NEURAL SUBSTRATES OF MINDFULNESS MEDITATION FOR SOCIAL ANXIETY DISORDER

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 介绍 这项研究比较了基于正念冥想的减压与基于健康/运动的减压对被诊断患有社交焦虑症的成年人的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正念减压（MBSR）相关的神经机制。临床研究表明，正念减压疗法可以减少心理困扰，增加幸福感[12]，[13]，[14]，但这些变化背后的机制还没有得到很好的描述。基础研究已经检查了健康对照组（HC）的情绪和情绪调节的神经基础[15，16]，但这项研究没有检查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，该框架描述了正念减压疗法对情绪调节的影响，即腹侧情绪生成脑区和背侧情绪调节脑区之间的相互作用。在这个框架内，我们建议比较MBSR和积极控制条件对参与者的情绪调节与广义社交恐惧症（SP）的影响。 参与者将被随机分配到MBSR或主动控制条件（ACC），即绘画班。所有参与者将使用自我报告清单和功能磁共振成像（fMRI）之前和之后的MBSR和ACC进行评估。三个目标将被解决：目标1调查MBSR对焦虑和幸福感的一般水平的影响。目的2探讨正念减压疗法对注意和认知情绪调节的影响。 目的3调查是否MBSR相关的注意力情绪调节的变化介导MBSR治疗反应（减少焦虑和增加幸福感）在治疗后和3个月的随访。这项研究的长期目标是促进对冥想干预的科学评估，这些干预有望改善临床和非临床人群的健康和福祉。 方法和材料 我们计划入组60名成年人（年龄21-55岁），他们在时间1基线时符合DSM-IV [101]标准，主要诊断为广泛性社交恐怖症（SP）。SP将被随机分配到MBSR或ACC。这个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影响的潜在介质。正如我们在最后一节（下文）中所描述的，来自这60名参与者的数据将作为我们未来R 01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访谈，行为评估，一系列问卷调查，计算机任务和功能磁共振成像任务，以评估焦虑，情绪反应和调节方面

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