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增加心血管疾病以及其他健康风险的风险，例如 脆弱，瀑布和痴呆症。运动有助于减慢与心脏相关的衰老相关变化的进展 并且是必不可少的心脏康复（CR），这是一个次要的预防计划 从心脏事件或手术程序中恢复速度。但是，大多数参加CR的患者 仅参加一部分会议和大多数参加的会议，无法维持足够的身体水平 CR计划后的活动。焦虑是最早，最激烈的心理反应之一 急性CVD。 “运动动画”，即恐惧和避免体育锻炼 - 可能与 成功的Cr。从认知行为框架中，存在与心脏有关的符号或合并症的存在 条件可以提高个人对身体感觉的认识，促进恐惧并担心健康和 安全，并导致避免运动。我们开发了一种手动的，理论上的认知行为 干预措施称为跨感受耐受性（BE-FIT）的行为暴露，旨在针对锻炼 CR患者的焦虑。全功率的父母赠款（R01AG070136-01A1）包括仔细检查 认知，行为和身体机制，有助于运动焦虑并成为重要的 治疗目标。父母赠款缺少的是对信息处理中的定义进行仔细检查 反映对威胁的偏见，这是动画病理学的核心特征，可以通过注意偏见评估（AB） 任务。关于AB到威胁的文献证明，与非焦虑的个人相比，焦虑 暴露威胁与各种焦虑症的关注偏见相关，有证据表明这些 偏见对干预有反应。但是，相对较不考虑如何与AB进行运动有关 威胁性刺激可能会影响身体活动行为。我们建议AB进行运动和医学 - 相关刺激在上下文上与CR中的患者相关，可以为运动动画做出贡献和维护， 反过来，这可能会破坏运动和体育活动的参与。与Not-OD-22-140一致，我们 计划开发和验证新的评估，以进一步评估当前的评估治疗机制 RCT，并评估该机制是否与干预研究的主要作用（效应）有关 行为倡议和维护。具体来说，我们建议将修改后的Stroop任务开发到 检查基本的注意力偏见，以在参加CR的患者中行使威胁，检查其与经过验证的关系 自我报告衡量恐惧运动和心脏病动画的恐惧，并很好地测试这些是否是否 威胁偏见随干预的函数而改善。通过制定和管理新的修改后的Stroop任务 为了检查威胁偏见，我们将能够照亮威胁偏见，这是一种潜在的行动机制，可以帮助 更好地了解拟合干预的工作方式（或不起作用）以改变运动和身体 CR中的活动行为。