NEURAL SUBSTRATES OF MINDFULNESS MEDITATION FOR SOCIAL ANXIETY DISORDER

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 引言 这项研究比较了基于正念冥想的减压和基于健康/锻炼的减压对被诊断为社交焦虑障碍的成年人情绪反应和调节的神经基础的影响。 具体目标 这项建议的总体目标是确定与基于正念的压力减轻(MBSR)相关的潜在变化的神经机制。临床研究表明，MBSR减少了心理痛苦，增加了幸福感[12]、[13]、[14]，但这些变化背后的机制还没有得到很好的描述。基础研究已经检测了健康对照组(HC)的情绪和情绪调节的神经基础[15，16]，但这项研究没有检测MBSR后的变化。为了整合临床和基础研究文献，我们使用了一个翻译框架，根据腹侧情绪生成脑区和背侧情绪调节脑区之间的相互作用来表征MBSR对情绪调节的影响。在这个框架内，我们建议比较MBSR和积极控制条件对患有广泛性社交恐惧症(SP)的参与者的情绪调节的影响。 参与者将被随机分配到MBSR或主动控制条件(ACC)，即绘图课程。所有参与者将在MBSR和ACC前后使用自我报告清单和功能磁共振成像(FMRI)进行评估。三个目标将被解决：目标1调查MBSR对焦虑和幸福的总体水平的影响。目的研究MBSR对注意和认知情绪调节的影响。目的3研究注意情绪调节的MBSR相关改变是否在治疗后和3个月随访中介导MBSR治疗反应(焦虑减少和幸福感增加)。这项研究的长期目标是促进对冥想干预措施的科学评估，这些干预措施有望改善临床和非临床人群的健康和福祉。 方法和材料 我们打算招募60名成年人(年龄21-55岁)，他们将符合DSM-IV[101]标准，在时间1基线时对广泛性社交恐惧症(SP)进行主要诊断。SP将随机分配到MBSR或ACC。这一样本量将提供足够的力量来研究MBSR对情绪反应和调节的行为和神经指标的影响，并检查MBSR影响的潜在中介因素。正如我们在最后一节(下文)所描述的，这60名参与者的数据将作为我们未来R01拨款提案的研究设计和实验刺激决策的坚实基础。所有参与者将接受诊断性访谈、行为评估、一系列问卷、计算机任务和功能磁共振任务，以评估焦虑、情绪反应和调节的各个方面

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Introduction This study is comparing the effect of mindfulness meditation based stress reduction versus wellness/exercise based stress reduction on the neural bases of emotional reactivity and regulation in adults diagnosed with social anxiety disorder. Specific Aims The overall goal of this proposal is to identify the neural mechanisms underlying changes associated with Mindfulness-Based Stress Reduction (MBSR). Clinical research has shown that MBSR reduces psychological distress and increases well-being [12], [13], [14], but the mechanisms underlying these changes are not well described. Basic research has examined the neural bases of emotion and emotion regulation in healthy controls (HC) [15, 16], but this research has not examined changes following MBSR. To integrate clinical and basic research literatures, we use a translational framework that characterizes the impact of MBSR on emotion regulation in terms of interactions between ventral emotion-generative brain regions and dorsal emotion-regulatory brain regions. Within this framework, we propose to compare the effects of MBSR and an active control condition on emotional regulation in participants with generalized social phobia (SP). Participants will be randomly assigned either to MBSR or to an active control condition (ACC), namely a drawing class. All participants will be assessed using self-report inventories and functional magnetic resonance imaging (fMRI) before and after MBSR and ACC. Three aims will be addressed: Aim 1 investigates the effects of MBSR on general levels of anxiety and well-being. Aim 2 investigates the effects of MBSR on attentional and cognitive emotion regulation. Aim 3 investigates whether MBSR-related changes in attentional emotion regulation mediate MBSR treatment response (decreases in anxiety and increases in well-being) at post-treatment and at the 3-month follow-up. The long-term objective of this research is to contribute to the scientific evaluation of meditation interventions that hold promise for improving health and well-being in clinical and non-clinical populations. Methods and Materials We intend to enroll 60 adults (ages 21-55 years) who will meet DSM-IV [101] criteria for a principal diagnosis of generalized social phobia (SP) at Time 1 baseline. SP will be randomly assigned to MBSR or ACC. This sample size will provide sufficient power to investigate the effects of MBSR on both behavioral and neural indices of emotional reactivity and regulation, and to examine potential mediators of the effects of MBSR. As we describe in the final section (below), data from these 60 participants will serve as a firm basis for making research design and experimental stimulus decisions for our future R01 grant proposal. All participants will undergo diagnostic interviewing, behavioral assessment, a battery of questionnaires, computer task, and fMRI task to assess facets of anxiety, emotional reactivity and regulation