Sleep-dependent negative overgeneralization in peri-pubertal anxiety

项目总结 认知行为疗法(CBT)是治疗焦虑症最成熟的疗法，但多达一种- 有一半的青春期青少年反应不足，这使得他们处于持续焦虑的高风险中， 抑郁、吸毒和自杀。这项建议的多样性补助金旨在补充家长津贴 使用从临床服务CBT收集的数据提供给参与者的负面过度泛化数据 青年，以(A)检查消极的过度泛化作为CBT结果的预测指标，并(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 焦虑的表现型，指的是从一种背景(房屋火灾)中概括厌恶反应的倾向 共享功能的其他环境(篝火)。在我们的概念模型中，表现出高水平的参与者 消极的过度泛化提供了一个广泛的、分散的目标，阻碍了CBT的成果。具体来说，在这些 参与者在暴露于一种引发焦虑的刺激的背景下学到的信息不会轻易获得 转移到远端相关的刺激，需要更密集和更长的暴露时间才能达到最佳结果。 青春期为初步测试概念模型的各个方面提供了最佳窗口，因为 在这个发展窗口期，消极的过度泛化的梯度变得更加明显。在……里面 根据NIMH的战略计划，我们考察了消极的过度泛化作为派生的多模式 使用神经成像、行为任务和自我报告数据的CBT结果相关的表型 家长助学金。此外，我们使用陈述句来刻画负的过度泛化的表型 记忆范式。陈述性记忆范式对青少年神经发育差异敏感 焦虑障碍并增强生态有效性，因为它们近似于复杂的生活经历 以及CBT中曝光的使用。此外，我们的范例允许我们测量神经计算过程 潜在的负面过度泛化基于我们团队记录其关系的理论和数据 青春期前有严重的焦虑。在这项拟议的补充中，我们将招募N=50的子集- 青春期青少年，10-13岁，患有焦虑症，由父母资助。在完成 家长资助方案，然后参与者将完成通过我们团队提供的焦虑症CBT 阴性患者焦虑结局和自我报告量表的临床和补充资料收集 过于泛化。在目标1中，我们考察了消极过度泛化的行为测量，作为预测 CBT结果。在目标2中，我们检验了负向过度泛化的神经测量作为CBT的预测因子。 结果。在目标3中，我们考察了自我报告的负面过度泛化是否与行为有关 和神经测量的负面过度泛化在基线，以及我们的行为，神经和自我 基线报告的负面过度泛化指数预测自我报告的负面过度泛化 通过检查每周自我报告的负面过度概括的变化进行交叉治疗。

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.