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: 7722897
• 负责人: PHILIPPE R GOLDIN
• 金额: $ 0.56万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7722897
• 关键词: 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; Personal Satisfaction; Questionnaires; Regulation; Research; Research Personnel; Resources; Sample Size; Sex Education; Social Phobia; Source; Therapeutic; Time; Translational Research; United States National Institutes of Health; base; emotion regulation; improved; neuromechanism; programs; relating to nervous system; response; social; theories

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.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 介绍 这项研究正在研究认知行为疗法对被诊断患有社交焦虑症的成年人情绪反应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交恐惧症（SP）中情绪反应和认知调节的神经基础，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 (HC) 的情绪反应和认知调节 [10, 11]，但这项研究尚未描述 SP 个体情绪调节的机制。临床研究表明，CBT 对于许多 SP 患者来说是一种有效的治疗方法 [12]，但治疗反应的变化机制和预测因素尚未得到很好的描述。为了整合基础和临床文献，我们使用了一个翻译框架，从腹侧情绪生成脑区和背侧情绪调节脑区之间的相互作用来看待情绪调节。在此框架内，我们建议检查 HC 和 CBT 前后具有广义 SP 的参与者情绪反应和认知调节的神经基础。我们提出的研究涉及 3 个目标：目标 1 检查 SP 与 HC 中情绪反应和认知调节的神经基础；目标 2 通过检查 CBT 前后的 SP 参与者来确定变革机制；目标 3 评估 CBT 长期治疗反应的预测因素。 该转化研究计划的广泛、长期目标是促进理论和临床干预措施的进步，从而改善 SP 患者的心理健康。 方法和材料 我们打算评估 120 名成年人（年龄 21-55 岁）。其中，80 名参与者将符合 DSM-IV [83] 在时间 1 初步诊断当前广泛性社交恐惧症 (SP) 的标准。其他 40 名参与者将是非精神科健康对照 (HC)，每名参与者在年龄上与 SP 相匹配、性别、教育、种族和惯用手。 此样本量将提供足够的统计功效来检查 (a) CBT 时间 1 前的 SP 与 HC（目标 1），(b) CBT 前后通过受试者内部和受试者之间的影响发生的变化（目标 2） ，(c) CBT 治疗长期反应的预测因素（目标 3）。 所有参与者都将接受诊断访谈、行为评估、一系列问卷、计算机任务和功能磁共振成像任务，以评估焦虑、情绪反应和调节等方面。