Cognitive and affective features of youth anxiety

本中心主要研究焦虑青年认知行为疗法(CBT)疗效的影响因素。 CBT对50%-60%焦虑的年轻人有效。因为人们对复苏的机制知之甚少 很难预测CBT对谁有效，或者如何改进。初步研究发现 情绪信息处理的生物底物的异常可能是CBT的目标，具体地说， 对威胁信息过度警惕，紧随其后的是迟钝的持续情绪 反应。这种模式可能受到杏仁核和前额叶区域的影响。了解是否 CBT中针对的这些机制将1)允许预测情绪信息处理 风格使个体更容易在CBT中恢复，以及2)CBT的改进以更具针对性地针对大脑 机械装置。该项目要求资金评估200名焦虑和40名控制青少年的情绪 使用功能磁共振成像(FMRI)、事件相关电位(ERP)、 还有瞳孔测量/眼球跟踪。焦虑的青少年将接受16次CBT或积极控制干预 (以儿童为中心的治疗)。所有参与者将在14周的干预过程中每2-4周接受一次评估 有瞳孔测量/眼球跟踪的时期。在第16次会议之后，参与者将再次接受相同任务的评估 使用我们所有的措施。对于焦虑的年轻人来说，CBT的恢复预计将是最强劲的，早期症状会增强 边缘反应，这是CBT的靶点。CBT预计会降低最初的边缘反应 情绪刺激，并增加持续反应(例如，减少回避)。积极的结果可能会将 大脑功能恢复，允许预测哪些焦虑的参与者将在CBT中恢复 CBT导致复苏的机制，并可验证拟议的CBT行动机制。 负面结果将表明，CBT的恢复可能取决于不同的作用机制 那些由临床和情感神经科学界提出的建议。该公司的规模 在检测情绪信息处理的神经关联方面，提出的研究是无与伦比的 对于焦虑的个人，特别是在人口发育和康复检查方面。这 量值是理解治疗中相当大的异质性背后的因素所必需的 在这群人中的反应。我们的团队非常适合开展拟议中的大规模研究。

Our Center focuses on factors affecting outcome in cognitive behavioral therapy (CBT) in anxious youth. CBT is effective for 50-60% of anxious youth. Because mechanisms of recovery are poorly understood it is difficult to predict whom CBT will be effective for or how to refine it. Initial research has identified abnormalities in biological substrates of emotional information processing likely targeted by CBT, specifically, a pattern of excessive vigilance for threatening information followed by blunted sustained emotional reactions. This pattern is likely subserved by the amygdala and prefrontal regions. Understanding whether these mechanisms are targeted in CBT will 1) allow prediction of whether emotional information processing styles predispose individuals to recovery in CBT and 2) refinement of CBT to more specifically target brain mechanisms. This project requests funds to assess 200 anxious and 40 control youths' emotional information processing using functional magnetic resonance imaging (fMRI), event-related potentials (ERP), and pupilometry/eyetracking. Anxious youths will receive 16 sessions of CBT or an active control intervention (child centered therapy). All participants will be assessed every 2-4 weeks over the 14 week intervention period with pupilometry/eyetracking. After session 16, participants will again be assessed on the same tasks using all our measures. Recovery in CBT is expected to be strongest for anxious youth with heightened early limbic responses, which are targeted by CBT. CBT is expected to decrease initial limbic responses to emotional stimuli, and increase sustained responses (e.g., decrease avoidance). Positive results could link brain function to recovery, allowing prediction of which anxious participants will recover in CBT, illustrate mechanisms by which CBT leads to recovery, and could validate proposed mechanisms of action for CBT. Negative results would suggest that recovery in CBT may depend on different mechanisms of action than those which have been proposed by the clinical and affective neuroscience community. The scale of the proposed research is unparalleled in examinations of neural correlates of emotional information processing in anxious individuals, particularly with developmental populations and examinations of recovery. This magnitude is necessary to understand factors underlying the considerable heterogeneity in treatment response in this population. Our group is uniquely suited to carrying out the proposed large-scale research.