Improving the control of fear: healthy adults to pathological anxiety

改善恐惧的控制：健康成年人走向病理性焦虑

• 批准号: 8870070
• 负责人: Joseph Edward Dunsmoor
• 金额: $ 8.4万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-15 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8870070
• 关键词: Adult; Affect; American; Amygdaloid structure; Animals; Anxiety; Anxiety Disorders; Attention; Award; Behavioral; Biological Models; Brain; Categories; Clinical; Clinical Research; Clinical Treatment; Computer Simulation; Disease; Effectiveness; Environment; Etiology; Event; Exhibits; Extinction (Psychology); Failure; Fostering; Fright; Functional Magnetic Resonance Imaging; Generalized Anxiety Disorder; Goals; Hippocampus (Brain); Human; Individual; Individual Differences; Investigation; Knowledge; Laboratory Research; Learning; Literature; Maintenance; Measures; Memory; Mental disorders; Mentors; Meta-Analysis; Methods; Modeling; Motivation; Neurosciences; Obsessive-Compulsive Disorder; Panic Disorder; Participant; Pathological anxiety; Pathology; Pathway interactions; Patients; Phase; Phobias; Population; Positioning Attribute; Post-Traumatic Stress Disorders; Postdoctoral Fellow; Prefrontal Cortex; Prevalence; Procedures; Psychopathology; Psychophysiology; Recovery; Regulation; Relapse; Research; Research Proposals; Research Training; Retrieval; Risk; Scientist; Severities; Staging; Symptoms; System; Techniques; Testing; Therapeutic; Therapeutic Intervention; Time; Training; Translations; base; biobehavior; career; classical conditioning; clinical anxiety; clinically relevant; conditioned fear; healthy volunteer; improved; innovation; interdisciplinary collaboration; learning extinction; memory retrieval; neural correlate; neurobehavioral; neuroimaging; neuromechanism; novel; prevent; public health relevance; relating to nervous system; resilience; theories; tool; virtual reality

 DESCRIPTION (provided by applicant): The objective of this Pathway to Independence Award is to support new mentored training in the control of fear and clinical research, as the candidate transitions from a postdoc position to an independent research career specializing in translation of new experimental techniques to improve the control of fear from healthy adults to anxiety pathologies. Anxiety pathologies are the most common mental illness, with a 12-month prevalence estimate of about 40 million American adults. Theoretical and technical aspects of fear conditioning continue to provide a valuable model to characterize and understand the etiology, maintenance, and treatment for pathologies of fear and anxiety. An example in the treatment domain is exposure therapy, which is based on the principles of extinction. However, prominent learning theory models have long recognized the shortcomings of extinction as a therapeutic tool; extinction is a fragile form of learning that fails to generalize, and fear behavors tend to return over time. Clinical research in the past two decades has revealed serious deficits in the ability to control fear expression following extinction across anxiety disorder categories, including posttraumatic stress disorder, panic disorder, and phobias. Laboratory research on the limits to extinction can describe why many severe fears and anxieties relapse following clinical treatment. Accordingly, there is strong motivation to develop innovative behavioral techniques to improve the control of fear so that maladaptive fears and anxieties are more responsive to treatment and less prone to relapse. Yet, systematic neurobehavioral research on novel techniques to improve the control of fear in humans has received limited attention. During the mentored phase of this proposal, the candidate will incorporate new training on theoretical, technical, and empirical aspects of fear extinction to test new behavioral techniques to improve the control of fear in healthy adults using combination functional magnetic resonance imaging and psychophysiology methods. Aim 1 looks to override maladaptive threat associations by introducing surprising, novel, non-threat associations to the participant. Aim 2 looks to promote the generalizability of extinction learning by conducting extinction under multiple different virtul reality contexts. The R00 project will carry forward this knowledge to investigate these two new experimental tasks in clinical anxiety populations characterized by the inability to control fear expression following standard extinction procedures. Research in clinical populations will be fostered by new supervised training in clinical research developed during the mentored phase. The research proposed here has the potential to advance biological models of psychopathology, establish neurobehavioral risk/resilience factors for disorders of fear and anxiety, and ultimately contribute to innovative and more effective therapeutic interventions for pathological anxiety. This Pathway to Independence Award lays the groundwork for the candidate to achieve these research and training goals, and to develop interdisciplinary collaborations with clinical research experts at an early stage of his career.

 描述（由适用提供）：这一获得独立奖励奖的目的是支持对恐惧和临床研究控制的新培训，因为候选人从博士后职位转变为独立研究职业，专门研究新实验技术的转化，以改善从健康成年人到焦虑病的恐惧控制。大约4000万美国成年人的患病率估计。恐惧条件的理论和技术方面继续提供一个有价值的模型，以表征和理解恐惧和焦虑病的病因，维护和治疗。治疗领域的一个例子是暴露疗法，该治疗基于扩展原理。但是，著名的学习理论模型长期以来已经认识到扩展作为一种治疗工具的缺点。扩展是一种脆弱的学习形式，无法概括，而恐惧行为往往会随着时间的流逝而回来。在过去的二十年中，临床研究揭示了在跨动画障碍类别延伸后控制恐惧表达的能力，包括创伤后应激障碍，恐慌症和恐惧症。实验室研究扩展的限制可以描述为什么临床治疗后许多严重的恐惧和动画接力。彼此之间，有强大的动机来发展创新的行为技术来改善恐惧的控制，从而使适应不良的恐惧和动画对治疗的反应更快，并且不容易得到缓解。然而，对改善人类恐惧控制的新技术的系统神经行为研究受到了有限的关注。在本提案的Mendate阶段，候选人将使用有关恐惧扩展的理论，技术和经验方面的新培训，以测试新的行为技术，以使用组合功能磁共振成像和心理生理学方法来改善健康成年人对恐惧的控制。 AIM 1希望通过向参与者引入惊喜，新颖的非威胁协会来超越适应不良的威胁协会。 AIM 2旨在通过在多个不同的Virtul现实背景下进行扩展来促进扩展学习的普遍性。 R00项目将推进这一知识，以调查临床动画人群中的这两个新的实验任务，其特征是无法按照标准扩展程序来控制恐惧表达。在修订阶段开发的临床研究中，新的监督培训将促进临床人群的研究。这里提出的研究有可能推进精神病理学的生物学模型，为恐惧和焦虑症建立神经行为风险/韧性因素，并最终 对病理焦虑的创新和更有效的治疗干预措施的贡献。这项获得独立奖的途径为候选人实现这些研究和培训目标的基础奠定了基础，并与临床研究开发跨学科合作 专家在他职业生涯的早期阶段。