Neurobehavioral Targets of Mindfulness in Youth At Risk for Mood Disorders

有情绪障碍风险的青少年正念的神经行为目标

• 批准号: 10612455
• 负责人: Danella Marie Hafeman
• 金额: $ 79.14万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-21 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10612455
• 关键词: 13 year old; Adolescence; Adolescent; Adult; Affective; Anxiety; Awareness; Behavioral; Behavioral Mechanisms; Bipolar Disorder; Child; Clinical; Clinical assessments; DSM-V; Data; Development; Diagnosis; Diagnostic; Ecological momentary assessment; Elements; Emotions; Exercise; Family history of; Feeling suicidal; Future; Goals; Impairment; Incidence; Individual; Intake; Intervention; Lead; Link; Literature; Measures; Mediating; Mental Depression; Meta-Analysis; Mind; Modification; Mood Disorders; Moods; Neuronal Plasticity; Onset of illness; Outcome; Parents; Participant; Patient Self-Report; Pilot Projects; Randomized; Randomized, Controlled Trials; Reporting; Research Personnel; Rest; Risk; Sampling; Scanning; Social Interaction; Symptoms; Task Performances; Testing; Thinking; Time; Work; Youth; biological adaptation to stress; design; early adolescence; emotion regulation; follow-up; group intervention; high risk; improved; mindfulness; mindfulness intervention; mood symptom; negative affect; neural; neural circuit; neurobehavioral; neurobehavioral test; personalized medicine; positive mood; post intervention; prevent; psychoeducation; psychoeducational; psychosocial; response; sex; suicidal risk; sustained attention; therapy design

Mood lability, defined as frequent and exaggerated changes in mood, is an important transdiagnostic symptom that causes significant impairment and increases suicide risk. This symptom is a common precursor to mood disorder onset, particularly in youth at familial risk. Since adolescence is a peak period for mood disorder onset and an important window of neural plasticity, it may be an optimal time for an intervention to decrease mood lability. Meta-analyses in youth have found that mindfulness-based interventions (MBIs) decrease mood symptoms and improve emotion/behavioral dysregulation, constructs closely related to mood lability; however, neural/behavioral mechanisms of these effects are unknown. It is essential to understand how and for whom MBIs work, to design interventions that more efficiently engage appropriate targets and deliver treatment to those most likely to benefit. In adults, MBIs have been shown to increase resting-state functional connectivity (rsFC) between the posterior cingulate (PCC) and the frontoparietal control network (FPCN), neural circuitry which may subserve awareness of mind-wandering. A behavioral indicator of unintentional mind-wandering, errors on the Sustained Attention to Response Task (SART), has also been found to decrease following MBIs. Since unintentional mind-wandering amplifies negative affect, awareness of mind-wandering may facilitate the adaptive use of emotion regulation strategies, leading to improved stress response and decreased mood lability. Indeed, previous studies have linked increased PCC-FPCN rsFC to downstream effects of decreased anxiety and depression; and our recent pilot study in youth found that MBI-related increases in PCC-FPCN rsFC predicted later decreases in mood lability. Given these promising pilot data, the next step is to conduct a randomized controlled trial to assess MBI-specific effects on mind-wandering related targets and mood lability. In a sample of 100 adolescents (11-13 years old) with mood lability and a parent with a major mood disorder, we propose to test whether: (1) an 8-week MBI (vs. control) modifies mind-wandering-related targets (PCC-FPCN rsFC, SART performance); (2) changes in mind-wandering measures lead to less mood lability; and (3) intake mind- wandering measures predict differential MBI benefit. Participants will be randomized – stratified on non-mood DSM-5 diagnosis and sex-by-pubertal status – to an 8-week MBI or control. We will scan youth before, 4 weeks into, immediately after, and 3 months after intervention to assess longitudinal relationships amongst changes in PCC-FPCN rsFC and behavioral/clinical measures. Behavioral/clinical outcomes will also be assessed at 9 months post-intervention. We will assess mood lability via self-report and ecological momentary assessment, focusing on variability in negative affect and ability to sustain positive mood. This design will allow us to assess, with temporal precision and across levels of analysis, the impact of decreasing unintentional mind-wandering on subsequent mood lability, focusing on a crucial developmental period in at-risk youth; and will also allow us to assess who will benefit most from MBIs, moving toward a personalized medicine approach.

情绪不稳定，被定义为经常和夸张的情绪变化，是一个重要的经诊断症状 这会导致重大损害并增加自杀风险。这种症状是心情的常见前体 疾病发作，特别是在家庭风险的青年中。由于青少年是情绪障碍发作的峰值时期 以及一个重要的神经塑性窗口，可能是干预措施的最佳时间 不稳定。青年中的荟萃分析发现，基于正念的干预措施（MBI）会减少情绪 症状并改善情绪/行为失调，构建与情绪劳动密切相关；然而， 这些作用的神经/行为机制尚不清楚。了解如何以及为谁而 MBIS的工作，设计干预措施，以更有效地将适当的目标和交付治疗与那些人接触 最有可能受益。在成年人中，已显示MBI会增加静息状态功能连通性（RSFC） 在后扣带回（PCC）和额叶控制网络（FPCN）之间，神经电路可能 予以意识到思维的意识。一个无意中思维的行为指标，在 对响应任务（SART）的持续关注也已被发现在MBI后减少。自从 无意的思维放大器负面影响，对思维的意识可能有助于适应性 使用情绪调节策略，从而改善了压力反应并改善了情绪实验室。的确， 先前的研究已将增加的PCC-FPCN RSFC与动画减少和下游的效应联系起来 沮丧;我们最近在青年中进行的试点研究发现，PCC-FPCN RSFC的MBI相关增加预测 后来减少情绪劳动。鉴于这些承诺的飞行员数据，下一步是进行随机 对照试验评估MBI特异性对与思维相关的目标和情绪劳动的影响。在样本中 我们有100名青少年（11-13岁）患有情绪不稳定和患有严重情绪障碍的父母 测试是否：（1）为8周的MBI（与控制）修改与心智相关的目标（PCC-FPCN RSFC，SART，SART 表现）; （2）改变思维措施的变化导致情绪不稳定； （3）进气 - 流浪措施可以预测MBI的差异益处。参与者将被随机分组​​ - 在非mood上分层 DSM-5诊断和性别状态 - 为8周的MBI或对照。我们将在4周之前扫描青年 干预后，立即进入，立即和三个月后，以评估变化的变化之间的纵向关系 PCC-FPCN RSFC和行为/临床测量。行为/临床结果也将在9时进行评估 干预后几个月。我们将通过自我报告和生态瞬时评估评估情绪不稳定， 专注于负面影响的变异性和维持积极情绪的能力。这种设计将使我们能够评估， 凭借临时的精度和跨越水平的分析，降低无意中思维的影响 随后的情绪劳动，重点是高危青年的关键发展时期；并将使我们能够 评估谁将从MBI中受益最大，朝着个性化的医学方法迈进。