Enhancing transdiagnostic mechanisms of cognitive dyscontrol using computer-based training

使用基于计算机的训练增强认知失调的跨诊断机制

• 批准号: 10283150
• 负责人: Jessica Bomyea
• 金额: $ 63.12万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10283150
• 关键词: Address; Adult; Affect; Anxiety; Behavioral; Benchmarking; Brain; Cellular Phone; Clinical; Cognition; Cognitive; Data; Disease; Distress; Dose; E-learning; Environment; Executive Dysfunction; Exercise; Foundations; Frequencies; Functional Magnetic Resonance Imaging; Goals; Individual; Intervention; Knowledge; Memory; Mental Depression; Mission; Modeling; Moods; National Institute of Mental Health; Neurobehavioral Manifestations; Neurobiology; Neurosciences; Outcome; Participant; Performance; Phase; Population; Post-Traumatic Stress Disorders; Public Health; Randomized; Randomized Controlled Trials; Research; Research Priority; Resources; Role; Sampling; Short-Term Memory; Symptoms; System; Task Performances; Testing; Therapeutic; Thinking; Training; Training Programs; Training Technics; Traumatic Stress Disorders; adverse outcome; associated symptom; base; clinical effect; cognitive enhancement; cognitive function; cognitive performance; cognitive system; cognitive task; cognitive testing; cognitive training; computerized; confirmatory trial; cost; design; disability; emotional functioning; emotional symptom; executive function; experience; improved; innovation; mHealth; mood symptom; negative mood; neuroimaging; novel; portability; primary outcome; psychologic; reduce symptoms; relating to nervous system; standard care; stem; suicidal risk; tool; treatment program

Mood, anxiety, and traumatic stress disorders are common psychiatric conditions - affecting over 40 million U.S. adults - and are leading causes of disability worldwide. People with these conditions are commonly plagued by difficulty controlling distressing personal thoughts and memories, collectively referred to as repetitive negative thinking symptoms. Models suggest that repetitive negative thinking is driven by executive functioning deficits, such that cognitive resources are insufficient to downregulate unwanted thoughts. Executive functioning deficits could be a promising treatment target but are not typically addressed with existing interventions. The long-term goal advanced by this proposal is to develop effective, mechanistic cognitive training programs that can improve cognition and reduce symptoms associated with mood, anxiety, and traumatic stress disorders. The objectives of this proposal are first to determine the optimal dose of a cognitive training program designed to improve executive functioning in this population using behavioral and neural outcomes (R61). If the cognitive training tested in the R61 successfully improves executive functioning (go/no-go decision), we will evaluate the relationship between change in executive functioning and change in clinical symptoms (R33). Our central hypothesis is that repeated training exercises will enhance executive functioning and will lead to a reduction of repetitive negative thinking in mood, anxiety, and traumatic stress disorders. The hypothesis will be tested by pursing two specific aims: Aim 1 is to identify the cognitive effects and optimal dose of cognitive training. Aim 2 is to evaluate the clinical effects of the optimized cognitive training program relative to a sham condition. We will also conduct an exploratory aim to determine generalization of cognitive training to real-world cognitive performance. The R61 phase will test Aim 1 by randomizing participants with depression, anxiety, and/or traumatic stress disorders to one of two doses of cognitive training or a no-treatment control condition. We will examine executive functioning change with cognitive task performance and functional neuroimaging assessments. The R33 phase will randomize participants to the dose decided by the R61 or a sham condition. The R33 intends to replicate the impact on executive functioning and assess the relationship between change in executive functioning and clinical symptoms. We will explore how cognitive training helps people in their daily lives by including assessments given with a smartphone mobile cognitive testing app. The research proposed is innovative because it aims to address symptoms by intervening on a cognitive target thought to generate symptoms across multiple disorders, thus explicitly testing the interactions of cognitive and emotional symptoms. Outcomes derived from the proposed research will include a novel treatment program and information about its utility for reducing clinical symptoms. Knowledge from this proposal will advance our treatment options by targeting a specific cognitive system, providing a foundation for neuroscience-based therapeutic alternative for symptoms that span mood, anxiety, and traumatic stress disorders.

情绪、焦虑和创伤性应激障碍是常见的精神疾病，影响着超过 4000 万美国人。 成年人 - 并且是全世界残疾的主要原因。患有这些病症的人通常会受到以下困扰 难以控制令人痛苦的个人想法和记忆，统称为重复性负面情绪 思维症状。模型表明，重复的消极思维是由执行功能缺陷驱动的， 这样认知资源不足以下调不需要的想法。执行功能缺陷 可能是一个有希望的治疗目标，但通常无法通过现有干预措施来解决。长期来看 该提案提出的目标是开发有效的、机械的认知训练计划，以提高 认知并减少与情绪、焦虑和创伤性应激障碍相关的症状。目标 该提案的首要任务是确定旨在提高认知能力的认知训练计划的最佳剂量。 使用行为和神经结果来评估该人群的执行功能（R61）。如果认知训练 在 R61 中进行测试成功改善了执行功能（继续/不继续决策），我们将评估 执行功能变化与临床症状变化之间的关系（R33）。我们的中央 假设是，重复的训练练习会增强执行功能，并导致减少 情绪、焦虑和创伤性应激障碍中的重复消极思维。该假设将通过以下方式进行检验 追求两个具体目标：目标 1 是确定认知训练的认知效果和最佳剂量。目标2 目的是评估优化的认知训练计划相对于假条件的临床效果。我们将 还进行探索性目标，以确定认知训练对现实世界认知的推广 表现。 R61 阶段将通过随机分组患有抑郁、焦虑和/或抑郁症的参与者来测试目标 1 创伤性应激障碍需要接受两剂认知训练之一或不治疗的控制条件。我们将 通过认知任务表现和功能神经影像检查执行功能变化 评估。 R33 阶段将随机分配参与者接受 R61 或假条件决定的剂量。 R33 旨在复制对执行功能的影响并评估变革之间的关系 执行功能和临床症状。我们将探讨认知训练如何帮助人们日常生活 生活包括通过智能手机移动认知测试应用程序进行的评估。提出的研究是 创新是因为它旨在通过干预认知目标来解决症状 多种疾病的症状，从而明确测试认知和情绪症状的相互作用。 拟议研究的结果将包括一种新颖的治疗方案及其相关信息 减少临床症状的效用。从该提案中获得的知识将通过以下方式推进我们的治疗选择： 针对特定的认知系统，为基于神经科学的治疗替代方案提供基础 涵盖情绪、焦虑和创伤性应激障碍的症状。