Development of a novel exercise threat attentional bias assay

一种新型运动威胁注意偏差测定的开发

• 批准号: 10666968
• 负责人: Samantha Gwen Farris
• 金额: $ 11.07万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10666968
• 关键词: Acute; Adherence; Adult; Aerobic Exercise; Aging; Ambulances; Anxiety; Anxiety Disorders; Attention; Awareness; Behavior; Behavior Therapy; Behavioral; Biological Assay; Blood Pressure Monitors; Cardiac; Cardiac rehabilitation; Cardiovascular Diseases; Cardiovascular system; Characteristics; Chest; Clinical Medicine; Cognitive; Cognitive Therapy; Cues; Dangerousness; Dementia; Development; Dizziness; Elderly; Enrollment; Ensure; Esthesia; Event; Exercise; Exercise Test; Exertion; Exhibits; Fatigue; Fright; Goals; Health; Health behavior; Health behavior change; Health education; Heart; Image; Individual; Intervention; Intervention Studies; Lead; Life Style; Link; Literature; Longevity; Maintenance; Measures; Mediating; Medical; Medicine; Mental Depression; Monitor; Operative Surgical Procedures; Outcome; Outpatients; Pain; Parents; Pathology; Patient Self-Report; Patients; Persons; Physical Exercise; Physical activity; Physiological; Prevention program; Process; Quality of life; Questionnaires; Reaction; Reaction Time; Recovery; Risk; Safety; Science; Secondary Prevention; Shortness of Breath; Speed; Stimulus; Supervision; Symptoms; Testing; Uncertainty; United States National Institutes of Health; Visual; Work; age related; aging population; anxiety treatment; anxious; attentional bias; behavior change; bodily sensation; cardiovascular disorder risk; cognitive process; comorbidity; design; efficacy testing; exercise adherence; exercise prescription; exercise regimen; experience; falls; frailty; improved; indexing; information processing; novel; parent grant; programs; psychologic; sustained attention; uptake; vigorous intensity

ABSTRACT Age-related changes to the heart increase risk for cardiovascular disease as well as other health risks, such as frailty, falls, and dementia. Exercise helps to slow the progression of aging-associated changes to the heart and is an essential component cardiac rehabilitation (CR), which is a secondary prevention program used to speed recovery from cardiac events or surgical procedures. However, the majority of patients who enroll in CR only attend a portion of sessions and the majority that do attend fail to maintain sufficient levels of physical activity after the CR program. Anxiety is among the earliest and most intense psychological reactions following acute CVD. “Exercise anxiety”, i.e., fear and avoidance of physical activity – may be particularly relevant to successful CR. From a cognitive-behavioral framework, the presence of heart-related symptoms or comorbid conditions can heighten individuals’ awareness of bodily sensations, promote fear and worry about health and safety, and lead to exercise avoidance. We developed a manualized, theoretically-informed, cognitive-behavioral intervention called Behavioral Exposure For Interoceptive Tolerance (BE-FIT) designed to target exercise anxiety in CR patients. The fully powered parent grant (R01AG070136-01A1) includes careful examination of cognitive, behavioral and physiological mechanisms that contribute to exercise anxiety and serve as important treatment targets. Missing from the parent grant is a careful examination of deficits in information processing that reflect a bias toward threat, a core feature of anxiety pathology that can be assessed via attentional bias (AB) tasks. The literature on AB to threat has documented that anxious, compared to non-anxious, individuals exhibit threat related attentional biases across a range of anxiety disorders and there is evidence that these biases are responsive to intervention. However, relatively no work has considered how AB to exercise-related threat stimuli could influence physical activity behavior. We propose that AB towards exercise and medical- related stimuli is contextually relevant to patients in CR, and can contribute to and maintain exercise anxiety, which in turn, can undermine exercise and physical activity participation. Consistent with NOT-OD-22-140, we plan to develop and validate a new assay in order to further assessment treatment mechanism in our current RCT, and evaluate whether this mechanism is related to the intervention study’s main effect (efficacy) over the course of behavior initiation and maintenance. Specifically, we propose to develop a modified Stroop task to examine basal attentional bias to exercise threat in patients attending CR, examine its relations with validated self-report measures of fear about exercise sensations and heart-focused anxiety, and test well as whether these threat biases improve as a function of intervention. By developing and administering a novel modified Stroop task to examine threat bias, we will be able illuminate the threat bias as a potential mechanism of action that can help to better understand how the BE-FIT intervention works (or does not work) to change exercise and physical activity behavior in CR.

抽象的 与年龄相关的心脏变化会增加心血管疾病以及其他健康风险的风险，例如 虚弱、跌倒和痴呆症有助于减缓与衰老相关的心脏变化的进展。 是心脏康复 (CR) 的重要组成部分，这是一项二级预防计划，用于 加速心脏事件或外科手术的恢复但是，大多数参加 CR 的患者。 只参加一部分课程，而参加的大多数人都未能保持足够的体能水平 CR 计划后的活动是最早、最强烈的心理反应之一。 急性心血管疾病。“运动焦虑”，即恐惧和回避体力活动，可能与以下情​​况特别相关： 成功的 CR。从认知行为框架来看，存在心脏相关症状或共病。 这些情况会提高个人对身体感觉的认识，加剧对健康的恐惧和担忧， 我们开发了一种手动的、有理论依据的认知行为。 名为“内感受耐受行为暴露”(BE-FIT) 的干预措施，旨在针对锻炼 CR 患者的焦虑症。充分支持的家长补助金 (R01AG070136-01A1) 包括仔细检查 认知、行为和生理机制会导致运动焦虑并发挥重要作用 家长补助金中缺少的是对信息处理缺陷的仔细检查。 反映对威胁的偏见，这是焦虑病理学的核心特征，可以通过注意偏见（AB）进行评估 关于威胁的文献表明，与不焦虑的人相比，焦虑的人。 在一系列焦虑症中表现出与威胁相关的注意力偏差，并且有证据表明这些 然而，相对没有工作考虑AB如何与运动相关。 威胁刺激可能会影响身体活动行为，我们建议AB转向运动和医疗。 相关刺激与 CR 患者的背景相关，并且可能导致和维持运动焦虑， 这反过来又会破坏锻炼和身体活动的参与，与 NOT-OD-22-140 一致，我们。 计划开发和验证一种新的检测方法，以进一步评估我们当前的治疗机制 RCT，并评估该机制是否与干预研究的主效应（功效）有关 具体来说，我们建议开发一个修改后的 Stroop 任务来 检查参加 CR 的患者对运动威胁的基本注意偏差，检查其与经过验证的关系 自我报告对运动感觉的恐惧和以心脏为中心的焦虑，并测试这些是否 通过开发和管理一项新颖的改良斯特鲁普任务，威胁偏见会随着干预而得到改善。 为了检查威胁偏见，我们将能够将威胁偏见阐明为一种潜在的行动机制，可以帮助 更好地了解 BE-FIT 干预措施如何发挥作用（或不起作用）来改变运动和身体状况 CR 中的活动行为。