Attention Training's Impact on Biobehavioral Correlates of Behavioral Inhibition

描述(由申请人提供)：儿童早期的气质，特别是行为抑制(BI)，被视为儿童对新奇事物和威胁的生物反应倾向的表现。行为受抑制的儿童在同伴交往中有困难，在新的社交环境中表现出退缩。此外，BI儿童在青春期和成年后患焦虑症的风险增加。虽然研究已经帮助确定了风险最高的儿童，但由于极端的气质、环境风险因素或生物脆弱性，我们没有强有力的干预措施来帮助缓解风险。事实上，一线或黄金标准的干预措施，如认知行为疗法(CBT)，汇款比率只有50%。成人文献表明，将注意力偏向于威胁可能有助于减少高危儿童的焦虑行为。这项工作建立在关注信息加工偏差的焦虑认知理论和实证研究的基础上，这些研究表明，对威胁的注意偏差可能在焦虑的出现中起到因果作用。事实上，最近的研究发现，将注意力从威胁中转移出来的注意力偏向修正(ABM)方案可以减少焦虑症状，并改善个人对实验室应激源的反应。以前的研究已经显示了BI和焦虑之间的许多生物行为相似之处，最近两年出现的新研究也发现BI儿童对威胁表现出注意偏差。目前的研究将首次检验为期数周的ABM方案对有焦虑症气质风险的儿童的疗效。为了检查潜在的ABM影响的呼吸，该研究将评估基线和干预后(结果)BI和焦虑的生物行为相关性。这些标记物包括事件相关电位(ERP)对注意偏向的反应，注意偏向的神经关联(通过功能磁共振成像)，休息时的右额叶脑电(EEG)不对称，遇到陌生的同龄同性同伴时的社会行为，最后是焦虑症状的父母和自我报告。9至12岁的三组儿童将参加：将接受主动ABM方案(BI-ABM)的BI儿童，接受注意安慰剂(BI-安慰剂)的BI儿童，以及也将经历安慰剂(非BI-安慰剂)的非抑制性儿童。我们的预期是，两个BI组都将在基线上显示出风险的生物行为模式。然而，在ABM后，我们预测BI-ABM组将显示出比BI-安慰剂组更低的风险，甚至可能与非BI-安慰剂组相当。如果成功，这项概念验证研究将为一种新的干预提供证据，这种干预是可移植的、有效的、易于实施的，并且可以用于非常年幼的儿童。这将扩大我们减轻痛苦的能力，并扩大不同地理位置、社会经济地位和年龄的治疗机会。

DESCRIPTION (provided by applicant): Early childhood temperament, particularly behavioral inhibition (BI), is seen as an expression of a child's biologically based reaction tendencies to novelty and threat. Behaviorally inhibited children have difficulty with peer interactions and exhibit withdrawal in novel social situations. In addition, BI children are at increased risk for anxiety in adolescence and into young adulthood. While research has helped identify the most at-risk children, due to extreme temperament, environmental risk factors, or biological vulnerabilities, we do not have strong interventions that may help ameliorate risk. Indeed, front-line or gold-standard interventions such as cognitive-behavioral therapy (CBT) have remittance rates of only 50%. The adult literature suggests that targeting attention biases to threat may help lessen anxious behaviors in at-risk children. This work builds on cognitive theories of anxiety that focus on information processing biases as well as empirical research suggesting that attention biases to threat may play a causal role in the emergence of anxiety. Indeed, recent work has found that attention bias modification (ABM) protocols that train attention away from threat decrease anxious symptoms and improve an individual's response to a laboratory stressor. Previous work has shown numerous biobehavioral parallels between BI and anxiety, and new studies emerging in the last two years also find that BI children show attention biases to threat. The current study will for the first time examine the efficacy of a multi-week ABM protocol with children at temperamental risk for anxiety. To examine the breath of the potential ABM effect the study will assess biobehavioral correlates of BI and anxiety at baseline and after intervention (outcome). These markers include event-related potential (ERP) response to attention bias, the neural correlates (via fMRI) of attention bias, right frontal encephalogram (EEG) asymmetry at rest, social behavior in an encounter with an unfamiliar same-age, same-sex peer, and finally, parental- and self-report of anxious symptomotology. Three groups of 9 to 12-year-old children will participate: BI children who will undergo an active ABM protocol (BI-ABM), BI children undergoing an attention placebo (BI-Placebo) and non- inhibited children who will also experience a placebo (non-BI-Placebo). It is our expectation that both BI groups will display a biobehavioral pattern of risk at baseline. However, post-ABM we predict that the BI-ABM group will show less risk than their BI-Placebo counterparts and may even be comparable to the non-BI- Placebo group. If successful, this proof of concept study will provide evidence for a novel intervention that is portable, efficient, easily-implemented and can be used with very young children. This would broaden our ability to ameliorate suffering and broaden access to treatment across geographic location, socioeconomic status, and age.