Neurally targeted group intervention to reduce early childhood anxiety

神经靶向群体干预减少儿童早期焦虑

基本信息

批准号：
10544492
负责人：
Kate Dimond Fitzgerald
金额：
$ 80.34万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-20 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10544492
关键词：
6 year old 7 year old Address Adult Affect Aftercare Anterior Anxiety Anxiety Disorders Behavior Behavior Control Behavior Therapy Behavioral Brain region Child Chronic Clinical Clinical Trials Disease remission Dorsal Dose Drops Early Intervention Educational Intervention Educational process of instructing Elderly Empirical Research Equilibrium Exercise Failure Frequencies Friends Fright Home Individual Intervention Interview Investigational Therapies Life Link Literature Longevity Measurement Measures Mental Depression National Institute of Mental Health Neurosciences Nursery Schools Outcome Parents Participant Phase Pilot Projects Play Prefrontal Cortex Public Health Randomized Reporting Research Risk Sampling School Drop-Outs School-Age Population Schools Services Severities Signal Transduction Specific qualifier value Structure Student Dropouts Substance abuse problem Suicide Symptoms Testing Theoretical model Time Training Work anxiety reduction anxiety symptoms anxiety treatment anxious behavior measurement brain behavior childhood anxiety cingulate cortex clinically significant cognitive training design dosage early childhood functional disability group intervention improved indexing neural neurobehavioral neurophysiology neuroregulation prevent randomized controlled design randomized trial randomized, clinical trials response selective attention skills targeted treatment theories therapy design transmission process

项目摘要

Clinically significant anxiety affects 20% of preschoolers and can become chronic, leading to depression, substance abuse, school-drop out and even suicide. To reduce anxiety and prevent its sequelae, clinically affected children must be effectively treated early. Available interventions for clinically anxious preschoolers are effective for some, but not all children, with as many as 50% of 4-7 year olds continuing to meet criteria for an anxiety disorder after treatment. To address this problem, we leverage theoretical models and empirical research suggesting that insufficient capacity for Effortful Control (EC) may underlie anxiety from its earliest stages. Insufficient capacity for EC reflects failures of frontal brain regions (e.g., dorsolateral prefrontal cortex/dlPFC and anterior cingulate cortex/ACC) to adaptively regulate threat circuits and maintain on-task behavior. These neural substrates for EC can be indexed using neurophysiological measures, the error-related negativity (ERN) and time frequency interchannel phase synchrony (ICPS), respectively. Findings from our labs and the work of others have shown that reduced ERN and ICPS relate to behavioral deficits in EC and enhanced threat reactivity similar to that documented in clinically anxious children. In response, our team developed a child-friendly group EC training (“Camp Kidpower”) designed to increase ERN, ICPS and related EC behaviors in the service of decreasing anxiety symptoms in preschoolers. Results of our pilot study indicate that this brief cognitive training approach engaged the intended EC neural and behavioral targets and reduced anxiety symptoms. Building on this pilot work, the current project aims to replicate and extend these findings in a larger sample using a randomized controlled design. Participants in this study will be 4- to 6-year-old children (n=90) with clinically significant symptoms who will be randomized into the EC training intervention (n=45) or a playgroup control (n=45). Outcomes will be assessed before and after each condition, using a multi-level approach that includes neurophysiological and behavioral indices of EC, as well as clinician-rated and parent- report on child anxiety symptoms (type and severity). Our aims are to: 1) confirm that participation in our EC training increases ERN and ICPS and improves EC behavior, 2) test whether engagement of these brain-behavior EC targets correspond to reductions in anxiety symptoms and explore whether anxiety reduction by EC training is moderated by baseline threat reactivity measures, and 3) identify whether greater dosage of EC training is associated with greater neuro-behavioral target engagement and reduction of anxiety symptoms. By evaluating how changes in neuroscience-derived targets relate to changes in anxiety symptoms, this work is responsive to the NIMH call for experimental therapeutics and addresses an urgent need for the design of interventions to reduce anxiety in young children.

临床上显着的焦虑影响 20% 的学龄前儿童，并可能变成慢性，导致抑郁，临床上，为了减少焦虑并预防其后遗症，药物滥用、辍学甚至自杀。受影响的儿童必须尽早得到有效的治疗，以应对临床焦虑的学龄前儿童。对部分儿童有效，但并非对所有儿童有效，4-7 岁儿童中多达 50% 的儿童仍符合治疗标准为了解决这个问题，我们利用理论模型和实证。研究表明，努力控制（EC）能力不足可能是焦虑最早的根源 EC 能力不足反映了额叶脑区域（例如背外侧前额叶）的失败。皮层/dlPFC 和前扣带皮层/ACC）来自适应调节威胁回路并维持任务这些 EC 的神经底物可以使用神经生理学测量（误差相关）进行索引。分别来自我们的负性（ERN）和时频通道间相位同步（ICPS）。实验室和其他人的工作表明，ERN 和 ICPS 的减少与 EC 和与临床焦虑儿童所记录的威胁反应增强类似，我们的团队对此做出了回应。开发了儿童友好团体 EC 培训（“Camp Kidpower”），旨在提高 ERN、ICPS 和相关能力我们的试点研究结果表明，EC 行为有助于减少学龄前儿童的焦虑症状。这种简短的认知训练方法涉及预期的 EC 神经和行为目标，并减少了在这项试点工作的基础上，当前的项目旨在复制和扩展这些发现。这项研究的参与者是 4 至 6 岁的儿童，采用随机对照设计。 (n=90) 具有临床显着症状，将被随机分配到 EC 培训干预 (n=45) 或游戏组控制（n=45）将使用多级别评估每种情况之前和之后的结果。方法，包括 EC 的神经生理学和行为指标，以及临床医生评价和家长评价关于儿童焦虑症状（类型和严重程度）的报告我们的目标是：1）确认参与我们的活动。 EC 培训可提高 ERN 和 ICPS 并改善 EC 行为，2) 测试这些人员的参与程度大脑行为 EC 目标对应于焦虑症状的减少以及是否探索焦虑通过基线威胁反应措施来调节 EC 培训的减少，并且 3) 确定是否更大剂量的 EC 训练与更大的神经行为目标参与度相关通过评估神经科学衍生目标的变化与焦虑症状的减少有何关系。焦虑症状的变化，这项工作响应了 NIMH 对实验疗法的呼吁，解决了设计干预措施以减少幼儿焦虑的迫切需要。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Startle to neutral, not negative stimuli: A neurophysiological correlate of behavioral inhibition in young children.

惊吓到中性刺激，而不是消极刺激：幼儿行为抑制的神经生理学相关性。

DOI：
发表时间：
2021
期刊：
影响因子：
2.2
作者：
Premo, Julie E;Mannella, Kristin A;Duval, Elizabeth R;Liu, Yanni;Morrison, Claire L;Moser, Jason S;Muzik, Maria;Rosenblum, Katherine L;Fitzgerald, Kate D
通讯作者：
Fitzgerald, Kate D