Using Multimodal Neuroimaging and Real-World Experience Sampling to Understand Negative Affect and Paranoid Ideation in Psychosis

使用多模态神经影像和现实世界经验采样来理解精神病中的负面情绪和偏执观念

• 批准号: 10175051
• 负责人: JACK J. BLANCHARD
• 金额: $ 72.92万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10175051
• 关键词: Acute; Amygdaloid structure; Animals; Anterior; Anxiety; Arousal; Base of the Brain; Belief; Benign; Biological; Brain; Brain imaging; Categories; Cellular Phone; Clinical Psychology; Communities; Complex; Cues; Data; Delusions; Development; Diagnosis; Dimensions; Discipline; Disease; Emotional; Enrollment; Environment; Etiology; Face; Fostering; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Human; Hypersensitivity; Image; Individual; Insula of Reil; Intervention; Life; Measures; Mediating; Mental disorders; Methods; Modeling; National Institute of Mental Health; Neurophysiology - biologic function; Neurosciences Research; Paranoia; Pathway interactions; Patients; Pattern; Perception; Perfusion; Plant Roots; Play; Prefrontal Cortex; Process; Psychiatric Diagnosis; Psychiatry; Psychopathology; Psychoses; Psychotic Disorders; Regulation; Reporting; Research; Research Domain Criteria; Research Personnel; Research Project Grants; Resistance; Rest; Role; Sampling; Scanning; Schizophrenia; Stimulus; Structure of terminal stria nuclei of preoptic region; Support System; Surveys; Symptoms; System; Technical Expertise; Techniques; Technology; Testing; Therapeutic; Time; United States National Institutes of Health; Work; affective neuroscience; anxious; base; biopsychosocial; clinically significant; digital intervention; disease classification; experience; ideation; innovation; insight; man; multidisciplinary; multimodality; negative affect; neuroimaging; neurophysiology; novel; public health relevance; relating to nervous system; response; social; theories; trait; translational model; vigilance

Paranoid ideation—the mistaken belief that intentional harm is likely to occur—spans a continuum, from mild suspicion to persecutory delusions. Among patients with schizophrenia and other psychosis disorders, elevated levels of paranoia are common, debilitating, and challenging to treat. The cues (public environments, strangers) and processes (anxiety) that promote paranoia have grown increasingly clear, but the brain bases of these pathways are unknown, thwarting the development of mechanistic models and, ultimately, the development of more effective or tolerable biological interventions. Leveraging our team’s unique multidisciplinary expertise and productive track record of NIH-sponsored research, this project will use an innovative combination of paranoia assessments, advanced neuroimaging techniques, and smartphone-based experience sampling to clarify the factors governing paranoia. We will enroll the full spectrum of paranoia without gaps or discontinuities—including psychosis patients with frank persecutory delusions and matched community controls. These data will allow us to rigorously examine the hypothesized contribution of brain circuits responsible for triggering anxiety and evaluating the threat potential of everyday social cues, such as faces. Integrating neuroimaging measures with experience-sampling data will enable us to extend these insights to the real world—a key step to establishing therapeutic relevance—for the first time. It has become increasingly clear that categorical psychiatric diagnoses (e.g. schizophrenia) present significant barriers to understanding pathophysiology. Our focus on dimensional measures of paranoia overcomes many of these barriers and dovetails with the National Institute of Mental Health’s Strategic Objectives and Research Domain Criteria (RDoC) initiative. This work would provide a potentially transformative opportunity to test and refine theory, deepen our understanding of etiology, guide the development of new translational models, discover new treatment targets, and provide an integrative biopsychosocial framework for unifying research across investigators, approaches, and scholarly guilds.

妄想症--一种认为可能发生故意伤害的错误信念--从温和的 对迫害妄想症的怀疑。在精神分裂症和其他精神障碍患者中， 妄想症的程度很常见，令人虚弱，治疗起来也很有挑战性。线索(公共环境、陌生人) 促进偏执狂的过程(焦虑)已经变得越来越清楚，但这些过程的大脑基础 路径是未知的，阻碍了机械论模型的发展，最终阻碍了 更有效或可容忍的生物干预措施。利用我们团队独特的多学科专业知识和 NIH赞助的研究的富有成效的记录，这个项目将使用偏执的创新组合 评估、先进的神经成像技术和基于智能手机的体验采样，以澄清 支配偏执狂的因素。我们将招收所有妄想症患者，不留空白或间断--包括 患有直白的受迫害妄想症和匹配的社区对照的精神病患者。这些数据将使我们 为了严格检查大脑回路对引发焦虑和 评估日常社交线索的潜在威胁，例如面孔。将神经成像措施与 体验-抽样数据将使我们能够将这些洞察力扩展到现实世界-这是建立 治疗相关性--这是第一次。越来越清楚的是，绝对的精神病学诊断 (例如，精神分裂症)对理解病理生理学构成了重大障碍。我们对维度的关注 偏执狂的测量克服了许多这些障碍，并与国家精神研究所相吻合 卫生的战略目标和研究领域标准(RDoC)倡议。这项工作将提供一种 潜在的变革性机会来检验和提炼理论，加深我们对病因学的理解，指导 开发新的转换模式，发现新的治疗靶点，并提供综合 生物心理社会框架，用于统一研究人员、方法和学术协会的研究。