Cognitive and affective features of youth anxiety

我们的中心专注于影响焦虑青少年认知行为疗法（CBT）结果的因素。 CBT对50-60%的焦虑青年有效。由于恢复机制知之甚少， 很难预测CBT对谁有效或如何改进它。初步研究已经确定， CBT可能针对的情绪信息处理的生物基质异常，具体来说， 一种对威胁性信息过度警惕的模式， 反应.这种模式可能是由杏仁核和前额叶区。了解是否 这些机制是针对CBT将1）允许预测是否情绪信息处理 风格倾向于个体在CBT中的恢复，2）CBT的改进更具体地针对大脑 机制等本研究申请经费，对200名焦虑和40名控制青少年的情绪状况进行评估， 使用功能性磁共振成像（fMRI），事件相关电位（ERP）， 和瞳孔测量/眼动追踪。安德拉克青年将接受16次CBT或主动控制干预 （Child Centered Therapy）在为期14周的干预期间，所有参与者将每2-4周接受一次评估 瞳孔测量/眼动追踪。在第16次会议之后，将再次对参与者进行相同任务的评估 使用我们所有的措施。CBT的恢复预计对焦虑的年轻人来说是最强的， CBT针对的边缘系统反应。CBT预计将减少最初的边缘系统反应， 情绪刺激，并增加持续的反应（例如，减少回避）。积极的结果可以联系 大脑功能恢复，允许预测哪些焦虑的参与者将在CBT中恢复，说明 CBT导致恢复的机制，并可以验证CBT的拟议行动机制。 阴性结果表明，CBT的恢复可能取决于不同的作用机制， 这些都是由临床和情感神经科学界提出的。的规模 在研究情绪信息处理的神经相关性方面， 在焦虑的个体中，特别是在发育人群和恢复检查中。这 为了了解治疗中相当大的异质性的潜在因素，有必要了解幅度 在这个人群中的反应。我们的团队非常适合进行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.