Facial Affect Sensitivity Training for young children with CU traits.

项目摘要 冷酷无情（CU）特质（例如，缺乏内疚或悔恨，低同情心，浅薄的影响）是 与成人精神病的核心情感特征一致，并且是一种确定的风险 早期出现的因素，持续和严重的青年不端行为。CU特征反映了损伤 在确定的神经认知机制，干扰儿童社会化和预测较差的 治疗结果，即使是对破坏性行为的成熟治疗，因此呼吁 新的干预措施。试图解释那些失败的理论， CU的特点是识别，并作出适当的反应，他人的情绪困扰都强调 情感敏感性的根本缺陷，包括对情感的关注和认知减少， 其他情绪线索，特别是痛苦的信号（例如，恐惧、悲伤的面部表情）。 另一方面，高CU的年轻人表现出正常到夸张的奖励反应。我们断言 对情绪困扰线索（恐惧和/或悲伤）的敏感性受损是机械性的， 与儿童的CU特征有关，并且通过直接通过面部情感敏感性（FAS） 计算机化的自动反馈和激励系统，我们可以发挥下游效应， CU特征。因此，我们提出了一种实验治疗方法，以开发和测试一种新的 神经认知干预对CU性状的影响。拟议项目的第一阶段（R61）将 在一项初步随机对照试验（RCT; N=30）中， 神经认知干预（面部情感敏感性训练：FAST）可以吸引目标， FAS（主要通过遇险表达的FER准确度来衡量，其次是 CU特征升高的儿童的眼睛凝视和神经活动增强）。我们将研究 条件之间的个体生长速率和试验斜率差异（FAST vs对照）。目标 在FAST与无FAST的比较中，参与将被定义为中等效应量（d > .40）。 治疗控制的主要目标（遇险FER）。我们还将确定最佳的 关于FER改善的疗程数的剂量参数（例如，局部定时 颠簸或衰减，变化量，何时发生最大变化），以及参与者满意度 会话频率、长度和数量。在R33阶段，我们的目标是复制目标 与新的，更大的高CU样本接触，并评估可行性和初步 FAST的疗效，在RCT（N = 50）的背景下，将FAST与活性药物 控制条件（ACC;隐式眼睛凝视训练），包括检查下游的变化， CU特征。如果FAST干预改善了FER并减少了CU性状，则这种训练在早期 童年可以帮助打断反社会后果的发展级联。

PROJECT SUMMARY Callous-unemotional (CU) traits (e.g., lack of guilt or remorse, low empathy, shallow affect) are consistent with the core affective features of adult psychopathy and are an established risk factor for early emerging, persistent, and severe youth misconduct. CU traits reflect impairment in identified neurocognitive mechanisms that interfere with child socialization and predict poorer treatment outcomes, even with well-established treatments for disruptive behavior, and thus call for novel interventions. Prominent theories that attempt to account for the failure of those with CU traits to recognize, and respond appropriately to, others' emotional distress all emphasize fundamental deficits in affect sensitivity, including reduced attention toward and recognition of others emotional cues, particularly signals of distress (e.g., facial expressions of fear, sadness). On the other hand, high-CU youth show normal to exaggerated reward responsivity. We assert that impaired sensitivity for emotional distress cues (fear and/or sadness) is mechanistically linked to CU traits in children, and that by targeting facial affect sensitivity (FAS) directly via a computerized automated feedback and incentive system, we can exert downstream effects on CU traits. We thus propose an experimental therapeutics approach to develop and test a novel neurocognitive intervention for CU traits. The first phase (R61) of the proposed project will demonstrate, in a preliminary randomized controlled trial (RCT; N=30), that a new neurocognitive intervention (Facial Affect Sensitivity Training: FAST) can engage the target, FAS (measured primarily by FER accuracy for distress expressions, and secondarily by heightened eye gaze and neural activity) in children with elevated CU traits. We will examine individual growth rates and test slope differences between conditions (FAST v control). Target engagement will be defined as medium effect size (d > .40) in the comparison of FAST vs. no- treatment control on the primary target (distress FER). We will also aim to determine optimal dose parameters with regard to number of sessions for FER improvement (e.g., timing of local bump or decay, amount of change, when maximal change occurs), and participant satisfaction with session frequency, length, and number. In the R33 phase, we aim to replicate target engagement with a new, larger high-CU sample, and evaluate feasibility and preliminary efficacy of FAST, in the context of an RCT (N = 50) in which FAST is compared to an active control condition (ACC; implicit eye gaze training), including examining downstream change in CU traits. If the FAST intervention improves FER and reduces CU traits, such training in early childhood could help interrupt the developmental cascade toward antisocial outcomes.