Can social support figures enhance fear extinction in patients with social anxiety?

项目摘要/摘要 据估计，在美国，大约三分之一的成年人将受到与恐惧有关的疾病的影响。 他们一生的历程。这些障碍包括诊断为广泛性焦虑症、社交 焦虑症，或创伤后应激障碍，以扰乱日常生活的恐惧为标志 并对健康和福祉产生有害的长期后果。然而，即使是最成功的 到目前为止的治疗，暴露疗法(一套利用恐惧消退过程来减少恐惧的程序) 效果有限，治疗过程中的不适导致辍学和复发仍然很常见 发生了。因此，加强暴露治疗和改善恐惧的方法的研究 减少策略对于改善患有恐惧相关障碍的个人的幸福感至关重要。 最近的研究表明，社会支持可能代表了一种这样的方法，表明 在健康的成年人中，社会支持提醒可以减少恐惧的获得，并增强恐惧的消退。 这些发现是出乎意料的，因为它们与目前的观点形成了直接对比，即所有安全信号，包括 在减少恐惧的干预期间，社会支持数字是有害的。因此，尽管目前的观点表明 这些线索增强了习得并减少了灭绝，社会支持提醒实际上减少了习得 并加强物种灭绝。这种差异可以用人类社会支持的关键作用来解释。 生存；具体地说，进化为加强社会纽带的神经生物学机制似乎 与支持恐惧学习的系统重叠，使社会支持具有独特的减少恐惧的能力。 这些以前的发现暗示了令人兴奋的可能性，即社会支持可能在 改善患有恐惧相关障碍的个人的结果。特别是，社会支持的存在 提醒(例如，图片)可以丰富策略，以防止有发展风险的个人获得恐惧 颠覆性恐惧和加强暴露治疗，提高灭绝结果。然而，虽然 社会支持的减少恐惧的效果已经在健康的成年人身上得到了证明，这些效果从来没有 在患有恐惧相关障碍的成年人身上进行了测试。因此，拟议的研究将是第一个探索 社交焦虑症患者的社会支持1)减少恐惧获得，2)增强恐惧消退 (悲伤)和健康对照。在第一项研究中，我们将测试是否存在社会支持形象(与 面带微笑的陌生人形象)减少了患有SAD的参与者(n=50，25名女性)和健康对照组的习得 (n=50，女性25例)。在第二项研究中，我们将测试是否存在社会支持形象(与 面带微笑的陌生人形象)导致被诊断为SAD的参与者(n=50，25名女性)的消亡程度增强 健康对照组(n=50，女性25例)。这项工作将确定社会上的减少恐惧的效果 支持从健康的成年人延伸到那些患有恐惧相关障碍的人，潜在地揭示了简单、 以廉价的方式减少新恐惧的形成，并加强目前的减少恐惧治疗。

Project Summary/Abstract It is estimated that roughly one third of adults in the US will be affected by a fear-related disorder over the course of their lifetime. These disorders, including diagnoses such as generalized anxiety disorder, social anxiety disorder, or post-traumatic stress disorder, are marked by disruptive fears that can interfere with daily life and have harmful long-term consequences on health and well-being. Yet, even the most successful treatment to date, exposure therapy (a set of procedures that employs fear extinction processes to reduce fear) has limited effects, with discomfort during therapy leading to drop-out and relapse remaining a common occurrence. Thus, investigation of methods to augment exposure therapy treatments and improve fear reduction strategies is critical for improving the well-being of individuals with fear-related disorders. Recent work has revealed that social support may represent one such method, demonstrating that social support reminders reduce the acquisition of fear and enhance the extinction of fear in healthy adults. These findings are unexpected, as they are in direct contrast with current views that all safety signals, including social support figures, are harmful during fear-reduction interventions. Thus, while current views would suggest that these cues enhance acquisition and reduce extinction, social support reminders in fact reduce acquisition and enhance extinction. This divergence may be explained by the crucial role of social support in human survival; specifically, the neurobiological mechanisms that have evolved to reinforce social bonds appear to overlap with the systems that support fear learning, making social support uniquely poised to reduce fear. These previous findings hint at the exciting possibility that social support may play an important role in improving outcomes for individuals with fear-related disorders. In particular, the presence of social support reminders (e.g., pictures) may enrich strategies to prevent fear acquisition in individuals at risk for developing disruptive fears and augment exposure therapy treatments, enhancing extinction outcomes. However, while the fear-reducing effects of social support have been demonstrated in healthy adults, these effects have never been tested in adults with fear-related disorders. Thus, the proposed studies will be the first to explore whether social support 1) reduces fear acquisition and 2) enhances fear extinction in adults with social anxiety disorder (SAD) and healthy controls. In the first study, we will test whether the presence of a social support image (vs. smiling stranger image) reduces acquisition in participants with SAD (n=50, 25 females) and healthy controls (n=50, 25 females). In the second study, we will test whether the presence of a social support image (vs. smiling stranger image) leads to enhanced extinction in participants diagnosed with SAD (n=50, 25 females) as well as healthy controls (n=50, 25 females). This work will establish whether the fear-reducing effects of social support extend beyond healthy adults to those with fear-related disorders, potentially shedding light on simple, inexpensive ways to attenuate the formation of new fears and augment current fear reduction treatments.