fMRI of Emotional Reactivity, Cognitive Regulation, and CBT for Social Phobia

情绪反应、认知调节和社交恐惧症 CBT 的功能磁共振成像 (fMRI)

• 批准号: 7474599
• 负责人: JAMES J GROSS
• 金额: $ 39.44万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7474599
• 关键词: Address; Affective; Anxiety; Basic Science; Brain region; Clinical; Clinical Research; Cognitive; Cognitive Therapy; Controlled Study; Dorsal; Emotional; Emotions; Functional Magnetic Resonance Imaging; Goals; Individual; Intervention; Literature; Measures; Mental Health; Outcome; Participant; Patients; Personal Satisfaction; Rate; Reading; Regulation; Research; Research Personnel; Social Phobia; Stimulus; Testing; Therapeutic; Time; Translational Research; Treatment outcome; Well in self; base; emotion regulation; follow-up; improved; indexing; neuromechanism; programs; relating to nervous system; response; social; theories; time interval; treatment effect

DESCRIPTION (provided by applicant): The overall goal of this proposal is to elucidate the neural bases of emotional reactivity and cognitive regulation in social phobia (SP), and to identify the neural mechanisms underlying therapeutic change associated with cognitive-behavioral therapy (CBT) for SP. Basic research has examined emotional reactivity and cognitive regulation in healthy controls (HC), but this research has not yet delineated the mechanisms underlying emotion regulation in individuals with SP. Clinical research has shown that CBT is an effective treatment for many individuals with SP, but mechanisms of change and predictors of therapeutic response are not yet well described. To integrate basic and clinical literatures, we use a framework that views emotion regulation in terms of interactions between ventral emotion-generative brain regions and dorsal emotion- regulatory brain regions. Within this framework, we propose to examine emotional reactivity and cognitive regulation in HC and in participants with generalized SP pre- and post-CBT. The proposed studies address 3 aims: Aim 1 examines the neural substrates of emotional reactivity and cognitive regulation in SP versus HC. Study 1A tests the hypothesis that SP individuals will show greater responses than HC in ventral emotion-generative brain regions to social anxiety stimuli, but comparable responses to (non-social) general anxiety or neutral stimuli. Study 1B tests the hypothesis that SP individuals will show lesser responses than HC in dorsal emotion-regulatory brain regions when asked to regulate responses to social anxiety stimuli, but comparable responses when asked to regulate responses to general anxiety stimuli. Aim 2 identifies mechanisms of change by examining SP patients pre- and post-CBT. SP patients who complete Studies 1A and 1B will undergo 4 months of CBT. Upon completion of treatment or waitlist (SP) or a matched time interval (HC), Study 2A tests the hypothesis that SP CBT responders will show lesser responses in ventral brain regions to social anxiety stimuli (a) than at pre-treatment, (b) than SP non-responders at post-CBT, and (c) than SP waitlist controls. Study 2B tests the hypothesis that CBT responders will show greater responses in dorsal brain regions to social anxiety stimuli (a) than at pre-treatment, (b) than SP non-responders at post- treatment, and (c) than SP waitlist controls. For both study 2A and 2B, we expect that SP CBT responders and HC at Time 2 will show comparable responses to social and general anxiety stimuli. Aim 3 assesses predictors of treatment responses to CBT. Study 3 tests the hypothesis that greater emotional reactivity (affective vulnerability) and lesser cognitive regulation (implementation deficit) pre- and post-treatment will independently predict worse clinical outcomes at 5 and 10 months post-CBT for individuals with SP. The broad, long-term objective of this translational research program is to contribute to advances in theory and clinical interventions that will improve psychological well-being in people suffering from SP.

描述（由申请人提供）：该提案的总体目标是阐明社会恐惧症（SP）中情绪反应性和认知调节的神经基础，并确定与SP的认知 - 行为治疗（CBT）相关的治疗性变化的神经机制。基础研究已经检查了健康对照（HC）中的情绪反应性和认知调节，但是这项研究尚未描述SP患者的情绪调节的机制。临床研究表明，CBT是许多SP的个体的有效治疗方法，但是变化机制和治疗反应的预测指标尚未得到很好的描述。为了整合基本文献和临床文献，我们使用一个框架，该框架根据腹侧情绪产生的大脑区域和背部情绪调节大脑区域之间的相互作用来调节情绪调节。在此框架内，我们建议在HC和CPERTIADS SP前和CBT的参与者中检查情绪反应性和认知调节。拟议的研究解决了3个目标：AIM 1检查了SP与HC中情绪反应性和认知调节的神经底物。研究1a检验了以下假设：SP个体在腹侧情绪产生大脑区域对社交焦虑刺激的反应比HC更大，但对（非社会）一般焦虑或中性刺激的反应可比。研究1b测试了以下假设：当被要求调节对社交焦虑刺激的反应时，在背部情绪调节大脑区域中，SP个体的反应比HC的反应要小，但是当要求调节对一般焦虑刺激的反应时，可比较的反应。 AIM 2通过检查CBT前后SP患者来识别变化的机制。完成研究1A和1B的SP患者将接受4个月的CBT。在完成治疗或候补（SP）或匹配的时间间隔（HC）（HC）后，研究2A检验了以下假设：SP CBT响应者比在CBT和SP SP SP SPETLIST CONTERAS的SP非反应器中，腹侧大脑对社交焦虑刺激（a）的反应要比SP非反应者比SP非反应者的响应较少。研究2b检验了以下假设：与治疗前的CBT响应者相比，（b）在治疗后的SP非反应器中，背侧大脑区域对社交焦虑刺激（A）的反应更大，而（c）比SP候车表控制列表。对于研究2a和2b，我们预计时间2的SP CBT响应者和HC将显示出对社会和一般焦虑刺激的可比反应。 AIM 3评估治疗反应对CBT的预测指标。研究3检验了以下假设：在CBT后5个月和10个月的患者中，治疗前和治疗后5个月，治疗前和治疗后的较大情绪反应性（情感脆弱性）和较少的认知调节（实施赤字）将独立预测临床结果。这项翻译研究计划的广泛长期目标是为理论和临床干预措施的进步做出贡献，这些进步将改善患有SP的人的心理健康。