Targeted Intervention for Adolescents following Child Maltreatment: Examining Neural and Behavioral Mechanisms within the Positive Valence System

对虐待儿童后的青少年进行有针对性的干预：检查正价系统内的神经和行为机制

• 批准号: 9754252
• 负责人: Jessica Lynne Jenness
• 金额: $ 16.13万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9754252
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Affective; Anhedonia; Antidepressive Agents; Assessment tool; Basal Ganglia; Behavior; Behavioral; Behavioral Mechanisms; Biological; Biological Markers; Child; Child Abuse and Neglect; Chronic; Cognitive Therapy; Comorbidity; Control Groups; Corpus striatum structure; Data; Depressed mood; Detection; Development; Diagnostic; Dorsal; Ensure; Environment; Etiology; Evidence based treatment; Exposure to; Fostering; Functional Magnetic Resonance Imaging; Future; Goals; Individual; Intervention; Intervention Studies; Investigational Therapies; Learning; Link; Longevity; Maintenance; Measures; Mental Depression; Mental Health; Mentorship; Methodology; Monitor; National Institute of Mental Health; Outcome; Pharmaceutical Preparations; Phenotype; Physical activity; Positioning Attribute; Positive Valence; Prefrontal Cortex; Process; Protocols documentation; Recording of previous events; Recurrence; Research; Research Activity; Research Priority; Research Training; Rewards; Risk; Sampling; Severities; Sexual abuse; Stimulus; Strategic Planning; System; Technology; Text; Time; Training; Training Activity; Ventral Striatum; Vulnerable Populations; Youth; abuse neglect; affective neuroscience; aged; alternative treatment; anxiety symptoms; base; behavior measurement; behavioral response; career; child depression; depressive symptoms; emotional abuse; emotional neglect; epidemiology study; experience; functional disability; habituation; high risk; improved; innovation; maltreatment; mobile computing; neural circuit; neurodevelopment; neuromechanism; novel; peer; personalized approach; personalized intervention; physical abuse; physical neglect; programs; recruit; relapse risk; relating to nervous system; response; reward circuitry; reward processing; social; social engagement; social media; targeted biomarker; treatment response

PROJECT SUMMARY National data indicate over 650,000 children and adolescents are exposed to physical, sexual, or emotional abuse or physical or emotional neglect each year. Moreover, youth with a history of childhood maltreatment (CM) are at least twice as likely to develop depression and are at substantial risk for non- response to current best practice depression interventions (i.e., cognitive behavioral therapy and antidepressants) compared to non-maltreated peers. Research suggests that CM increases risk for depression through disruptions in the positive valence system, such as reward processing, and Behavioral Activation (BA) may be an alternative depression intervention that targets these deficits. This proposal takes an innovative approach integrating neural, behavioral, and novel mobile technologies to measure longitudinal change in reward processing as a mechanism of BA intervention response among depressed adolescents with a history of CM. This proposed K23 bridges the candidate's prior training in environmental, biological, and affective etiological processes contributing to adolescent depression with new training in 1) target-focused intervention research, 2) developmental affective neuroscience, and 3) technology-based assessment tools. This training will uniquely position the candidate to investigate biomarkers of intervention response across multiple levels of analysis, with an emphasis on vulnerable youth at risk for intervention non-response. Specifically, depressed adolescents with a history of CM will complete pre- and post- BA intervention fMRI and behavioral measures of reward processing along with daily passive mobile monitoring of physical (steps) and social (amount of texts, calls, social media usage) activity to determine 1) how BA targets neural and behavioral reward processing and real-world behavioral engagement (Specific Aim 1), and 2) whether change in neural and behavioral reward processing predicts intervention response and maintenance (Specific Aim 2). To achieve these research and training goals, the candidate will receive training from an ideal mentorship team within an optimal scientific training environment. Dr. McCauley is an expert in the etiology and treatment of adolescent depression and developed a BA protocol targeting the increase of rewarding experiences and decrease of avoidance specific to adolescents. Dr. McLaughlin has significant expertise in developmental affective neuroscience and the use of fMRI methodology to study neural circuitry related to affective and reward processing among youth exposed to maltreatment. Dr. Areán provides additional expertise in target-focused depression intervention research as well as extensive experience in the use of mobile technologies to assess real-time behavior, affect, and mental health. Training and research activities will prepare the candidate to achieve the career objective of developing a larger program of research contributing to Objective 3 of NIMH Strategic Research Priorities by investigating innovative biomarkers of intervention response in an effort to tailor interventions and optimize outcomes in vulnerable populations.

项目概要 国家数据表明，超过 650,000 名儿童和青少年遭受身体、性或 每年都会遭受精神虐待或身体或情感忽视。此外，有童年历史的青少年 虐待 (CM) 患抑郁症的可能性至少是正常人的两倍，并且有很大的风险患上非 对当前抑郁症干预最佳实践的反应（即认知行为疗法和 抗抑郁药）与未受虐待的同龄人相比。研究表明 CM 会增加患抑郁症的风险 通过正价系统的破坏，例如奖励处理和行为激活（BA） 可能是针对这些缺陷的另一种抑郁症干预措施。该提案采取了创新的 方法整合神经、行为和新颖的移动技术来测量纵向变化 奖励处理作为有抑郁史的青少年 BA 干预反应的机制 CM。拟议的 K23 衔接了候选人之前在环境、生物和情感方面的培训 通过以下方面的新培训来了解导致青少年抑郁症的病因过程 1) 以目标为中心的干预措施 研究，2) 发展情感神经科学，以及 3) 基于技术的评估工具。本次培训 将使候选人处于独特的地位，以研究跨多个水平的干预反应的生物标志物 分析，重点关注面临干预不响应风险的弱势青年。具体来说就是郁闷 有 CM 病史的青少年将完成 BA 干预前后的功能磁共振成像 (fMRI) 和行为测量 奖励处理以及对身体（步数）和社交（文本量、 通话、社交媒体使用）确定 1）BA 如何针对神经和行为奖励处理的活动 和现实世界的行为参与（具体目标 1），以及 2）神经和行为是否发生变化 奖励处理预测干预反应和维持（具体目标 2）。 为了实现这些研究和培训目标，候选人将接受理想的培训 导师团队在最佳的科学培训环境中。麦考利博士是病因学和 治疗青少年抑郁症并制定了一项旨在增加奖励的 BA 方案 青少年特有的经历和回避的减少。麦克劳克林博士在以下方面拥有丰富的专业知识 发展情感神经科学和使用功能磁共振成像方法来研究与相关的神经回路 遭受虐待的青少年的情感和奖励处理。 Areán 博士提供了额外的信息 以目标为中心的抑郁症干预研究方面的专业知识以及使用 移动技术来评估实时行为、情感和心理健康。培训和研究活动 将为候选人做好准备，以实现开发更大的研究计划的职业目标 通过调查创新生物标志物，为 NIMH 战略研究重点的目标 3 做出贡献 干预响应，努力调整干预措施并优化弱势群体的结果。