Remediation of Elevated Delay Discounting in Mid-Life Individuals

 描述(由申请人提供)：早年的不利条件阻碍了正常的发展轨迹，并增加了健康不良、个人和经济后果的风险，这些后果对中年个人来说尤为明显。这在贫困社区是一个重大的公共卫生问题，这些社区不成比例地遭受与老龄化相关的负面后果。不幸的是，目前的干预措施针对的是单一的初级临床结果，而不是各种与衰老相关的后果的靶向机制，因此是有限的。此应用程序旨在针对提升延迟折扣(DD)，这是中年期间产生这些负面后果的核心机制。DD升高表明了对直接回报的夸大偏好，与早年处于不利地位的人在中年观察到的一系列危害健康的行为和负面后果有关。在一个小规模的第二阶段随机对照试验设计的背景下，使用计算机化的执行功能(EF)训练干预，这项应用试图从实验上检验经历过早期劣势的中年个体的EF和DD的变化。主要目的是检查15次训练课程的初始和维持(6个月)对EF和DD的影响，与匹配的对照训练条件和不训练条件进行对比。我们期望EF在积极训练条件后立即和6个月内改善和减少DD，而不是在对照或不训练条件下。一个探索性的目的是检查EF的改善是否是对DD的干预效果的一种机制。我们预计DD的减少将通过EF的改善来实现。拟议的研究可能会揭示一种创新的方法，这种方法可能特别适用于贫困社区，并广泛影响因早年不利而导致不良后果风险增加的中年个人的健康和健康。

 DESCRIPTION (provided by applicant): Early-life disadvantage impedes normal developmental trajectories and confers elevated risk for poor health, personal, and financial consequences that are particularly pronounced for individuals in mid-life. This is a significant public health issue in impoverished communities that disproportionately suffer aging-related negative outcomes. Unfortunately, current interventions target single primary clinical outcomes rather than a target mechanism of various aging-related consequences, and are thus limited. This application seeks to target elevated delay discounting (DD), a core mechanism for these negative consequences in mid-life. Indicative of exaggerated preference for immediate rewards, elevated DD is associated with a wide spectrum of health- compromising behaviors and negative outcomes observed in mid-life of individuals with early-life disadvantage. Using a computerized executive function (EF) training intervention in a context of a small-scale Stage-II RCT design, this application seeks to experimentally examine changes in EF and DD in a sample of mid-life individuals who have experienced early-life disadvantage. Primary Aims are to examine initial and maintained (6 month) effects of 15 training sessions on both EF and DD, in contrast to a matched control training condition and a no training condition. We expect EF improvement and reductions in DD immediately and 6-months following the active training condition but not in the control or no training conditions. An Exploratory Aim is to examine if improvements in EF is a mechanism of intervention effects on DD. We expect that reductions in DD will be mediated by improvement in EF. The proposed research may illuminate an innovative approach that may be particularly applicable to impoverished communities and broadly impact the health and wellness of mid-life individuals with increased risk for poor consequences due to early-life disadvantage.