Progressive social withdrawal in trauma-exposed older adolescents and young adults: neurocircuitry predictors

遭受创伤的老年青少年和年轻人的渐进性社交退缩：神经回路预测因素

基本信息

批准号：
10672968
负责人：
ISABELLE M ROSSO
金额：
$ 46.75万
依托单位：
MCLEAN HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-20 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10672968
关键词：
20 year old Accelerometer Adolescent Adolescent and Young Adult Adult Age Alcohol consumption Amygdaloid structure Anhedonia Automobile Driving Behavioral Biological Markers Brain region Categories Cellular Phone Characteristics Clinical Code Data Data Collection Development Diagnostic Ecological momentary assessment Emotions Enrollment Evolution Exposure to Extinction Face Frequencies Fright Functional Magnetic Resonance Imaging Future Health Human Immune response Impairment Incentives Individual Intervention Interview Literature Location Loneliness Longevity Machine Learning Major Depressive Disorder Measures Mental Health Mental disorders Metadata Modeling National Institute of Mental Health Neurobiology Nucleus Accumbens Outcome Participant Pathologic Patient Self-Report Phenotype Population Post-Traumatic Stress Disorders Prefrontal Cortex Process Psychopathology Recording of previous events Research Rest Rewards Risk Risk Factors Role Sampling Social Behavior Social Interaction Social Network Specific qualifier value Structure Text Time Trauma Well in self Withdrawal Work cardiovascular risk factor density depressive symptoms digital disability follow-up functional MRI scan innovation interpersonal trauma learning strategy longitudinal design mortality neural circuit neurobiological mechanism neurofeedback neuroimaging physical conditioning post-traumatic symptoms prediction algorithm predictive modeling prospective rapid growth response reward circuitry reward processing social social anxiety social engagement substance use suicidal risk therapy development trauma exposure

项目摘要

Social withdrawal is a transdiagnostic phenotype that is strongly associated with detrimental physical and mental health outcomes across the lifespan. As quantified using structural features of individuals’ social networks, social withdrawal is associated with 60-70% increased mortality and a threefold increase in suicide risk. Recent findings document associations between trauma-related psychopathology and altered social network structural features, including size, density, diversity, and embeddedness. Critically, because the transition to adulthood (age 16-20) is a period of rapid expansion in social networks, forms of psychopathology that produce social withdrawal may confer particular risk for poor outcomes during this developmental stage. Thus, the transition to adulthood is a key developmental period for the evolution of social withdrawal in trauma- exposed populations. Recent literature indicates that social reward processing may drive social network size and complexity, but the role of disrupted social reward functioning in driving progressive social withdrawal following trauma exposure is poorly understood. Using an innovative longitudinal design including digital phenotyping of social behavior, the proposed study will investigate activity and connectivity within brain regions that bidirectionally code for social approach and avoidance, including the basolateral amygdala (BLA), ventromedial prefrontal cortex (VMPFC), and nucleus accumbens (NAcc). The hypothesis is that BLA-VMPFC- NAcc functional connectivity will prospectively predict progressive social withdrawal during the transition to adulthood following interpersonal trauma exposure. We will enroll 120 trauma-exposed participants (ages 16- 20) who endorse posttraumatic and/or depressive symptoms, and 60 healthy controls. Trauma-exposed participants will be stratified for baseline self-reported social anhedonia. We obtain baseline social withdrawal measures, including active self-reports of social interaction and passive smartphone based phenotyping of activity via accelerometer, GPS, and call/text metadata. Participants will complete an fMRI scan to obtain measures of BLA-VMPFC-NAcc connectivity, followed by one year of digital phenotyping using active and passive data to measure social withdrawal. Based on our extensive preliminary data, we hypothesize that: 1) baseline social withdrawal will be associated with baseline BLA-VMPFC-NAcc connectivity; (2) baseline BLA- VMPFC-NAcc connectivity will prospectively predict progressive social withdrawal over the course of a 12- month follow-up; (3) predictive models of social withdrawal that include BLA-VMPFC-NAcc connectivity will outperform alternate models. The proposed integrated approach (fMRI, digital phenotyping) will identify specific circuitry associated with progressive social withdrawal during the transition to adulthood, and will develop predictive algorithms that forecast social withdrawal trajectories based on baseline connectivity within BLA- VMPFC-NAcc circuitry. Ultimately this work could lead to the development of targeted interventions (e.g. neurofeedback), and may shift the field toward reward-circuitry accounts of social withdrawal.

社交退出是一种经诊断的表型，与有害的身体和整个生命周期的心理健康成果。使用个人社会的结构特征量化网络，社交戒断与增加死亡率增加60-70％，自杀增加了三倍风险。最新发现文件证明与创伤相关的心理病理学与改变社会之间的关联网络结构特征，包括大小，密度，多样性和嵌入性。批判性，因为过渡到成年（16-20岁）是社交网络，心理病理学形式的快速扩张时期在这个发展阶段，这种社会戒断可能会涉及对不良结果的特殊风险。这是，过渡到成年是在创伤中社会撤离演变的关键发展时期裸露的人群。最近的文献表明，社会奖励处理可能会推动社交网络规模和复杂性，但是社会奖励功能破坏在推动渐进式社会戒断中的作用经过创伤后的暴露率很少。使用创新的纵向设计，包括数字社会行为的表型，拟议的研究将调查大脑区域内的活动和连通性关于社会方法和回避的双向代码，包括基础型杏仁核（BLA），腹前额叶皮层（VMPFC）和伏隔核（NACC）。假设是bla-vmpfc- NACC功能连接可能会预测过渡到向人际创伤暴露后的成年。我们将招募120名受创伤的参与者（16岁年龄 20）谁认可创伤后和/或抑郁症状，以及60个健康对照。暴露创伤参与者将被分层为基线自我报告的社会anhedonia。我们获得基线社会退出措施，包括社交互动的积极自我报告和基于被动智能手机的表型通过加速度计，GP和呼叫/文本元数据进行活动。参与者将完成fMRI扫描以获得 BLA-VMPFC-NACC连接的度量，然后使用Active和Active和被动数据以衡量社交退出。根据我们广泛的初步数据，我们假设：1）基线社会退出将与基线BLA-VMPFC-NACC连接有关；（2）基线bla- VMPFC-NACC连接可能会预测在12-- 随访；（3）包括BLA-VMPFC-NACC连接在内的社交戒断的预测模型优于替代模型。提出的综合方法（fMRI，数字表型）将确定具体在过渡到成年期间，与进行性社会退缩相关的电路，并将发展预测算法，这些算法基于Bla-内的基线连接来预测社会退出轨迹 VMPFC-NACC电路。最终，这项工作可能导致有针对性的干预措施的发展（例如神经反馈），并可能将领域转向社会退出的奖励循环。