symptoms that span mood, anxiety, and traumatic stress disorders.

情绪，焦虑和创伤性压力障碍是常见的精神病 - 影响超过4000万美国 成人 - 是全球残疾的主要原因。患有这些条件的人通常会困扰 难以控制令人痛苦的个人思想和记忆，共同称为重复性负面 思维症状。模型表明，重复的负面思维是由执行功能障碍驱动的， 因此，认知资源不足以下调不需要的思想。执行功能不足 可能是一个有前途的治疗目标，但通常不会通过现有干预措施来解决。长期 该建议提出的目标是制定有效的机械认知培训计划，以改善 认知并减少与情绪，焦虑和创伤性障碍有关的症状。目标 该提案首先确定旨在改善的认知培训计划的最佳剂量 使用行为和神经结局在该人群中的执行功能（R61）。如果认知训练 在R61中测试成功改善了执行功能（GO/No-Go决定），我们将评估 执行功能变化与临床症状变化之间的关系（R33）。我们的中心 假设是，重复的训练练习将增强执行功能，并导致减少 情绪，焦虑和创伤性压力障碍的重复性负面思维。该假设将通过 追求两个具体目标：目标1是确定认知训练的认知效果和最佳剂量。目标2 是为了评估相对于假条件的优化认知训练计划的临床影响。我们将 还进行探索性目的，以确定认知训练对现实世界认知的概括 表现。 R61阶段将通过随机使抑郁症，焦虑和/或的参与者随机测试目标1 两种剂量的认知训练或无治疗控制条件中的一种创伤性应激障碍。我们将 通过认知任务表现和功能性神经影像检查执行功能变化 评估。 R33阶段将将参与者随机为由R61或假条件决定的剂量。 R33打算复制对执行功能的影响并评估变更之间的关系 在执行功能和临床症状中。我们将探讨认知培训如何帮助人们每天参加他们 通过包括智能手机移动认知测试应用程序进行的评估来生活。提出的研究是 创新性是因为它旨在通过介入被认为产生的认知目标来解决症状 跨多种疾病的症状，因此明确测试了认知和情绪症状的相互作用。 拟议的研究得出的结果将包括一个新颖的治疗计划及其有关其的信息 减少临床症状的实用程序。该建议的知识将通过 针对特定的认知系统，为基于神经科学的治疗替代方案提供了基础 涵盖情绪，焦虑和创伤性压力障碍的症状。