NEURAL SUBSTRATES OF COGNITIVE-BEHAVIORAL THERAPY FOR SOCIAL ANXIETY DISORDER

社交焦虑症认知行为治疗的神经基础

• 批准号: 8169844
• 负责人: PHILIPPE R GOLDIN
• 金额: $ 1.85万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8169844
• 关键词: 21 year old; Address; Adult; Age; Anxiety; Anxiety Disorders; Basic Science; Behavior assessment; Brain region; Clinical; Clinical Research; Cognitive; Cognitive Therapy; Computer Retrieval of Information on Scientific Projects Database; Computers; DSM-IV; Diagnosis; Diagnostic; Dorsal; Emotional; Emotions; Ethnic Origin; Functional Magnetic Resonance Imaging; Funding; Goals; Grant; Handedness; Individual; Institution; Intervention; Interview; Literature; Mental Health; Methods; Participant; Questionnaires; Regulation; Research; Research Personnel; Resources; Sample Size; Sex Education; Social Phobia; Source; Therapeutic; Time; Translational Research; United States National Institutes of Health; base; effective therapy; emotion regulation; improved; meetings; neuromechanism; programs; relating to nervous system; response; social; theories; treatment response

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Introduction This study is examining the effect of cognitive-behavioral therapy on the neural bases of emotional reactivity and regulation in adults diagnosed with social anxiety disorder. Specific Aims 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). Basic research has examined emotional reactivity and cognitive regulation in healthy controls (HC) [10, 11], 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 [12], but mechanisms of change and predictors of therapeutic response have not yet been well described. To integrate basic and clinical literatures, we use a translational 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 the neural substrates of emotional reactivity and cognitive regulation in HC and in participants with generalized SP pre- and post-CBT. Our proposed studies address 3 aims: Aim 1 examines the neural substrates of emotional reactivity and cognitive regulation in SP versus HC; Aim 2 identifies mechanisms of change by examining SP participants pre- and post-CBT; Aim 3 assesses predictors of longer-term treatment responses to CBT. The broad, long-term objective of this translational research program is to contribute to advances in theory and clinical interventions that will improve the psychological health of individuals suffering from SP. Methods and Materials We intend to assess 120 adults (ages 21-55 years). Of these, 80 will meet DSM-IV [83] criteria for a primary diagnosis of current generalized social phobia (SP) at Time 1. The other 40 participants will be non-psychiatric healthy controls (HC) each matched to an SP on age, sex, education, ethnicity, and handedness. This sample size will provide sufficient statistical power to examine (a) SP vs. HC at pre-CBT Time 1 (Aim 1), (b) pre- to post-CBT changes via within- and between-subjects effects (Aim 2), and (c) predictors of longer-term response to CBT treatment (Aim 3). All participants will undergo diagnostic interviewing, behavioral assessment, a battery of questionnaires, computer task, and fMRI task to assess facets of anxiety, emotional reactivity and regulation.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 介绍 这项研究正在研究认知行为疗法对被诊断为社交焦虑症的成年人情绪反应性和调节的神经基础的影响。 具体目标 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底座，并确定与认知行为疗法（CBT）相关的治疗变化的神经机制。基础研究已经检查了健康对照中的情绪反应性和认知调节[10，11]，但是这项研究尚未描述SP患者中情绪调节的基本机制。临床研究表明，CBT对于许多SP [12]的个体是一种有效的治疗方法，但是尚未很好地描述了变化的机制和治疗反应的预测指标。为了整合基本文献和临床文献，我们使用一个翻译框架，该框架以腹侧情绪产生的大脑区域和背部情绪调节性大脑区域之间的相互作用来查看情绪调节。在此框架内，我们建议检查HC和CMAD PESTER PERE-CBT和CASTERS的参与者的情绪反应性和认知调节的神经底物。我们提出的研究解决了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； AIM 2通过检查CBT前后的SP参与者来确定变化的机制； AIM 3评估了对CBT的长期治疗反应的预测指标。 这项转化研究计划的广泛，长期目标是为理论和临床干预措施的进步做出贡献，以改善患有SP的人的心理健康。 方法和材料 我们打算评估120名成年人（21-55岁）。其中，80将符合DSM-IV [83]标准，用于在时间1的当前广义社会恐惧症（SP）的主要诊断。其他40名参与者将是非精神病患者的非精神病患者（HC），各个参与者均与年龄，性别，教育，种族和惯用性相匹配。 该样本量将提供足够的统计能力来检查（a）在CBT之前1（AIM 1），（b）通过受试者内部和受试者之间的效应（AIM 2）和（c）预测长期对CBT治疗的长期响应的预测指标（AIM 3）。 所有参与者将接受诊断访谈，行为评估，一系列问卷调查，计算机任务和FMRI任务，以评估焦虑，情感反应性和调节方面。