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

• 批准号: 10320446
• 负责人: Kate Dimond Fitzgerald
• 金额: --
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2022-01-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320446
• 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; Custom; Disease remission; Dorsal; Dose; Early Intervention; Educational Intervention; Elderly; Empirical Research; Equilibrium; Exercise; Failure; Frequencies; 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; Randomized Clinical Trials; Reporting; Research; Risk; Sampling; School Drop-Outs; Services; Severities; Signal Transduction; Specific qualifier value; Structure; Student Dropouts; Substance abuse problem; Suicide; Symptoms; Testing; Theoretical model; Time; Training; Work; aged; anxiety reduction; anxiety symptoms; anxiety treatment; anxious; base; behavior measurement; brain behavior; childhood anxiety; cingulate cortex; clinically significant; cognitive training; design; dosage; early childhood; functional disability; group intervention; improved; indexing; neurobehavioral; neurophysiology; neuroregulation; prevent; randomized controlled design; randomized trial; relating to nervous system; response; selective attention; skills; targeted treatment; theories; therapy design; transmission process

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.

临床上显著的焦虑影响了20%的学龄前儿童，并可能变成慢性的，导致抑郁，