Neurocognitive Mechanisms of Pediatric Anxiety Disorders

描述（由申请人提供）：理由：儿童焦虑症非常普遍，并与不良长期后果相关。这些疾病被认为是受潜在的认知和神经机制的影响，这些机制尚未得到很好的理解。最近的研究表明与成人焦虑症相关的特定神经认知模型;年轻人的数据很少。目的：发展专业知识，在儿童焦虑症的神经认知机制的研究，使用功能性磁共振成像（fMRI）。最初的研究集中在青少年广泛性焦虑症（GAD）。长期计划是成为一名独立的研究者，并将研究扩展到其他儿科焦虑症。培训计划：候选人将接受以下方面的培训：1）与青少年焦虑症相关的发展和诊断问题，2）认知和情感神经科学研究及其在儿科焦虑症中的应用，3）fMRI研究设计和数据分析技术，以及4）临床研究的道德行为。培训将包括：1）认知神经科学，功能磁共振成像和伦理学的正式课程; 2）指导; 3）与多学科专家的咨询; 4）参加科学会议; 5）补充职业发展活动的研究计划。研究计划：本研究旨在检验广泛性焦虑症的不确定性不容忍模型，该模型假设广泛性焦虑症个体相对不能容忍不确定性，从而导致过度担忧和损伤。第一项研究将使用决策任务作为GAD青少年和对照组不确定性耐受的行为测量。基于成人研究结果，假设与对照组相比，GAD受试者在更大的不确定性条件下做出决定所需的时间明显更长。第二项研究将扩展不确定性不容忍模型，使用功能磁共振成像测试GAD青少年和正常对照组在决策任务中的神经活动的差异。预计与对照组相比，GAD受试者在更不确定的条件下，在涉及决策和焦虑的边缘核区域中将显示出显著更大的激活。结果将通知候选人的未来R 01申请进一步的研究，将这种新的理论观点GAD到当前的神经认知方法，包括那些检查情绪识别和恐惧处理在儿科焦虑症中的作用。

DESCRIPTION (provided by applicant): Rationale: Pediatric anxiety disorders are highly prevalent and associated with adverse long-term consequences. These disorders are believed to be influenced by underlying cognitive and neural mechanisms which are not well understood. Recent studies suggest specific neurocognitive models associated with adult anxiety disorders; such data in young individuals are scant. Purpose: To develop expertise in the study of neurocognitive mechanisms in pediatric anxiety disorders using functional magnetic resonance imaging (fMRI). Initial studies focus on adolescents with generalized anxiety disorder (GAD). Long-term plans are to become an independent investigator and extend research to other pediatric anxiety disorders. Training Plan: The candidate will receive training in: 1) developmental and diagnostic issues relevant to anxiety disorders in youth, 2) cognitive and affective neuroscience research and its applications to pediatric anxiety disorders, 3) fMRI study design and data analytic techniques, and 4) the ethical conduct of clinical research. Training will include: 1) formal coursework in cognitive neuroscience, fMRI, and ethics; 2) mentoring; 3) consultation with multidisciplinary experts; 4) participation at scientific meetings; and 5) a research plan that complements career development activities. Research Plan: The proposed research aims to test the intolerance of uncertainty model of GAD, which postulates that GAD individuals are relatively unable to tolerate uncertainty, which leads to excessive worry and impairment. The first study will use a decision making task as a behavioral measure of intolerance of uncertainty in GAD adolescents and controls. Based on adult findings, it is hypothesized that compared to controls, GAD subjects will take significantly longer to make decisions under conditions of greater uncertainty. The second study will extend the intolerance of uncertainty model by using fMRI to test for differences between GAD adolescents and normal controls in neural activity during a decision making task. It is expected that compared to controls, GAD subjects will show significantly greater activation in paralimbic regions implicated in decision making and anxiety, during more uncertain conditions. Results will inform the candidate's future R01 application for further research linking this novel theoretical perspective on GAD to current neurocognitive approaches including those examining the role of emotion recognition and fear processing in pediatric anxiety disorders.