Psychotherapy in Social Anxiety Disorder and alterations in neural processing (PANDA)

社交焦虑症的心理治疗和神经处理的改变（PANDA）

• 批准号: 426604649
• 负责人: Professor Dr. Stephan Heinzel
• 金额: --
• 依托单位: Arbeitsbereich Gesundheitspsychologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2023-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/426604649?language=en
• 关键词: Psychotherapy; Social; Anxiety; Disorder; alterations

Social Anxiety Disorder (SAD) is characterized by an intense fear of negative social evaluation due to embarrassing or humiliating behavior. Without adequate treatment, the course of SAD is often chronic and leads to a significant reduction in quality of life. Negative self-beliefs play a key role for the development and maintenance of SAD symptoms. On a neurobiological level, SAD is associated with a hyperreactivity of the salience network and a dysregulation of the executive control network. While effects of a cognitive behavioral therapy (CBT) have been evaluated by several meta-analyses, research on psychological and neurobiological mechanisms of CBT is still sparse. In the proposed study, a psychological change model of CBT will be tested in 80 patients with SAD and associated with neurobiological mechanisms. Specifically, we will investigate CBT-associated changes in negative self-beliefs and fear of social evaluation on a behavioral and neural level by means of functional Magnetic Resonance Imaging. For the first time, a paradigm on negative self-beliefs will be tested in combination with a paradigm on executive functions in a social-evaluative situation before and after CBT. Thus, we will be able to test assumptions on CBT-induced changes in effective (directional) fronto-limbic connectivity (top-down and bottom-up modulations) by means of Dynamic Causal Modelling for the first time. Furthermore, we will investigate if CBT-non-response can be predicted by abnormally high connectivity from Amygdala to Anterior Cingulate Cortex. An improved understanding of neurobiological mechanisms of CBT and the prediction of CBT outcome may explain underlying causal mechanisms for CBT-non-response and may contribute to the development of more effective and individualized treatment strategies for SAD.

社交焦虑障碍（SAD）的特征是由于尴尬或羞辱行为而对负面社会评价的强烈恐惧。如果没有适当的治疗，SAD的病程往往是慢性的，并导致生活质量的显著下降。消极的自我信念在SAD症状的发展和维持中起着关键作用。在神经生物学水平上，SAD与突出网络的过度反应性和执行控制网络的失调有关。虽然认知行为疗法（CBT）的效果已经通过一些荟萃分析进行了评估，但对CBT的心理和神经生物学机制的研究仍然很少。在本研究中，我们将在80例SAD患者中测试CBT的心理变化模型并与神经生物学机制相关。具体而言，我们将通过功能磁共振成像在行为和神经水平上研究cbt相关的消极自我信念和社会评价恐惧的变化。本文首次将消极自我信念范式与认知行为疗法前后社会评价情境下的执行功能范式结合起来进行测试。因此，我们将能够首次通过动态因果模型来测试cbt诱导的有效（定向）额边缘连接（自上而下和自下而上调制）变化的假设。此外，我们将研究是否可以通过杏仁核到前扣带皮层的异常高连接来预测cbt无反应。对CBT的神经生物学机制和CBT结果预测的进一步了解可能解释CBT无反应的潜在因果机制，并可能有助于开发更有效和个性化的SAD治疗策略。