Blunted and Discordant Affect: A Transdiagnostic Construct in Psychopatholog

钝化和不一致的情感：精神病理学中的跨诊断结构

基本信息

批准号：
8537511
负责人：
Wendy Michelle D'Andrea
金额：
$ 56.92万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-01 至 2017-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8537511
关键词：
Address Affect Affective Amygdaloid structure Anhedonia Anxiety Anxiety Disorders Awareness Borderline Personality Disorder Categories Child Abuse Chronic Clinical Conscious Cues Data Diagnosis Diagnostic Dimensions Disease Dissociation Emotional Emotions Event Exposure to Failure Functional Magnetic Resonance Imaging Future Individual Lead Literature Measures Mental Depression Methods Nature Participant Patient Self-Report Patients Peripheral Physiological Physiology Post-Traumatic Stress Disorders Prevalence Process Psychopathology Pupil Reaction Recording of previous events Repression Research Sensory Side Specificity Stimulus Survivors Syndrome Testing Time Trauma Treatment outcome Work clinically relevant common treatment conventional therapy coping distraction effective therapy emotional stimulus experience gaze improved indexing instrument neuroimaging neuromechanism relating to nervous system response theories therapy development trait vigilance

项目摘要

DESCRIPTION (provided by applicant): We propose to assess the validity of a blunted and discordant affect (BADA) construct in multiply- symptomatic pan-diagnostic individuals stratified on abuse history and diagnosis, compared to healthy individuals. Common treatments for depression, anxiety, Post-Traumatic Stress Disorder (PTSD), and Borderline personality disorder (BPD), which are typically effective for up to 40-60% of patients, work to reduce high affective intensity and reactivity, e.g., hyperarousal, irritability, or threat sensitivity. The opposite pole, involving blunted and discordant affective responses, is frequently described by clinicians, e.g., as "shutting down", but is rarely researched, and is not as explicitly addressed in common treatments. Clinicians particularly note these features in survivors of chronic childhood abuse, who often have affective psychopathologies. Improved understanding of this construct, including its prevalence, mechanisms, and differentiation from affective hyper-reactivity, could lead to specialized and effective treatment for individuals characterized by it. We will examine this construct via affect-rating, physiological, and neuroimaging during conventional tasks and tasks that approximate conditions in which functional deficits are observed in 150 patients with depression, anxiety, PTSD, and Borderline Personality Disorder as well as 50 healthy participants. Primary aims, will be to examine: 1) Construct validity-the magnitude, time course, and neural mechanisms of blunted and discordant affect, 2) Concurrent validity-relationships of the assessed measures of blunted and discordant affect with self-reported trait coping and affect constructs such as such as dissociation, numbing, repression, suppression, distraction, avoidance, and discordant attachment. This aim puts the construct in the context of the broader similar literature, and 3) External validity-specificity of observed constructs with respect to abuse history, diagnostic category, hyper-reactivity, valence, and functioning. This aim characterizes the generalizability of the construct with regard to whether it is a dimension or syndrome, trauma history, axis I and II diagnoses, valence specificity, and functioning. Positive results could suggest it is necessary to abandon the practice of averaging self-report, physiological, and neuroimaging data across patients and instead assess both hyper- and hypo-reactivity as important to psychopathology. Next steps would entail examining whether these poles are differentially associated with treatment outcome in conventional treatments and development of treatments to target both hyper- and hypo-reactivity.

描述（由申请人提供）：我们建议评估与健康个体相比，在滥用病史和诊断上分层的多症状pan诊断个体中钝化和不一致的影响（BADA）结构的有效性。抑郁症，焦虑，创伤后应激障碍（PTSD）和边缘性人格障碍（BPD）的常见治疗方法，通常可有效40-60％的患者，努力降低高情感强度和反应性，例如高伴侣，烦躁或威胁敏感性。相反的极是涉及钝性和不和谐的情感反应的相反的极点，例如临床医生，例如“关闭”，但很少受到研究，并且没有在常见治疗中明确解决。临床医生尤其注意到这些特征在慢性儿童虐待的幸存者中，这些特征经常具有情感心理病理学。对这种结构的了解，包括其流行率，机制和与情感性过度反应性的分化，可能会导致对其特征的个人进行专门和有效的治疗。我们将在传统的任务和任务中通过影响评分，生理和神经影像学检查这种结构，这些任务和任务近似于150例抑郁症，焦虑，PTSD和边缘性人格障碍以及50名健康参与者的疾病的状况。主要目的是检查：1）构建有效性 - 钝性和不和谐影响的大小，时间过程和神经机制，2）评估的有效性关系的同时有效性关系，与自我报告的特质应对和不一致的影响和不和谐的影响影响诸如解离，麻木，抑制，抑制，分心，回避和不一致的依恋之类的构造。这个目的使该构造在更广泛的类似文献的背景下，以及3）关于滥用历史，诊断类别，超反应性，价值，价和功能的观察构建体的外部有效性特异性。这个目的是该构建体是关于它是维度还是综合征，创伤历史，轴I和II诊断，价特异性和功能的普遍性。积极的结果可能表明，有必要放弃对患者的自我报告，生理和神经影像学数据平均的实践，而评估对心理病理学重要的高反应性和低反应性。下一步将需要研究这些极点是否与常规治疗中的治疗结果有差异性和治疗的发展相关，以靶向超反应性和低反应性。