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Novel Behavioral Intervention to Target Social Reward Sensitivity and Attachment

针对社会奖励敏感性和依恋的新颖行为干预

基本信息

批准号：
10460269
负责人：
Charles Taylor
金额：
$ 69.68万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-05 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10460269
关键词：
Address Adverse effects Affect Anxiety Behavior Behavior Therapy Behavioral Brain region Buffers Clinical Common Data Element Corpus striatum structure Data Depression and Suicide Dimensions Disease Dose Event Facial Expression Frequencies Future Impairment Individual Intervention Knowledge Life Link Measurable Measures Mediating Medicine Mental Depression Mental Health Modeling Moods Motivation National Institute of Mental Health Negative Finding Negative Valence Neurobiology Neurosciences Outcome Outcome Measure Participant Pathway interactions Patient Self-Report Patients Personal Satisfaction Persons Phase Physiological Physiology Positive Valence Process Psychometrics Psychopathology Public Health Randomized Research Research Domain Criteria Rewards Sampling Social Behavior Social Functioning Social Interaction Social Network Social isolation Social outcome Societies Source Strategic Planning Stress Surveys Symptoms System Testing Training Translating Trauma Treatment Protocols United States National Institutes of Health Work active control anxiety symptoms anxiety treatment biobehavior confirmatory clinical trial cost depressive symptoms design experience gratitude improved indexing neural circuit novel primary outcome psychosocial relating to nervous system satisfaction social social interventions social media social relationships stress management stressor substance use therapy design therapy development

项目摘要

Social relationships are fundamental determinants of psychological health and well-being. Poor quality relationships and social isolation heighten vulnerability to and exacerbate a myriad of negative mental health outcomes (e.g., anxiety, depression, suicide), which create substantial costs to the individual and society. Although the biobehavioral processes that support the formation of positive social relationships are well- delineated, a fundamental gap exists in translating that knowledge to develop mechanism-informed interventions for psychiatric conditions. The proposed project seeks to fill this gap by testing a neurally- mediated pathway for enhancing social connections through an experimental medicine approach. We draw on research implicating the positive valence system (PVS), a core dimension of the Research Domain Criteria (RDoC) framework, as a fundamental mechanism that promotes social affiliation and attachment. Building on our initial treatment development work, we will evaluate the effects of a novel psychosocial intervention – social approach training – designed to up-regulate components of the PVS (social approach motivation and reward responsiveness, or “social reward sensitivity”) in treatment-seeking individuals with anxiety or depression who present with social functioning impairments. R61 phase: Aim 1 will test the hypothesis that social approach training can up-regulate social reward sensitivity (intervention target) across neural, physiological, behavioral, and self-report units of analysis in n=60 patients randomized to one of two treatment doses, or a no intervention control condition. Aim 2 will investigate optimal dosing of social approach training to maximally engage the target. Aim 3 will establish further psychometric support (e.g., test-retest reliability) for the proposed measures of target engagement. R33 Phase: Pending initial demonstration that social approach training modulates social reward sensitivity (R61-Aim 1), Aim 1 of the R33 phase seeks to replicate evidence of target engagement by comparing participants randomized to receive the optimal dose of social approach training (n=50) or to an active control condition (stress management training; n=50). Aim 2 will examine whether changes in social reward sensitivity are associated with improvements in the frequency and strength of social connections assessed through self-report, social network surveys, and observation of real-world social behavior acquired through social media. Through this approach we will gain unprecedented ecological validity to ascertain the impact of the intervention on real-world functioning, a high priority of the NIMH Strategic Plan. We will also explore changes in mental health outcomes following treatment. By targeting social approach mechanisms rather than disorder-bound symptoms, and linking changes in neural circuit function to changes in real-world social connections, we will (1) deepen our understanding of the mechanisms that support positive connections with others, and (2) advance neuroscience-informed and targeted intervention approaches with the potential to yield clinically meaningful outcomes with measurable real-world impact.

社会关系是心理健康和幸福的基本决定因素。质量差人际关系和社会孤立增加了对各种负面心理健康的脆弱性，并使其恶化结果（例如，焦虑，抑郁，自杀），这给个人和社会造成了巨大的成本。尽管支持积极社会关系形成的生物行为过程是良好的- 但是，在将这些知识转化为开发机制信息方面存在着根本的差距。对精神疾病进行干预。拟议的项目旨在通过测试神经- 通过实验医学方法增强社会联系的介导途径。我们利用研究涉及正价系统（PVS），研究领域标准的核心维度（RDoC）框架，作为促进社会联系和依恋的基本机制。基础上在我们最初的治疗开发工作中，我们将评估一种新的社会心理干预的效果-社会方法培训-旨在上调PVS（社会方法动机和奖励）的组成部分反应性，或“社会奖励敏感性”）在寻求治疗的焦虑或抑郁个体中，存在社会功能障碍。R61阶段：目标1将检验社会方法训练可以在神经，生理，行为，和自我报告的分析单位，n=60例患者随机接受两种治疗剂量之一，或无干预控制条件。目标2将研究社会方法训练的最佳剂量，攻击目标目标3将建立进一步的心理测量支持（例如，重测信度）提出的目标参与措施。R33阶段：有待初步证明社会办法训练调节社会奖励敏感性（R61-Aim 1），R33阶段的Aim 1试图复制以下证据：通过比较随机接受最佳剂量社交方法的参与者，训练（n=50）或主动控制条件（压力管理训练; n=50）。目标2将检查社会奖励敏感性的变化是否与频率和强度的改善有关通过自我报告、社交网络调查和对现实世界的观察评估的社会联系通过社交媒体获得的社交行为。通过这种方式，我们将获得前所未有的生态确定干预对现实世界功能的影响的有效性，这是NIMH的一个高度优先事项战略计划。我们还将探讨治疗后心理健康结果的变化。通过瞄准社会接近机制，而不是疾病的症状，并将神经回路功能的变化与在现实世界的社会关系的变化，我们将（1）加深我们的机制，支持与他人的积极联系，以及（2）先进的神经科学信息和有针对性的干预有可能产生具有临床意义的结果并具有可衡量的现实影响的方法。