Linking neural mechanisms of emotion and attention with naturalistic trauma symptom experience: An event-related potential and ecological momentary assessment study

项目摘要：大约70%的人在一生中会经历重大的创伤事件。 尽管任何创伤的存在都与认知和情感反应的中断有关， 日常事件，经历人际创伤（例如，（1）与增加的 与非个人创伤相关的创伤后应激障碍（PTS）症状（例如，灾害、事故），以及 似乎遵循一个单独的，更严重的症状病因。总的来说，创伤后的症状 事件（即，侵入性想法，回避症状，认知和情绪的负面改变， 过度警觉和反应性）对个体功能和行为健康造成实质性负担 服务虽然所有这四种症状群的存在构成了创伤后综合征的诊断， 压力障碍（PTSD），影响8.3%的人在他们的一生中，另外14.7%将经历亚 PTS的阈值症状，与PTSD的类似功能困难相关（即，抑郁症状， 精神共病，社会/职业困难，冲动应对和物质使用，增加 攻击/敌意和自杀意念）。然而，大多数关于PTS的研究采用分类方法， 症状分化，结合创伤类型，可能有不同的病因途径，依赖于交叉， 部分研究设计，并未能纳入多个单位的分析。本研究采用了 跨诊断方法来评估神经认知脆弱性和日常经验的PTS症状， 结合脑电图/事件相关电位（EEG/ERP）来评估 情绪调节和对具体创伤相关刺激的注意力。基线自我报告措施 症状将补充生态瞬时评估（EMA）进行为期两周的随访 在自然环境中评估PTS的日常症状和对急性应激事件的反应。项目 研究目的包括：（1）评估情绪调节和注意偏向是否与指标相关 创伤可以建立PTS的神经标志物;（2）研究EMA是否可以用于检测PTS的差异 创伤性侵入症状的频率和严重程度、高度警惕和反应性、阴性 认知和情绪，以及日常负面经历后的回避症状。多层次模型将 用于整合这些数据，以评估基线神经标志物和日常创伤之间的关系 症状本研究的目标和方向与NIMH战略计划一致， 特别是通过探索PTS治疗学的课程来评估精神疾病， 心理破坏性事件（即，创伤）通过生物学、行为学和 环境因素与症状异质性的技术整合重复生态 评估。该项目旨在整合对生物和行为指标的理解， PTS的维度结构对新的治疗靶点和症状预测有意义 过程和严重性。

Project Summary: Around 70% of individuals will experience a significant traumatic event in their lifetime. Although the presence of any trauma is associated with disruptions to cognitive and emotional reactions to everyday events, experiencing an interpersonal trauma (e.g., assault, abuse) is associated with increased symptoms of post-traumatic stress (PTS) relative to impersonal traumas (e.g., disasters, accidents), and appears to follow a separate, more severe symptomatic etiology. Collectively, symptoms following a traumatic event (i.e., intrusive thoughts, avoidance symptoms, negative alterations to cognitions and mood, hypervigilance and reactivity) cause substantial burden on both individual functioning and behavioral health services. While the presence of all four of these symptom clusters comprise a diagnosis of Post-Traumatic Stress Disorder (PTSD), affecting 8.3% of individuals in their lifetimes, an additional 14.7% will experience sub- threshold symptoms of PTS, associated with similar functional difficulties to PTSD (i.e., depressive symptoms, psychiatric comorbidity, social/occupational difficulties, impulsive coping and substance use, increased aggression/hostility, and suicidal ideation). However, most research on PTS utilizes a categorical approach to symptom differentiation, combines trauma types that may have separate etiological pathways, relies on cross- sectional research designs, and fails to incorporate multiple units of analysis. The present study utilizes a transdiagnostic approach to assess neurocognitive vulnerability and the daily experience of PTS symptoms by incorporating electroencephalography/event-related potentials (EEG/ERP) to assess neural mechanisms of emotion regulation and attention to idiographic, trauma-relevant stimuli. Baseline self-report measures of symptoms will be supplemented with ecological momentary assessments (EMA) for a two-week follow-up period to assess daily symptoms of PTS and reactions to acute stressful events in naturalistic settings. Project aims include (1) To assess if emotion regulation and attention bias to idiographic stimuli relevant to an index trauma can establish neural markers for PTS and (2) To investigate if EMAs can be used to detect differences in frequency and severity of symptoms of traumatic intrusions, hypervigilance and reactivity, negative cognitions and mood, and avoidance symptoms following daily negative experiences. Multilevel models will be used to integrate these data to assess the relationship between baseline neural markers and daily trauma symptoms. The objectives and directions of this research are consistent with the NIMH Strategic Plan, specifically by assessing mental illness by probing the course of PTS symptomatology in the aftermath of psychologically disruptive events (i.e., trauma) through the analysis of biological, behavioral, and environmental contributors to symptom heterogeneity with techniques integrating repeated ecological assessments. This project aims to integrate understanding of biological and behavioral indicators of dimensional constructs of PTS that carry implications for novel treatment targets and the prediction of symptom course and severity.