Sleep-dependent negative overgeneralization in peri-pubertal anxiety

围青春期焦虑中睡眠依赖性消极过度概括

• 批准号: 10357320
• 负责人: DANA L MCMAKIN
• 金额: $ 4.41万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10357320
• 关键词: Address; Adolescent; Age; Anger; Anxiety; Anxiety Disorders; Award; Behavior; Behavioral; Canis familiaris; Child; Childhood; Clinic; Clinical Data; Clinical Services; Clinical Trials; Cognitive Therapy; Complex; Data; Data Collection; Data Reporting; Development; Diffuse; Distal; Etiology; Evidence based treatment; Exhibits; Exposure to; Fire - disasters; Functional Magnetic Resonance Imaging; Future; Generations; Hand; Health; Hippocampus (Brain); Intervention; Life Experience; Measures; Memory; Mental Depression; Methods; Modeling; National Institute of Mental Health; Neurosciences; Outcome; Participant; Patient Self-Report; Phenotype; Positioning Attribute; Process; Protocols documentation; Puberty; Research; Research Support; Research Training; Severities; Sleep; Stimulus; Strategic Planning; Suicide; Testing; Theoretical model; Treatment outcome; Youth; anxiety reduction; base; behavior measurement; career development; childhood anxiety; conditioned fear; high risk; indexing; insight; learning extinction; memory recall; multimodality; neuroimaging; novel; outcome prediction; parent grant; precision medicine; prospective; recruit; relating to nervous system; response; substance use; theories; therapy outcome; treatment of anxiety disorders

PROJECT SUMMARY Cognitive-Behavioral Therapy (CBT) is the most well-established treatment for anxiety disorders, yet up to one- half of peri-pubertal youth show insufficient response, leaving these youth at high risk for continued anxiety, depression, substance use, and suicide. This proposed Diversity Supplement aims to supplement parent grant data on negative overgeneralization with data collected from clinical services CBT, offered to participating youth, to (a) examine negative overgeneralization as a predictor of CBT outcomes and (b) support the research training and career development of the candidate, Carlos Yeguez. Negative overgeneralization is a phenotype of anxiety that refers to the tendency to generalize aversive responses from one context (house fire) to other contexts (camp-fire) that share features. In our conceptual model, participants who exhibit high negative overgeneralization present a broad, diffuse target that hinders CBT outcomes. Specifically, in these participants information learned in the context of exposure to one anxiety-provoking stimulus will not readily transfer to distally-related stimuli, requiring more intensive and longer exposure to achieve optimal outcomes. Peri-puberty provides the optimal window for preliminarily testing aspects of our conceptual model because gradients of negative overgeneralization become more pronounced during this developmental window. In accordance with the NIMH strategic plan, we examine negative overgeneralization as a multi-modality derived phenotype associated with CBT outcome using neuroimaging, behavior task, and self-report data from the parent grant. Further, we characterize the phenotype of negative overgeneralization using a declarative memory paradigm. Declarative memory paradigms are sensitive to neurodevelopmental differences in youth with anxiety disorders and enhance ecological validity because they approximate complex experiences of life and use of exposures in CBT. Further, our paradigm allows us to measure neurocomputational processes underlying negative overgeneralization based on theory and data from our team documenting its relationship with anxiety severity in peri-pubertal youth. In this proposed supplement, we will recruit a subset of N=50 peri- pubertal youths ages 10-13 years with anxiety disorders drawn from the parent grant. After completing the parent grant protocol, participants will then complete CBT for anxiety disorders offered through our team’s clinic and supplemental data collection on anxiety outcomes and self-report measures of negative overgeneralization. In Aim 1 we examine a behavioral measure of negative overgeneralization as a predictor of CBT outcome. In Aim 2 we examine a neural measure of negative overgeneralization as a predictor of CBT outcome. In Aim 3 we examine whether self-reported negative overgeneralization is associated with behavioral and neural measures of negative overgeneralization at baseline, and whether our behavioral, neural, and self- report indices of negative overgeneralization at baseline predict self-reported negative overgeneralization across treatment by examining changes in weekly self-reported negative overgeneralization.

项目摘要 认知行为疗法（CBT）是最成熟的焦虑症治疗方法，但多达一个- 一半的青春期青年表现出反应不足，使这些青年处于持续焦虑的高风险中， 抑郁症药物滥用和自杀这项拟议的多样性补充旨在补充父母补助金 关于负面过度概括的数据，数据收集自临床服务CBT，提供给参与者 青年，（a）检查消极的过度概括作为CBT结果的预测因素，（B）支持 候选人卡洛斯耶格斯的研究培训和职业发展。消极的过度概括是一种 焦虑的表型，指的是从一种情境（房屋火灾）中概括出厌恶反应的倾向 到其他环境（篝火）共享功能。在我们的概念模型中， 消极的过度概括是一个广泛的、分散的目标，阻碍了CBT的结果。具体而言，在这些 参与者在暴露于一个引起焦虑的刺激的背景下学习的信息不会容易地 转移到远端相关的刺激，需要更密集和更长的曝光，以达到最佳效果。 青春期为初步测试我们的概念模型提供了最佳窗口，因为 在这个发育窗口期，负向过度概括的梯度变得更加明显。在 根据NIMH的战略计划，我们研究了消极的过度概括作为一个多模态衍生 表型与CBT结果相关，使用神经影像学，行为任务和自我报告数据 家长补助此外，我们使用声明性的负过度泛化的表型的特征 记忆范式陈述性记忆范式对青少年神经发育差异敏感 焦虑症和增强生态有效性，因为它们近似于复杂的生活经验， 以及CBT中暴露的使用。此外，我们的范例允许我们测量神经计算过程， 基于理论和我们团队记录其关系的数据， 与青春期前青年的焦虑严重程度有关。在这个拟议的补充中，我们将招募N=50个样本的子集- 10-13岁患有焦虑症的青春期青年，从父母补助金中提取。完成后 父母补助协议，参与者将完成CBT的焦虑症提供通过我们的团队的 关于焦虑结果和阴性症状自我报告测量的临床和补充数据收集 过度概括在目标1中，我们研究了一种消极过度概括的行为测量方法， CBT结果。在目标2中，我们研究了一个神经测量的负面过度概括作为预测的CBT 结果。在目标3中，我们研究了自我报告的消极过度概括是否与行为相关。 以及基线时消极过度概括的神经指标，以及我们的行为、神经和自我 基线时负性过度概括的报告指数预测自我报告的负性过度概括 通过检查每周自我报告的消极过度概括的变化来研究治疗过程中的变化。