A Precision Medicine Approach to Target Engagement for Emotion Regulation

情绪失调是一种跨诊断维持因素，涉及一系列代价高昂和 令人衰弱的精神疾病。尽管许多全模式行为健康治疗已经被 这些治疗旨在提高患者的情绪调节能力，由多个组成部分组成， 这使得人们很难辨别哪些是导致负面情绪强度降低的积极机制。 此外，目前还不清楚这些基于证据的组成部分的交付是否可以针对个人量身定做 有耐心的。拟议的以患者为导向的导师研究职业发展奖(K23)为期四年 计划支持申请者的长期职业目标，即成为一名具有以下专业知识的临床科学家(1) 为精神病理学确定情绪调节干预的积极机制，(2)量身定制 针对个别患者的干预措施，以及(3)开发可扩展的干预措施，以便广泛传播。这个 到目前为止，申请者的培训和职业生涯都与这些长期目标保持一致。在他的整个研究生工作中， 他进行了测试跨诊断样本中情绪调节机制的研究，并使用了 探索这些机制对谁的影响最大的信息。K23的近期目标 奖励是给申请人在密集的纵向实验设计方面变得熟练，以分解 从人与人之间的机制变化，提高他进行和分析的熟练程度 情绪调节的多方法评估。本提案使用两个阶段的方法来解决这些问题 目标。按照实验治疗学的方法，第一阶段的目标是比较 讲授一到三种情绪调节技巧，了解不同人群负性情绪强度的日常变化 情绪失调症患者。第二阶段的第一个目标是应用个性化 基于阶段1数据的独立样本算法，以确定哪个基线参与者 这些特征预示着在每个实验条件下，负面情绪强度会有更大程度的降低。这个 第二阶段的第二个目标是比较情绪调节技能(S)的教学效果 基于个性化算法的最优或非最优递送条件。培训计划 与拟议的研究和长期目标紧密匹配，包括(A)发展先进的理解 在检验情绪调节干预的人与人之间和人内机制的统计方法中，(B) 熟练应用新颖的个性化算法；及(C)加强 情绪调节技能多方法测评的实施与分析这样做的更广泛的目的 研究和培训是为了满足对更有效、更个性化和更可扩展的干预措施的需求 跨诊断精神疾病，符合NIMH战略计划。这项研究将回答重要的问题 不同情绪调节机制对临床疗效的理论与实践问题 可促进制定更具针对性和可传播性的干预措施的成果。

Emotion dysregulation is a transdiagnostic maintenance factor involved in a wide array of costly and debilitating psychiatric disorders. Although numerous full-model behavioral health treatments have been designed to improve patients’ emotion regulation capacities, these treatments consist of multiple components, making it difficult to discern which are active mechanisms leading to reductions in negative emotion intensity. Further, it is unclear whether the delivery of these evidence-based components can be tailored to the individual patient. The proposed Mentored Patient-Oriented Research Career Development Award (K23) is a four-year plan to support the applicant’s long-term career goal of becoming a clinical scientist with expertise in (1) identifying active mechanisms of emotion regulation interventions for psychopathology, (2) tailoring these interventions to individual patients, and (3) developing scalable interventions for wide dissemination. The applicant’s training and career thus far are aligned with these long-term goals. Throughout his graduate work, he conducted studies testing emotion regulation mechanisms in transdiagnostic samples and used this information to explore for whom these mechanisms were most impactful. The immediate goals of the K23 award are for the applicant to become skilled at intensive longitudinal experimental designs to disaggregate between- from within-person mechanisms of change and enhance his proficiency in conducting and analyzing multimethod assessments of emotion regulation. This proposal uses a two-phase approach to address these goals. In line with an experimental therapeutics approach, the goal of Phase 1 is to compare the effects of teaching one or three emotion regulation skills on daily changes in negative emotion intensity among participants with elevated emotion dysregulation. The first goal of Phase 2 is to apply a personalization algorithm based on Phase 1 data to an independent sample to determine which baseline participant characteristics predict greater reductions in negative emotion intensity in each experimental condition. The second goal of Phase 2 is to compare the effects of teaching participants emotion regulation skill(s) according to their optimal or non-optimal delivery condition, based on the personalization algorithm. The training plan closely matches the proposed research and long-term goals, including (a) developing advanced understanding in statistical methods to test between- and within-person mechanisms of emotion regulation interventions, (b) gaining proficiency in applying novel personalization algorithms, and (c) enhancing expertise in the implementation and analysis of multimethod assessments of emotion regulation skills. The broader aim of this research and training is to address the need for more efficient, personalized, and scalable interventions for transdiagnostic psychiatric conditions, in line with the NIMH strategic plan. This study will answer important theoretical and practical questions about the efficacy of different emotion regulation mechanisms on clinical outcomes that may promote the development of more targeted and disseminable interventions.