Cognitive and affective features of youth anxiety

青少年焦虑的认知和情感特征

• 批准号: 8107510
• 负责人: GREG J SIEGLE
• 金额: $ 42.05万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8107510
• 关键词: Accounting; Address; Adult; Affect; Affective; Aftercare; Age; Amygdaloid structure; Anterior; Anxiety; Behavioral; Biological; Brain; Child; Childhood; Clinical; Cognitive; Cognitive Therapy; Communities; Coupling; Data; Development; Disease; Disease remission; Emotional; Emotions; Evaluation; Event-Related Potentials; Eye; Functional Magnetic Resonance Imaging; Funding; Generalized Anxiety Disorder; Heterogeneity; Individual; Intervention; Link; Measures; Mediating; Mental Depression; Mental Health; Mood Disorders; Mydriasis; Outcome; Participant; Pattern; Peripheral; Physiological; Population; Process; Psychotherapy; Qualifying; Reaction; Recommendation; Recovery; Regulation; Research; Severities; Support System; Symptoms; Techniques; Testing; Time; Translational Research; United States National Institutes of Health; Variant; Youth; active control; affective neuroscience; childhood anxiety; depressive symptoms; emotion regulation; emotional reaction; emotional stimulus; executive function; improved; indexing; information processing; neuroimaging; relating to nervous system; response; treatment response; vigilance

Our Center focuses on factors affecting outcome in cognitive behavioral therapy (CBT) in anxious youth. CBT is effective for 50-60% of anxious youth. Because mechanisms of recovery are poorly understood it is difficult to predict whom CBT will be effective for or how to refine it. Initial research has identified abnormalities in biological substrates of emotional information processing likely targeted by CBT, specifically, a pattern of excessive vigilance for threatening information followed by blunted sustained emotional reactions. This pattern is likely subserved by the amygdala and prefrontal regions. Understanding whether these mechanisms are targeted in CBT will 1) allow prediction of whether emotional information processing styles predispose individuals to recovery in CBT and 2) refinement of CBT to more specifically target brain mechanisms. This project requests funds to assess 200 anxious and 40 control youths' emotional information processing using functional magnetic resonance imaging (fMRI), event-related potentials (ERP), and pupilometry/eyetracking. Anxious youths will receive 16 sessions of CBT or an active control intervention (child centered therapy). All participants will be assessed every 2-4 weeks over the 14 week intervention period with pupilometry/eyetracking. After session 16, participants will again be assessed on the same tasks using all our measures. Recovery in CBT is expected to be strongest for anxious youth with heightened early limbic responses, which are targeted by CBT. CBT is expected to decrease initial limbic responses to emotional stimuli, and increase sustained responses (e.g., decrease avoidance). Positive results could link brain function to recovery, allowing prediction of which anxious participants will recover in CBT, illustrate mechanisms by which CBT leads to recovery, and could validate proposed mechanisms of action for CBT. Negative results would suggest that recovery in CBT may depend on different mechanisms of action than those which have been proposed by the clinical and affective neuroscience community. The scale of the proposed research is unparalleled in examinations of neural correlates of emotional information processing in anxious individuals, particularly with developmental populations and examinations of recovery. This magnitude is necessary to understand factors underlying the considerable heterogeneity in treatment response in this population. Our group is uniquely suited to carrying out the proposed large-scale research.

我们的中心专注于影响焦虑青年认知行为疗法（CBT）中结果的因素。 CBT对50-60％的焦虑青年有效。因为恢复机制的理解很少 很难预测CBT对谁有效或如何完善它。最初的研究已经确定 情绪信息处理的生物底物异常可能是CBT针对的，特别是 过度警惕的模式，以威胁信息，然后持续持续的情感 反应。这种模式可能由杏仁核和前额叶区域提供。了解是否 这些机制是针对CBT的目标1）允许预测情感信息是否处理 样式使个人易于在CBT中恢复和2）更具体地靶向大脑 机制。该项目要求资金评估200名焦虑和40个控制年轻人的情感 使用功能磁共振成像（fMRI），与事件相关电位（ERP）的信息处理， 和化学测定法/眼影。焦虑的年轻人将获得16次CBT或主动控制干预措施 （以儿童为中心的疗法）。所有参与者将在14周干预中每2-4周评估一次 具有化学测定法/眼影的期间。会议16之后，将再次对参与者进行相同的任务进行评估 使用我们所有的措施。预计CBT的恢复对于早期焦虑的年轻人的恢复最强 边缘响应，由CBT靶向。预计CBT将减少对 情绪刺激并增加持续反应（例如，减少回避）。积极的结果可能会链接 大脑功能恢复，允许预测焦虑的参与者将在CBT中康复，说明 CBT导致恢复的机制，并可以验证提出的CBT作用机理。 负面的结果表明，CBT的恢复可能取决于行动机制，而不是 那些由临床和情感神经科学界提出的。规模 在检查情感信息处理的神经相关性的检查中，拟议的研究是无与伦比的 在焦虑的个人中，特别是在发展人群和康复的检查中。这 对于理解治疗中相当多异质性的因素，必须进行大小级级 在这个人群中的反应。我们的小组非常适合进行拟议的大规模研究。